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Abstrak :
Tujuan: Membuktikan kesahihan dan keandalan Foot and Ankle Ability Measure (FAAM) dalam versi Bahasa Indonesia Metode: Desain uji potong lintang. Penelitian dilakukan pada 42 orang tentara pasukan khusus dengan instabilitas pergelangan kaki. Setiap responden mengisi kuesioner FAAM versi Bahasa Indonesia yang sudah diujicobakan terlebih dahulu. Kemudian dilakukan pengisian kuesioner SF-36 sebagai baku emas kuesioner kualitas hidup untuk menilai kesahihan konvergen. 2 minggu dari pengisian pertama dilakukan pengisian kembali kuesioner FAAM untuk menilai keandalan test-retest. Hasil: Didapatkan korelasi bermakna dengan nilai korelasi sedang untuk antara FAAM subskala aktivitas keseharian dengan skor komponen mental dan skor komponen fisik terhadap dengan nilai r secara berurutan 0,417, dan 0,458. Didapatkan korelasi bermakna dengan nilai korelasi sedang untuk antara FAAM subskala olahraga dengan skor komponen fisik dan fungsi fisik terhadap dengan nilai r secara berurutan 0,430 dan 0,464. Didapatkan konsistensi internal dengan cronbach alpha 0,917 dan 0,916 untuk subskala aktivitas keseharian dan subskala olahraga. Didapatkan nilai korelasi interkelas sedang untuk subskala olahraga sebesar 0,78. Kesimpulan: FAAM versi Bahasa Indonesia memiliki kesahihan dan keandalan yang baik. ......Objective: to assess validity and realibility of Foot Ankle Ability Measure in Indonesia version . Method : design of this study is cross sectional study. This research was to 42 special force army personal with ankle instability. Every subject was asked to fill out Indonesian version of Foot and Ankle Ability Measure quetionairre. And SF-36 quetionairre as gold standard of quality of life to assess validity. After 2 weeks, subject is asked to fill FAAM quetionairre again to assess test-retest realibility. Result : There was significant correlation with moderate value between FAAM-I activity daily living subscale and mental component summary and physical component summary with r 0,417 and 0,458 respectively. There was also significant correlation with moderate value between FAAM-I sport subscale with r 0,430 and 0,464 respectively. The internal consistency with cronbach alpha was 0,917 and 0,916 for ADL subscale and sport subscale. Interclass correlation for sport subscale was 0,78. Conclusion : Indonesian version of FAAM have good validity and realibility.

Abstrak :
Diabetes melitus (DM) menyebabkan gangguan saraf autonom, sensorik, dan motorik, terutama di kaki dan pergelangan kaki yang menyebabkan perubahan postur kaki dan deformitas. Artritis pergelangan kaki penyandang DM mengakibatkan gangguan fungsional sehingga artrodesis merupakan suatu opsi tata laksana pembedahan. Sayangnya, gangguan metabolik DM mengakibatkan komplikasi yang tak jarang yakni non-union. Terapi sel dan derivatnya merupakan opsi terapi regeneratif untuk meningkatkan kesembuhan tulang. Pembuatan model artritis hewan DM dengan injeksi streptozotosin (STZ), diet tinggi lemak (HFD), dan injeksi complete freud adjuvant (CFA) dilanjutkan studi eksperimental in vivo dengan fokus hasil augmentasi fusi dengan granul hidroksiapatit (HA), sel punca mesenkimal asal tali pusat (SPM-TP), dan sekretom jaringan adiposa (JA). Sebanyak 16 sampel kaki dibagi menjadi 3 kelompok: kontrol negatif (kelompok 1), kontrol positif yang diberikan autologous bone graft (kelompok 2), dan perlakuan yang diberikan HA, SPM-TP, dan sekretom-JA (kelompok 3). Dilakukan evaluasi parameter klinis, radiologis, profil histomorfometris, dan ekspresi biomarker di subjek model artritis DM tikus Sprague Dawley (SD). Status DM tercapai setelah induksi STZ dengan rerata kadar glukosa 421 ± 27,16 mg/dL. Kelompok artritis menunjukkan perubahan diameter ankle yang bermakna dibanding kontrol serta perubahan radiologis sendi pergelangan kaki. Artritis berat (skor 3) ditemukan