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"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."

"[ABSTRAKLatar belakang : Cedera ligamentum krusiatum anterior merupakan salah satu cedera olahraga yang sering terjadi. Penanganan dengan operasi rekonstruksi diharapkan dapat membantu pasien untuk kembali melakukan aktivitas fisik seperti semula. Tujuan: Mengetahui aktivitas fisik dan kemampuan fungsional pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga, serta faktor-faktor yang mempengaruhinya. Metode: Dikumpulkan 11 subyek dari daftar rumah sakit tempat praktek dokter spesialis bedah ortopedi anggota IHKS dan IOSSMA. Data demografik dan kondisi fungsional subyektif lutut dikumpulkan menggunakan kuesioner IKDC, data aktivitas fisik menggunakan kuesioner aktivitas fisik Tegner, dan data kondisi fungsional obyektif lutut menggunakan tes lompat satu kaki. Hasil: Sebagian besar subyek memiliki indeks massa tubuh di atas normal dan kebiasaan merokok. Seluruh cedera ligamentum krusiatum anterior yang dialami terjadi akibat suatu mekanisme cedera non-kontak dengan biomekanisme yang khas, yaitu: permukaan plantar kaki menempel di lantai dan berada di posisi menjauhi pusat massa tubuh, sendi lutut berada dalam keadaan hampir ekstensi dan valgus, serta batang tubuh bergeser ke lateral. Namun, sebagian besar subyek tidak menjalani program rehabilitasi sebelum operasi rekonstruksi. Hampir seluruh subyek memiliki tingkat aktivitas fisik lebih rendah dibandingkan dengan tingkat aktivitas fisiknya sebelum cedera, dan alasan utamanya adalah karena adanya rasa takut untuk kembali ke aktivitas fisiknya seperti semula. Sebagian besar subyek memiliki kondisi fungsional sendi lutut yang buruk, baik secara subyektif maupun obyektif, dan didapatkan kecenderungan adanya hubungan antara hal tersebut dengan beberapa faktor, yaitu jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum maupun sesudah operasi rekonstruksi. Kesimpulan: Pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga memiliki tingkat aktivitas fisik dan kemampuan fungsional yang rendah. Dan terdapat kecenderungan bahwa hal tersebut dipengaruhi oleh jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum dan sesudah operasi rekonstruksi yang dijalani.

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ABSTRACTBackground: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstruction surgery. It is hoped that the patient can get back to previous physical activity level after the surgery. Objective: To know the physical activity level and functional ability of patients 12-24 months post anterior cruciate ligament reconstruction surgery due to sports injury and their related factors. Methods: Eleven subjects were selected from hospitals where orthopedic surgeons of IHKS and IOSSMA having their practice. The followings data were collected: demographic and subjective functional knee evaluation using IKDC questionnaire, physical activity level using Tegner activity scale, and objective functional knee evaluation using single leg hop test. Results: Most of the subjects had high body mass index and smoking habit. All the anterior cruciate ligament injuries happened due to a non-contact mechanism with a classic biomechanics: plantar surface of the foot planted on the ground and positioned away from the center of mass of the body, valgus and almost fully extended knee, and lateral trunk motion. Unfortunately, most of the subjects did not have pre-surgical rehabilitation program. Almost all the subjects had a lower physical activity level compare to the one before injury, and the main reason was afraid to do their previous physical activity. Most of the subjects also had bad subjective and objective functional knee condition, and there was a possibility that it was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-reconstruction surgery. Conclusion: The patients 12-24 months post ACL reconstruction surgery due to sports injury had low physical activity level and functional ability. There was a propensity that this condition was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery., Background: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstructionsurgery. It is hoped that the patient can get back to previous physical activity levelafter the surgery.Objective: To know the physical activity level and functional ability of patients12-24 months post anterior cruciate ligament reconstruction surgery due to sportsinjury and their related factors.Methods: Eleven subjects were selected from hospitals where orthopedicsurgeons of IHKS and IOSSMA having their practice. The followings data werecollected: demographic and subjective functional knee evaluation using IKDCquestionnaire, physical activity level using Tegner activity scale, and objectivefunctional knee evaluation using single leg hop test.Results: Most of the subjects had high body mass index and smoking habit. Allthe anterior cruciate ligament injuries happened due to a non-contact mechanismwith a classic biomechanics: plantar surface of the foot planted on the ground andpositioned away from the center of mass of the body, valgus and almost fullyextended knee, and lateral trunk motion. Unfortunately, most of the subjects didnot have pre-surgical rehabilitation program. Almost all the subjects had a lowerphysical activity level compare to the one before injury, and the main reason wasafraid to do their previous physical activity. Most of the subjects also had badsubjective and objective functional knee condition, and there was a possibility thatit was affected by the time interval duration between the injury and reconstructionsurgery, and the rehabilitation program given pre- and post-reconstructionsurgery.Conclusion: The patients 12-24 months post ACL reconstruction surgery due tosports injury had low physical activity level and functional ability. There was apropensity that this condition was affected by the time interval duration betweenthe injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery.]"

"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."