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"This paper discusses the design and development of a prototype of a knee surgery cutting jig, the jig holder, and the jig injection mold by Rapid Prototyping (RP). The aim of this study is to design a jig and a jig holder that allow surgeons to correctly, precisely, and consistently perform knee replacement surgery. The design concept for the surgery jig and jig holder was selected using the Pugh method with medical-grade 316L stainless steel for material fabrication. A rapid prototype model was built directly from its CAD model in stereo lithography (STL) format by using the Fused Deposition Method (FDM). MasterCAM and Moldflow simulation were performed to generated G-codes and a possibility of jig fabrication using Metal Injection Molding (MIM), respectively. The Moldflow result provided an enhanced interpretation of the injection mold design. A conceptual mold design was again developed by the FDM. The prototype of the cutting jig and its holder underwent a machining process. The prototype was then tested on dummy bones to determine the functional performance and efficiency of the said prototype. Results indicated an increase in cutting accuracy and cutting time compared with computer-assisted total knee surgery without the jig system."

"ABSTRAKOperasi Total knee replacement (TKR) adalah prosedur pilihan pada penanganan osteoartritis berat. Terdapat dua jenis prostesis yang umum digunakan, yaitu cruciate retaining (CR) dan cruciate substituting (CS). Belum ada kesepakatan ahli mengenai mana prostesis yang lebih baik. Penelitian ini bertujuan untuk membandingkan luaran fungsional pasien yang menjalani TKR menggunakan dua jenis prostesis tersebut. Penelitian ini merupakan uji klinis acak tersamar ganda. Pasien dengan osteoartritis berat dibagi 2 kelompok dan dinilai luaran fungsional 3 bulan dan 6 bulan pasca-TKR. Hasilnya sudut fleksi lutut kelompok CS lebih baik 13,1 derajat setelah 3 bulan dan 12,9 derajat setelah 6 bulan. Penilaian subjektif menggunakan skor IKDC tidak terdapat perbedaan bermakna antara kedua kelompok.

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ABSTRACTTotal knee replacement (TKR) is a procedure of choice in the management of severe osteoarthritis. Currently two types of prosthesis are widely used, cruciate retaining (CR) and cruciate substituting (CS). Experts has not yet reached agreement regarding which one is better. This study aims to compare functional outcome between the two types of prosthesis. This study was a randomized double-blind clinical trial. Patients with severe osteoarthritis were divided into two groups, and evaluated in 3 and 6 months after operation. Result of this study were that flexion angle of CS group was 13,1 degrees better in 3 months and 12,9 degrees in 6 months. Subjective evaluation using IKDC score did not show significant differences between two groups."

"This volume focuses on the biomechanical modeling of deformable soft tissues in the context of Computer Assisted Surgery (CAS). Discussion includes biomechanical models, estimation of in vivo mechanical behavior, real-time numerical simulations and more. "

"Tesis ini membahas analisis dan perancangan Computer Assisted Surgery (CAS) untuk robot ortopedi yang menggunakan metode Rod and Screw Correcive Manipulation (RSCM) dengan tujuan hasil analisis dan perancangan dapat dipergunakan untuk pembuatan prototipe. Penelitian ini dilakukan dengan tahapan: analisis kebutuhan, analisis sistem dan perancangan sistem. Hasil penelitian menerangkan bahwa masukan sistem ini didefinisikan sebagai nilai pengukuran yang dilakukan oleh robot ortopedi, dan keluarannya merupakan tampilan pada layar monitor yang memberikan nilai tekanan, besar sudut koreksi tulang belakang dan amplitudo keadaan syaraf. Proses untuk mendapatkan keluaran dibuat sesederhana mungkin sehingga proses berjalan cepat dan tepat.

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This thesis discusses the analysis and design of Computer Assisted Surgery (CAS) for orthopedic robot using Rod and Screw Corrective Manipulation (RSCM) methods with the purpose, that the analysis and design can be used for prototyping. This research was carried out in phases: requirements analysis, system analysis and system design.

The results explained that the input defined as the value of measurements made by the orthopedic robot, and its output is the display on the monitor which gives the value of pressure, the angle of correction and the amplitude of spinal nerves. The process to get the output was made as simple as possible so the process goes quickly and accurately."

