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"Pendahuluan: Rekonstruksi ACL merupakan salah satu operasi orthopaedi yang paling sering dilakukan. Beratnya cedera, mahalnya harga implan dan teknik yang cukup sulit menimbulkan masalah sosial dan ekonomi yang cukup besar pada pasien dengan cedera ACL. Rekonstruksi ACL tanpa implan dengan teknik pressfit femoral dapat menjadi alternatif untuk pasien cedera ACL. Penelitian ini bertujuan untuk mengetahui apakah rekonstruksi ACL tanpa implan memberikan luaran fungsional objektif dan subjektif setara (non-inferior) dengan metode implan.Metode Penelitian: Duabelas pasien menjalani rekonstruksi ACL tanpa implan dengan teknik press-fit femoral dan 24 pasien menjalani rekonstruksi ACL dengan implan selama Maret 2013-Maret 2014 di RSPAD Gatot Subroto, Jakarta. Seluruh pasien diikuti mulai dari praoperasi dengan minimal follow-up 6 bulan paska operasi (cohort prospective). Luaran objektif berupa pengukuran rolimeter, serta luaran subjektif berupa skor IKDC, Tegner-Lysholm dan KOOS dinilai pada saat praoperasi, serta 1 bulan, 3 bulan dan 6 bulan pascaoperasi.Temuan Penelitian dan Diskusi: Tidak didapatkan perbedaan yang bermakna pada luaran fungsional objektif dan subjektif antara kelompok tanpa implan dan kelompok implan pada pengukuran praoperasi, serta 1 bulan, 3 bulan dan 6 bulan pascaoperasi. Didapatkan rerata hasil pengukuran rolimeter sebagai luaran fungsional objektif pada 6 bulan pascaoperasi dengan hasil lebih tinggi pada kelompok tanpa implan (95% IK) sebesar 0,82 (-0,09-1,73) milimeter (p=0,075). Nilai rolimeter 6 bulan pascaoperasi antara lutut yang cedera dan lutut yang sehat (side to side diference) menunjukkan median rentang antar kuartil (RAK) 1,00 (0,067-2,08) dan 1,34 (0,33-1,92) milimeter (p=0,779). Median (RAK) rolimeter praoperasi dan 6 bulan pascaoperasi (time to time diference) 5,17 (3,41-6,17) dan 5,00 (4,08-6,00) pada kelompok tanpa implan dan implan (p=0,882). Median (RAK) skor Tegner-Lysholm pada 6 bulan pascaoperasi untuk kelompok tanpa implan dan kelompok implan adalah 95.00 (87.00-100,00) dan 95,00 (90.00- 100,00) dengan p=0,989. Rerata (simpang baku) skor IKDC pada 6 bulan pascaoperasi untuk kelompok tanpa impan dan kelompok implan 73.47 (10.473) dan 69,65 (10.286) (p=0.303). Penilaian KOOS 6-bulan pascaoperasi pada kelompok tanpa implan dan kelompok implan memiliki median (RAK) 90,20 (81.13-90.95) dan 88,10 (84.65-93.35) dengan p=0,999. Non-inferioritas diperiksa secara parametrik dan batas non- inferioritas selisih rerata d=8 poin untuk skor IKDC dan d=10 poin untuk skor KOOS dan Tegner, tidak terlampaui.Simpulan: Luaran fungsional objektif dan subjektif pasien yang menjalani rekonstruksi ACL tanpa implan dengan teknik press-fit femoral menunjukkan hasil yang non-inferior dibandingkan dengan yang menggunakan implan dalam evaluasi yang dilakukan selama 6 bulan (short-term follow up).

