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"This book is the first monograph to examine all aspects of femoroacetabular impingement (FAI), an important disease first described early in the twenty-first century. Comprising 27 chapters and including many color illustrations, the book contains a variety of points of view from more than 50 experts from 11 countries and represents an up-to-date compilation of professional knowledge on FAI. The full range of available surgical treatments is carefully described and evaluated, including arthroscopic treatment, the open and mini-open approaches, periacetabular osteotomy, hip resurfacing arthroplasty, and combined techniques. Differential diagnosis, imaging, postoperative management, and treatment outcome are also discussed in appropriate detail."

"ABSTRAKLatar Belakang: masalah yang sering terjadi setelah pembedahan sendi panggul yaitu defisit kekuatan otot, gangguan fisik, dan gangguan kemampuan berjalan kondisi ini dapat mengakibatkan ketidakmampuan pasien dalam menyelesaikan tugas fungsionalnya secara mandiri. Oleh karena itu, diperlukan intervensi yang berkelanjutan untuk dapat mengembalikan status fungsional pasien. Intervensi berupa program activehip exercise dengan melibatkan keluarga dilakukan untuk meningkatkan kemampuan fungsional. Tujuan: mengetahui pengaruh activehip exercise dan keterlibatan keluarga terhadap kemampuan fungsional pasien pasca pembedahan sendi pinggul. Desain penelitian: penelitian kuantitatif dengan menggunakan quasi experiment pre and post test without control group design dengan jumlah sampel 23 pasien pasca pembedahan panggul. Analisis data menggunakan uji Paired t-Test, Independet t-Tes dan Pearson Correlation. Hasil: analisis menunjukkan terdapat pengaruh activehip exercise dan keterlibatan keluarga dilihat dari adanya perbedaan rerata nilai status fungsional sebelum dan sesudah intervensi (p=0,0001). Hasil analisis bivariat menunjukkan adanya hubungan yang signifikan antara usia (0,001) dan nyeri (0,001) terhadap status fungsional. Kesimpulan: adanya pengaruh activehip exercise dengan keterlibatan keluarga terhadap status fungsional pasien paca pembedahan panggul.

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ABSTRACTBackground: Problems that usually happen after hip joint surgery are deficits in muscle strength, physical disorders, and impaired difficulties to walk or impaired mobility. These conditions can causes patient inablity to to fullfill their functional tasks independently. Therefore, a intervention is required to return functional status optimally. This intervention which is Activehip exercise which is modified with the family involvement was conducted to improve functional abilities. Objective: to identifiy the effect of Activehip exercise and family involvement on the functional abilities of patients after hip joint surgery. Design study: Quantitative research using quasi pre and posttest experiments without control group design with 23 patients after hip joint surgery as a sample. Data analysis used Paired t-Test, Independent t-Test and Pearson Correlation. Results: the result showed that there was an effect of Activehip exercise and family involvement as seen from the difference in mean functional status values before and after the intervention (p = 0.0001). The results of the bivariate analysis showed a significant relationship between age (0.001) and pain (0.001) to status functional. Conclusion: There was an effect of Activehip exercise and family involvement on the functional status of hip joint surgery's patients."