"Latar belakang: Injeksi intra-artikular merupakan prosedur terapi osteoartritis (OA) yang memerlukan tingkat akurasi tinggi. Penelitian ini bertujuan menentukan rerata jarak antara kulit dan rongga intra-artikular yang dapat digunakan sebagai panduan untuk memilih panjang jarum ketika melakukan injeksi intra-artikular pada pasien osteoartritis lutut.Metode: Dua puluh satu MRI lutut diambil dari 16 pasien wanita dengan osteoartritis lutut. Panjang jarum yang dibutuhkan untuk mencapai ruang intra-artikular didapatkan melalui rekonstruksi gambaran garis lurus dari kulit ke ruang intra-artikular. Uji t berpasangan dipakai untuk melihat perbedaan mean hasil pengukuran bagian kiri dengan bagian kanan, dengan tingkat kemaknaan nilai p < 0,05.Hasil: Hasil menunjukkan tempat masuk dari parapatela pada medial dan lateral lebih kranial dari garis mid-patellar. Pada portal medial, jarak terdekat antara kulit dan cairan intra-artikular adalah 27,81 mm ± 7,58 mm. Jarak rerata titik portal adalah 4,46 ± 2,16 mm kranial dari garis mid-patellar, dan 14,20 ± 4,45 mm posterior dari permukaan medial patela. Pada portal lateral, jarak terdekat dari kulit dan cairan intra-artikular adalah 16,84 ± 6,79 mm. Jarak rata-rata titik injeksi adalah 11,10 ± 5,95 mm kranial dari garis mid-patellar, dan 8,91 ± 3,83 mm posterior dari permukaan lateral patela.Kesimpulan: Studi MRI lutut menunjukkan bahwa rerata jarak antara kulit dan rongga intra-artikular lutut pada portal medial 27,81 ± 7,58 mm sedangkan pada portal lateral 16,84 ± 6,79 mm. Portal tersebut terletak kranial dari garis tengah patela dimana portal lateral lebih kranial dibandingkan medial, sehingga panjang jarum dan lokasi injeksi harus disesuaikan untuk meningkatkan akurasi injeksi intra-artikular.

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AbstractBackground: Intra-articular injection is a common therapeutic procedure in osteoarthritis (OA) that need high accuracy. This study was aimed to measure the distance between parapatellar skin and intra-articular space as a guidance to choose the length of needle needed to perform intra-articular injection.Methods: Twenty one knees MRI were taken from 16 females with knee osteoarthritis. The length of the needle needed to reach intra-articular space was reconstructed by drawing straight line from skin to intra-articular fluid. Paired t-test was using to analyze the mean difference of measurement of left side compare with right side with significant indicator if p-value < 0.05.Results: The entry point on both medial and lateral parapatellar were more cranial than transverse mid-patellar line. On medial portal, the closest distance from skin to intra-articular space is 27.81 ± 7.58 mm. Mean point of entry is 4.46 ± 2.16 mm cranial to mid-patellar line, and 14.20 ± 4.45 mm posterior to the prominence of medial border of patella. On lateral portal, the closest distance from skin to intra-articular space is 16.84 ± 6.79 mm. Mean point of entry is 11.10 ± 5.94 mm cranial to mid-patellar line, and 8.91 ± 3.83 mm posterior to the prominence of lateral border of patella.Conclusion: MRI knee osteoarthritis study showed that the mean distance between skin and intra-articular joint space of medial portal is 27.81 ± 7.58 mm, and lateral portal is 16.84 ± 6.79 mm. The portals on both sides is cranial to midpoint of patella, lateral appears more proximal than medial. This should be put into consideration in choosing needle length and portal projection to increase intra-articular injection accuracy."

"Latar Belakang: Oklusi total kronik (OKT) adalah salah satu lesi paling sulit untuk ditangani dalam intervensi koroner perkutan (IKP). Menurut studi, kesintasan pasien yang telah melalui IKP bergantung kepada beberapa faktor resiko. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kesintasan pasien OKT yang telah melalui IKP. Metode: Riset ini menggunakan desain penelitian kohort retrospektif dengan kriteria sampel pasien OKT yang telah dilakukan tindakan IKP di Rumah Sakit Umum Pendidikan Nasional Dr, Cipto Mangunkusumo sejak tahun 2017 sampai 2019. Observasi melalui analisis Kaplan-meier dan cox regression dilakukan untuk menentukan kesintasan satu tahun. Hasil: Terdapat 204 sampel yang telah dikumpulkan dalam studi ini. Kesintasan satu tahun yang didapatkan adalah 88,2%, dengan mayoritas kematian terjadi di bulan pertama. Rata-rata pasien merupakan 58,46 + 11,06 ciri ciri pasien lebih banyak di kelompok umur <60 tahun (62,7%) dan laki-laki (87,7%). Rasio hazard menunjukkan pasien OKT setelah IKP lebih beresiko untuk kematian bila merupakan laki-laki, lebih tua dari 60 tahun, memiliki komorbiditas diabetes dan penyakit ginjal kronis, dan memiliki lesi di LAD, LCX dan RCA. Sedangkan pasien yang memiliki hipertensi dan dislipidemia lebih tidak berisiko untuk kematian. Kesimpulan: Pasien OKT setelah IKP memiliki kesintasan 88,2% setelah satu tahun, fator resiko yang ditemukan tidak signifikan secara statistik untuk menentukan faktor resiko kematian.