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Introduction: ACL reconstruction is one of the most common procedures performed by many orthopedic surgeons. The severity of injury, cost of implants and high demanding technique operation leave enormous social and economic issues for the patient. Implantless ACL reconstruction with press-fit femoral fixation technique is one of the alternatives to solve the problems. The aim of this study was to find whether implantless ACL reconstruction gave comparable functional outcome (non-inferior) objectively and subjectively compared to the ACL reconstruction using implant technique.Methods: Twelve patients underwent implantless ACL reconstruction with pressfit femoral technique and 24 patients underwent ACL reconstruction with implant between March 2013 and March 2014 at Gatot Soebroto Army Hospital, Jakarta. All patients were followed from preoperative until minimum of 6 months follow up post operatively (cohort prospective). Objective functional outcome were measured using rolimeter, and subjective functional outcome were measured according to IKDC, Tegner-Lysholm and KOOS.Result and Discussion: There were no significant differences in objective and subjective functional outcome between implantless group compared to implant group at the preoperative measurement, as well as at 1 month, 3 months, and 6 months post operative. Mean rolimeter measurement result is obtained as objective functional outcome at 6 months post operative with higher result in implantless group (95%CI) of 0,82 (-0,09-1,73) millimeter (p=0,075). Rolimeter measurement in 6 months post operation between the injured knee and the healthy knee (side to side difference) showed a median inter-quartile range (IQR) 1,00 (0,067-2,08) and 1,34 (0,33-1,92) millimeter with p value 0,799. Median (IQR) for Tegner-Lysholm score at 6 months post operation for implantless group and implant group were 95.00 (87.00-100,00) and 95,00 (90.00-100,00) respectively with p value = 0,989. Mean (Standard Deviation) IKDC score at 6 months post operative in implantless group and implant group were 73.47 (10.473) and 69,65 (10.286) respectively with p value = 0.303. KOOS assessment at 6 month post operative in implant less group and implant group have median (IQR) 90,20 (81.13-90.95) and 88,10 (84.65-93.35) respectively, with p value = 0,999. Noninferiority was checked parametrically with non-inferiority border difference mean d = 8 points for IKDC score and d = 10 points for KOOS and Tegner score, were not concede.Conclusion: Objective and subjective functional outcome of patient who underwent implantless ACL reconstruction using press-fit femoral fixation showed a non-inferior result compared to patients who underwent ACL reconstruction using implant in 6 months of short term follow up."