"Pendahuluan: Teknik reaming posteroinferior-superioanterior (PISA) pada total hip arthroplasty (THA) pasien displasia panggul dewasa memiliki banyak keuntungan dibandingkan asetabuloplasti. Akan tetapi, kegagalan reaming PISA dapat meningkatkan biaya serta memperpanjang waktu operasi karena dokter harus melakukan asetabuloplasti sebagai alternatif. Tujuan: Mengeksplorasi parameter radiografi panggul preoperatif dalam memprediksi keberhasilan preparasi asetabulum dengan teknik reaming PISA pada pasien displasia panggul dewasa. Metode: Kohort retrospektif ini menggunakan data sekunder rekam medis seluruh pasien displasia panggul yang menjalani prosedur THA di Rumah Sakit dr. Cipto Mangunkusumo (Jakarta, Indonesia) pada Januari 2015–Agustus 2024. Parameter radiografi panggul preoperatif berupa acetabular depth rasio (ADR), acetabular inclination (AI), lateral center-edge angle (LCEA), serta Tönnis angle diukur dengan menggunakan PACS Viewer. Hasil: Sebanyak 36 pasien (72,2% perempuan, usia rerata 46,5415,02 tahun) dianalisis. Sebanyak 24 pasien berhasil dilakukan preparasi asetabulum dengan teknik reaming PISA, sementara sisanya harus menjalani asetabuloplasti. Tidak ada perbedaan jenis kelamin, usia atau keterlibatan sisi pada kelompok PISA dan asetabuloplasti. Kelompok Crowe III-IV memiliki odds 55 kali lipat lebih besar untuk menjalani asetabuloplasti (odds ratio [OR] 55, interval kepercayaan [IK] 95%: 5,45–554,96; p<0,001). Nilai ADR, AI, LCEA dan Tönnis angle secara berturut-turut adalah 33,2911,44%, 52,357,81 , 23,92(7,70–62,73) dan 9,61(0,79–44,81) . Kelompok reaming PISA memiliki ADR yang lebih tinggi dan AI yang lebih rendah dibandingkan kelompok asetabuloplasti (p<0,001). Tidak terdapat perbedaan LCEA (p=0,198) dan Tönnis angle (p=0,251) pada kedua kelompok. Analisis regresi logistik dengan mengontrol ADR, AI, dan LCEA menunjukkan bahwa ADR (adjusted OR 0,85; IK 95%: 0,75–0,95) dan AI (adjusted OR 1,11; IK 95%: 1,03–1,19) berhubungan dengan dilakukannya asetabuloplasti. Probabilitas dilakukan asetabuloplasti dapat diprediksi dengan rumus ln p/(1-p) = - 0,169(ADR)+0,104(AI)-0,040(LCEA). Model ini memiliki ketepatan 88,9% dengan diskriminasi yang sangat baik (area under the curve=0,913 (IK 95%: 0,800–1)). Simpulan: Angka ADR dan AI preoperatif dapat memprediksi keberhasilan reaming PISA dengan diskriminasi yang sangat baik. Studi prospektif lebih lanjut dapat dilakukan dengan sampel dan parameter radiografi yang lebih banyak untuk memvalidasi temuan ini.

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Introduction: The posteroinferior-superioanterior (PISA) reaming technique in total hip arthroplasty (THA) in adult hip dysplasia patients has many advantages over acetabuloplasty. However, failure of PISA reaming could increase costs and prolong surgery time because doctors must perform acetabuloplasty as an alternative. Purpose: To examine preoperative pelvic radiographic parameters in predicting the success of acetabular preparation with the PISA reaming technique in adult hip dysplasia patients. Methods: This retrospective cohort used secondary data from medical records of all adult patients with hip dysplasia who underwent THA procedures at Dr. Cipto Mangunkusumo Hospital (Jakarta, Indonesia) from January 2015 to August 2024. Preoperative pelvic radiographic parameters such as acetabular depth ratio (ADR), acetabular inclination (AI), lateral center-edge angle (LCEA), and Tönnis angle were measured using PACS Viewer. Results: Thirty-six patients (72.2% female, mean age 46.54±15.02 years) were analyzed. Twenty four patients had successful acetabular preparation by using reaming PISA technique, while the rest underwent acetabuloplasty. There was no difference in gender, age, or site of involvement between patients in reaming PISA and acetabuloplasty groups. The Crowe III-IV group had 55-fold greater odds of undergoing acetabuloplasty (odds ratio [OR] 55, 95% confidence interval [CI]: 5.45–554.96; p<0.001). The ADR, AI, LCEA, and Tönnis angle values were 33.29±11.44%, 52.35±7.8, 23.92 (7.70–62.73) , and 9.61 (0.79–44.81) respectively. The reaming PISA group had a higher ADR and lower AI than the acetabuloplasty group (p<0.001). Both groups had no difference in LCEA (p=0.198) and Tönnis angle (p=0.251). Logistic regression analysis controlling ADR, AI, and LCEA showed that ADR (adjusted OR 0.85; 95% CI: 0.75–0.95) and AI (adjusted OR 1.11; 95% CI: 1.03–1.19) were associated with acetabuloplasty. The probability of acetabuloplasty can be predicted by the formula ln p/(1-p) = - 0.169(ADR)+0.104(AI)-0.040(LCEA). This model has an accuracy of 88.9% with excellent discrimination (area under the curve=0.913 (95% CI: 0.800–1)). Conclusion: Preoperative ADR and AI values can predict the success of reaming PISA with excellent discrimination. Further prospective studies with more samples and radiological parameters should be done to validate these findings."