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Background: Chronic total occlusion (CTO) lesion is considered one of the most technically challenging intervention in percutaneous coronary intervention (PCI). The survival of patients who have undergone the procedure varies among research and is affected by several risk factors. This research aims to determine the risk factors and 1 year survival of CTO patients post-PCI. Method: This research uses a retrospective cohort study design with samples of CTO patients that had undergone PCI at Dr. Cipto Mangunkusumo Hospital between 2017 to 2019. The one-year survival of the patients was observed through Kaplan-Meier analysis and cox regression. Result: From 204 samples included in this study, the one-year survival was 88.2%, with the majority of death occuring in the first month. The mean age of the patients was 58.46 + 11.06, with more patients in the <60 age group (62.7%) and males (87.7%). The hazard ratio shows that CTO patients were more likely to experience mortality after PCI when they were older than 60 years old, males, had diabetes, CKD, occlusion on the LAD, LCX and RCA. In contrast, patients were less likely of death when they had hypertension and dyslipidemia. Conclusion: CTO patients that had undergone PCI had a survival rate of 88.2% after one year, and risk factors were statistically insignificant in determining risk factors leading to mortality."

"This book constitutes the proceedings of the Third International Conference on Information Processing in Computer-Assisted Interventions IPCAI 2012, held in Pisa, Italy, on June 27, 2012. The 17 papers presented were carefully reviewed and selected from 31 submissions during two rounds of reviewing and improvement. The papers present novel technical concepts, clinical needs and applications as well as hardware, software and systems and their validation. The main technological focus is on patient-specific modeling and its use in interventions, image-guided and robotic surgery, real-time tracking and imaging."

"Tujuan: Mengetahui jumlah berbagai kategori IMT pada penduduk Lombok usia ?50 tahun, prevalensi katarak senilis, proporsi katarak senilis di kelompok IMT rendah dan mencari hubungan IMT dengan katarak senilis.Metode: Penelitian ini merupakan penelitian observasional cross-sectional, meliputi 2720 subyek dari 68 klaster. Semua subyek dilakukan kunjungan rumah untuk pemeriksaan oftalmologi yang meliputi pemeriksaan visus secara kasar dengan pin-hole, pemeriksaan lensa serta segmen posterior menggunakan senter, dan oftalmoskopi langsung. Setiap subyek dihitung IMT-nya. Hubungan IMT dan katarak senilis dihitung dengan analisa statistik multivariat.Hasil: Subyek yang dapat diperiksa secara lengkap sebesar 93,5% dari semua target. Prevalensi katarak di Lombok 12,4%. Penduduk yang masuk dalam kategori IMT severe thinness 13,6%, mild thinness 12,7%, normal 59%, mild overweight 7,7%, dan severe overweight 7%. Proporsi katarak senilis pada IMT rendah sebesar 36,6%. Tidak ada hubungan secara statistik antara IMT dan katarak senilis.Kesimpulan: Prevalensi katarak senilis di Lombok masih cukup tinggi, dan diperlukan penanganan yang komprehensif dan lintas sektoral. Distribusi IMT di penduduk Lombok usia ?50 tahun merupakan distribusi normal. Perin diteliti lebih lanjut tentang hubungan antara katarak senilis dan IMT dengan memperhatikan jenis katarak dan faktor-faktor resiko katarak yang lain.

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Objective: To determine the frequency of each category of BMI, prevalence of senile cataract, proportion of senile cataract in thin subjects, and the relationship between thinness and senile cataract of population aged 50 years and older living in Lombok.Method: An observational cross-sectional study was carried out involving 2720 subjects aged 50 years. and over divided into 68 clusters. Home visits were conducted for ophthalmology examination including visual acuity evaluation with pin-hole, inspection of posterior segment and lens using flash light, and direct ophthalmoscopy. HMI was calculated after ophthalmology examination. Relations between BMI and senile cataract was anal-zed using multivariate statistical method.Result: Ninety three point five percent subjects were examined completely. Prevalence of senile cataract in Lombok was 12,4%, severe thinness category was 13,6%, mild thinness 12,7%, normal 59%, mild overweight 7,7%, and severe overweight 7%. Proportion of senile cataract in subjects with low BMI was nearly 36,6%. No stastitical correlation was found between BMI and senile cataract.Conclusion: Prevalence of senile cataract in Lombok is quite high. More comprehensive cataract management is needed. Normal BMI distribution was detected in this study. Further study is necessary to find the relationship between BMI and senile cataract regarding contribution of cataract maturation, type and other risk factors."