"ABSTRAK Pendahuluan. Osteoarthritis (OA) adalah sebuah penyakit sendi degeneratif yangmenyebabkan disabilitas dengan prevalensi yang terus meningkat. Hormonpertumbuhan memiliki efek regenerasi tulang rawan secara langsung melaluistimulasi sel kondroblas dan proses morphoangiogenesis juga melalui faktorpertumbuhan secara sistemik. Penelitian ini bertujuan untuk mengetahui manfaatsuntikan sendi dengan hormon pertumbuhan pada kasus Osteoarthritis. Metode Penelitian. Penelitian dilakukan di Rumah Sakit Hewan InstitutPertanian Bogor pada bulan Mei hingga September 2015. Desain penelitian adalahrandomized post test only control group. Sejumlah 21 ekor kelinci Selandia Baruputih, berat 1.9-2.6kg, usia 7-8 bulan. Kelinci dibagi secara acak menjadikelompok kontrol (NaCl 0.9%), suntikan hormon pertumbuhan (4iu), dan suntikanasam hyaluronat (6mg) . Dengan metode acak tersamar dilakukan suntikankolagenase tipe II C. Histolyticum pada hari 1 dan ke 4 pada lutut kiri, kemudiantindakan penyuntikan dilakukan sebanyak tiga kali dengan selang waktu 1minggu. Evaluasi dengan periode kepincangan, skoring makroskopis, histologisdilakukan pada minggu ke-8 pasca penyuntikan pertama. Temuan Penelitian. Berdasarkan hasil penelitian ditemukan periode kepincanganpada grup yang diberikan hormon pertumbuhan lebih singkat, dan bermaknasecara statistik dibandingkan dengan grup kontrol (p<0.001), grup asamhyaluronat (p<0.03), dan grup hormon pertumbuhan (p<0.001). Evaluasi skormakroskopik dengan skor yoshimi menunjukan bahwa kelompok hormonpertumbuhan memiliki kerusakan tulang rawan yang lebih ringan jikadibandingkan dengan grup kontrol (p=0.001) dan grup asam hyaluronat (p=0.04).Skoring histopatologis menggunakan skor modifikasi Mankin menunjukan padakelompok dengan hormon pertumbuhan memiliki angka terendah dibandingkangrup lainnya (p=0.001), grup kontrol (p=0.001), grup asam hyaluronat (p=0.015). Kesimpulan. Suntikan hormon pertumbuhan ke dalam sendi memiliki efektifitasyang lebih baik dibandingkan dengan Asam hyaluronat pada model osteoarthritis.Hormon pertumbuhan memberikan harapan baru sebagai alternatif dalam terapiosteoarthritis.ABSTRACT Introduction. Osteoarthritis is a degenerative joint disorder that cause disabilityfor patients all over the globe, with an increasing number of patients. Growthhormone (GH) works trough direct and indirect effect on cartilage regeneration bychondroblast stimulation, stimulation of growth factors and morphoangiogenesisprocess. Further research is needed to know the effects of intra articular jointinjection of growth hormone using validated animal model and reliable outcomemeasurement. Methods. This study was conducted in Animal Hospital of Agricultural InstituteBogor west Java, from May to September 2015. The design of the study wasrandomized posttest only control group. Male white New Zealand rabbit (n=21)weighted 1.9-2.6kg, age 6-7months were used in this study. The sample wasrandomized and divided into three groups. All groups recieved intra articularinjection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline(0.6ml) were done at 2 weeks after collagenase injection once a week forconsecutive 3 weeks. Evaluation of weight and lameness periode is doneperiodically, histopathological and macroscopic score were done at 8 weeks sincethe first injection. Result. The lameness priode for control group is significantly longer than both ofthe experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).Macroscopic score evaluation taken from the lateral condyle of the left femur showed that the GH group received significantly less cartilage damage than theHA group (P=0.04) and placebo (P=0.01). Histopathological score was also foundlowest at the GH group (p=0.001), with significant difference in control(p=0.001), and HA group (p=0.015).).Conclusion. Intraarticular injection of growth hormone is found to be moreeffective compared to hyaluronic acid on rabbit osteoarthritis model. This resultsshowed promising result for intra articular injection of GH as an alternativetreatment for osteoarthritis.;Introduction. Osteoarthritis is a degenerative joint disorder that cause disabilityfor patients all over the globe, with an increasing number of patients. Growthhormone (GH) works trough direct and indirect effect on cartilage regeneration bychondroblast stimulation, stimulation of growth factors and morphoangiogenesisprocess. Further research is needed to know the effects of intra articular jointinjection of growth hormone using validated animal model and reliable outcomemeasurement. Methods. This study was conducted in Animal Hospital of Agricultural InstituteBogor west Java, from May to September 2015. The design of the study wasrandomized posttest only control group. Male white New Zealand rabbit (n=21)weighted 1.9-2.6kg, age 6-7months were used in this study. The sample wasrandomized and divided into three groups. All groups recieved intra articularinjection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline(0.6ml) were done at 2 weeks after collagenase injection once a week forconsecutive 3 weeks. Evaluation of weight and lameness periode is doneperiodically, histopathological and macroscopic score were done at 8 weeks sincethe first injection. Result. The lameness priode for control group is significantly longer than both ofthe experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).Macroscopic score evaluation taken from the lateral condyle of the left femur showed that the GH group received significantly less cartilage damage than theHA group (P=0.04) and placebo (P=0.01). Histopathological score was also foundlowest at the GH group (p=0.001), with significant difference in control(p=0.001), and HA group (p=0.015).).Conclusion. Intraarticular injection of growth hormone is found to be moreeffective compared to hyaluronic acid on rabbit osteoarthritis model. This resultsshowed promising result for intra articular injection of GH as an alternativetreatment for osteoarthritis.;Introduction. Osteoarthritis is a degenerative joint disorder that cause disabilityfor patients all over the globe, with an increasing number of patients. Growthhormone (GH) works trough direct and indirect effect on cartilage regeneration bychondroblast stimulation, stimulation of growth factors and morphoangiogenesisprocess. Further research is needed to know the effects of intra articular jointinjection of growth hormone using validated animal model and reliable outcomemeasurement. Methods. This study was conducted in Animal Hospital of Agricultural InstituteBogor west Java, from May to September 2015. The design of the study wasrandomized posttest only control group. Male white New Zealand rabbit (n=21)weighted 1.9-2.6kg, age 6-7months were used in this study. The sample wasrandomized and divided into three groups. All groups recieved intra articularinjection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline(0.6ml) were done at 2 weeks after collagenase injection once a week forconsecutive 3 weeks. Evaluation of weight and lameness periode is doneperiodically, histopathological and macroscopic score were done at 8 weeks sincethe first injection. Result. The lameness priode for control group is significantly longer than both ofthe experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).Macroscopic score evaluation taken from the lateral condyle of the left femur showed that the GH group received significantly less cartilage damage than theHA group (P=0.04) and placebo (P=0.01). Histopathological score was also foundlowest at the GH group (p=0.001), with significant difference in control(p=0.001), and HA group (p=0.015).).Conclusion. Intraarticular injection of growth hormone is found to be moreeffective compared to hyaluronic acid on rabbit osteoarthritis model. This resultsshowed promising result for intra articular injection of GH as an alternativetreatment for osteoarthritis."