"Pendahuluan: Arthroplasty primer panggul dan lutut merupakan pilihan tindakan pada pasien dengan patah tulang panggul dan OA setelah pengobatan medikamentosa tidak berhasil. Periprosthetic Joint Infection (PJI) merupakan salah satu komplikasi serius yang terjadi setelah operasi yang memerlukan biaya yang mahal dan lama untuk menyembuhkannya. Ada beberapa faktor risiko yang menimbulkan PJI. Tujuan: Penelitian ini dilakukan untuk mengetahui prevalensi PJI dan faktor risiko PJI pada arthroplasty primer panggul dan lutut di RSCM dan RSUP Fatmawati periode tahun 2019 – 2023. Dari studi ini diharapkan dapat memberikan gambaran prevalensi PJI, pemahaman yang lebih baik tentang faktor-faktor risiko yang berkontribusi terhadap PJIMetode: Analitik Retrospektif Cross-Sectional, dengan menggunakan data sekunder dari catatan medis pasien Arthroplasty primer. Faktor risiko yang diteliti adalah Hipertensi, ASA≥ 3, Diabetes mellitus, Jenis kelamin, Usia.Hasil: Dilakukan Analisa 1038 arthroplasty primer (yang didalamnya terdapat 95 kasus PJI) sesuai kriteria inklusi dan eklusi, dengan karakteristik populasi penelitian 69.3% kasus Perempuan, 30.7% kasus laki-laki. Prevalensi PJI berdasar asal arthroplasty primer, di RSCM (3 kasus) 1.4%, RS Fatmawati (7 kasus) 1.0%. Di kedua rumah sakit tersebut; PJI pada Panggul (Bipolar 0%, THR 0,7%). PJI pada Lutut (TKR 2,3%, UKA 0%). Dari seluruh kasus PJI yang ditemukan 89,5% merupakan kasus dengan arthroplasty primer diluar RSCM dan RS Fatmawati. Dari perhitungan SPSS faktor risiko ASA≥ 3 bermakna secara statistik (95% CI, sig<0,05 prevalensi rasio 14,9), faktor risiko DM, bermakna secara statistik (95% CI, sig<0,05 odd ratio 7,8). Hipertensi bermakna secara statistik (95% CI, sig 0,034 odd rasio 1,8), faktor risiko laki- laki bermakna secara statistik (95% CI, sig 0,022 odd ratio 1,60). Begitu juga hasil regeresi logistik, faktor risiko yang berhubungan adalah ASA ≥3 dan DM. Didapatkan skoring sistem Faktor risiko (skor); ASA ≥ 3(skor 5), DM (skor 4), hipertensi (skor 1), laki-laki (skor 1), dengan katagori risiko; rendah (0-3), sedang (4-6), tinggi (7-11)Simpulan: Faktor risiko yang berhubungan dengan PJI adalah ASA≥3, diabetes melitus, hipertensi dan jenis kelamin laki-laki. Perlu dilakukan penelitian lebih lanjut dengan jumlah variabel lebih banyak dan desain penelitian yang berbeda untuk mendapatkan hasil yang lebih baik.

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Introduction: Primary hip and knee arthroplasty are treatment options for patients with hip fractures and osteoarthritis (OA) when conservative (medicinal) treatment fails. Periprosthetic Joint Infection (PJI) is one of the most serious complications following surgery, requiring high costs and a long healing process. Several risk factors contribute to the development of PJI.

Objective: This study aims to determine the prevalence of PJI and the associated risk factors in primary hip and knee arthroplasty at RSCM and RSUP Fatmawati during the period 2019–2023. The study is expected to provide an overview of PJI prevalence and a better understanding of the contributing risk factors.

Method: A retrospective analytical cross-sectional study using secondary data from the medical records of patients who underwent primary arthroplasty. The risk factors assessed were hypertension, ASA ≥ 3, diabetes mellitus, gender, and age.

Results: A total of 1,038 primary arthroplasty cases (including 95 PJI cases) were analyzed according to inclusion and exclusion criteria. Of the study population, 69.3% were female and 30.7% male.PJI prevalence based on hospital: RSCM: 3 cases (1.4%) RS Fatmawati: 7 cases (1.0%) PJI by joint type: Hip arthroplasty: Bipolar 0%, THR 0.7%, Knee arthroplasty: TKR 2.3%, UKA 0%. Of all the PJI cases found, 89.5% were cases with primary arthroplasty performed outside of RSCM and Fatmawati Hospital. Based on SPSS analysis, the risk factor ASA ≥ 3 was statistically significant (95% CI, p < 0.05; prevalence ratio 14.9). Diabetes mellitus was also a statistically significant risk factor (95% CI, p < 0.05; odds ratio 37.8). Hypertension showed statistical significance (95% CI, p = 0.034; odds ratio 1.8), and male gender was also a statistically significant risk factor (95% CI, p = 0.022; odds ratio 1.60) Logistic regression confirmed ASA ≥ 3 and diabetes mellitus as significantly associated risk factors. A risk scoring system was developed based on the following: ASA ≥ 3 (score 5), Diabetes mellitus (score 4), Hypertension (score 1) Male gender (score1) Risk categories were defined as: Low (0–3), Medium (4–6), High (7–11)

Conclusion: Significant risk factors for PJI included ASA ≥ 3, diabetes mellitus, hypertension, and male gender. Further research with more variables and other design is needed to obtain more robust results."