di mayoritas (80%) sampel kelompok 1 yang merupakan kontrol negatif (hanya induksi DM). Kelompok perlakuan menunjukkan skor artritis terendah serta osifikasi di sisi anterior tibiotalar. Terdapat perbedaan bermakna osteokalsin (p = 0,017) dan gen chordin (p = 0,003) antara ketiga kelompok. Simpulan: Model artritis DM pada tikus SD berhasil dibuat dengan injeksi STZ dan HFD serta induksi artritis kronik dengan injeksi CFA di sendi pergelangan kaki selama 4 minggu. Pemberian SPM-TP, sekretom JA, dan granul HA menunjukkan skor artritis yang lebih rendah. Namun, pemberian ketiga bahan tersebut tidak menghasilkan gambaran fusi yang lebih baik, serta tidak meningkatkan kadar osteokalsin, namun menghasilkan jumlah chordin (protein inhibisi BMP) yang lebih kecil dibandingkan baku standar. ......Diabetes mellitus (DM) can cause disturbances in the autonomic, sensory, and motor nerves, particularly in the feet and ankles, eventually leading to changes in foot posture and specific deformities. The advancement of management using stem cells and their secretome has shown promising outcomes. A model of DM arthritis can be created by inducing experimental animals with streptozotocin (STZ). In the DM arthritis model, the evaluation of ankle arthrodesis augmented with umbilical cord mesenchymal stem cell (MSC-Uc) and adipose tissue secretome (Secretome-AD) can be carried out to observe the existing outcomes. This study is divided into two stages wherein the first stage involves creating an arthritis model in DM animals. The study utilizes a pretest-posttest design to measure clinical and laboratory parameters before and after treatment. Subsequently, the second stage involves an in vivo experimental study focusing on the outcomes of fusion augmentation with MSC-Uc, secretom-AD, and HA granule. The second stage of the study includes assessments using single-blinding methods for clinical, radiological, histomorphometric profile, and biomarker expression in the SD rat model of DM arthritis. DM status was achieved after STZ injection, with an average glucose level of 421 ± 27.16 mg/dL. The final diameter averages in groups 1 – 3, which were not induced with arthritis (9.64 ± 0.49 mm), significantly differed from group 4 (12.50 ± 0.87 mm, p = 0.003) and 5 (11.85 ± 0.74 mm, p = 0.037). The arthritis groups showed radiological changes in the ankle joint. After modeling, there was a significant increase in fasting blood glucose compared to pre-modeling measurements. Severe arthritis (score 3) was found in the majority (80%) of samples in group 1, which served as the negative control (DM induction only). Anova test results for the IHC parameter showed significant differences (p = 0.017) in osteocalcin and chordin gene (p = 0.003) among the three groups. Conclusion: A model of DM arthritis in SD rats was successfully created by STZ and HFD induction, followed by the induction of chronic arthritis with CFA injection in the ankle joint for 4 weeks. The administration of MSC-Uc, secretome-AD, and HA granule indicated lower arthritis scores. However, the administration of these three substances did not produce a better fusion picture, nor did it increase osteocalcin levels, but it resulted in a smaller amount of chordin (BMP inhibition protein) compared to the standard.

Abstrak :
A comprehensive textbook of some of the most common and difficult to deal with pathologies. The first truly international, multidisciplinary manual of foot and ankle surgery by the specialty’s leaders and most experienced surgeons. The management of various conditions in the foot and ankle will be approached by authors in different parts of the world. Authors will be invited to provide radiographs, diagrams, and intra-operative pictures to illustrate the procedures described. Current up to date trends and techniques using a scientific approach including evidence based guidelines where applicable.