"Pendahuluan. Glukosamin, Kondroitin sulfat dan Methylsufonylmethane (MSM) merupakan suplemen yang sering diberikan pada pasien osteoarhritis (OA) derajat I dan II. Organisasi kedokteran seperti AAOS, OARSI, EULAR memberikan rekomendasi yang berbeda tentang penggunaannya. Studi ini bertujuan untuk menilai efektivitas Glukosamin-Kondroitin sulfat (GK) dan GKM terhadap perbaikan klinis pasien OA sendi lutut.Bahan dan Cara Kerja. Studi ini merupakan uji klinis acak tersamar ganda pada 147 pasien dengan OA lutut derajat Kellgren-Lawrence I atau II. Subjek dipilih dengan metode randomisasi dengan blok permutasi ke tiga kelompok yaitu GK (n=49), GKM (n=50) dan plasebo (n=48). Obat-obatan ini diberikan sekali sehari selama 3 bulan berturut-turut. Skor VAS dan WOMAC dinilai sebelum pemberian suplemen, kemudian minggu ke 4, 8, dan 12.Hasil. Rata-rata usia pasien adalah 61 tahun, dimana 67,3% pasien adalah perempuan. Bila dibandingkan terhadap Skor WOMAC pada kelompok Plasebo, kelompok GKM menurunkan skor WOMAC secara signifikan (perbedaan rerata 7.15, IK 12.06-2.23, p=0.005). Kelompok GK menurunkan Skor WOMAC secara signifikan (perbedaan rerata 8.17, IK 13.49-2.84, p=0.003). Sementara itu pada penilaian Skor VAS, kelompok GKM menurunkan skor secara signifikan terhadap dua kelompok lain, yaitu terhadap kelompok GK secara signifikan (perbedaan rerata 0.68, IK 1.18-0.19, p=0.007), dan Plasebo (perbedaan rerata 0.86, IK 1.37-0.35, p=0.001).Simpulan. Kombinasi suplemen GKM lebih efektif dalam menurunkan nyeri dan meningkatkan fungsi pada pasien OA sendi lutut derajat I dan II dibandingkan dengan GK dan plasebo. Sedangkan suplemen GK secara keseluruhan tidak lebih baik dibandingkan dengan plasebo dalam memberikan perbaikan klinis pada pasien OA sendi lutut derajat Kellgren Lawrence I-II.

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Introduction. Glucosamine-Chondroitin sulfate-Methylsufonylmethane (MSM) as combination are the most popular supplements for patients with knee osteoarthritis (OA). There are emerging controversies and also different recomendation from many medical associations such as AAOS, OARSI, and EULAR regarding the effectiveness of these supplements. This current study evaluated the efficacy of Glucosamine-Chondroitin sulfate (GC), Glucosamine-Chondroitin-MSM (GCM), and placebo on clinical improvement of patients with knee OA Kellgren Lawrence gr I-II.

Material and Methods. This study was a double blind, randomized controlled clinical trial on 147 patients with knee OA Kellgren-Lawrence grade I-II. Subjects were allocated by permuted block randomization to three groups, either GC (n=49), or GCM (n=50), or placebo (n=48). VAS and WOMAC score were measured before treatment, then at 4 th, 8 th and 12th week after treatment.

Result. Mean age of patients was 61 years, and 67,3% were woman. As compared with Placebo group, WOMAC score in GCM group was significantly lower (MD 7.15, CI 12.06-2.23, p=0.005), and in GC group WOMAC Score was also lower (mean difference 8.17, CI 13.49-2.84, p=0.003). Whereas VAS score in GCM group was significantly lower compared to that in GC group (MD 0.18, CI 1.18-0.19, p=0.007) and also compared with Placebo group (MD 0.86, CI 1.37-0.35, p=0.001).

Conclusions. Combinations of GCM made a clinical improvement in patients with knee OA Kellgren Lawrence gr I-II compared with GC and Placebo. GC did not make clinical improvement in overall groups of patients with knee OA Kellgren Lawrence gr I-II."

"Adanya tren perubahan perilaku selama pembatasan aktivitas sosial masyarakat penularan pandemi COVID-19 memberikan pengaruh pada berbagai aspek dalam kehidupan di Indonesia, khususnya dalam dunia pendidikan tinggi memaksa mahasiswa menjalani kuliah secara daring. Penelitian ini bertujuan untuk melihat kondisi tingkat aktivitas fisik dihubungkan dengan kondisi postur, keluhan muskulosketal serta faktor-faktor lainnya, pada mahasiswa yang telah mengalami program kuliah daring selama minimal 2 tahun. Penelitian menggunakan desain potong lintang dengan pendekatan analisis hubungan, teknik pengambilan consecutive sampling, dengan mengolah data primer yang didapat dari instrumen kuesioner IPAQ-SF bahasa Indonesia, CMDQ dan penilaian NYPRS untuk dianalis univariat dan bivariat. Didapatkan hasil dari subjek (n=112) variasi postur terbanyak forward neck (76%), asimetri bahu (76%), kifosis (68%) dengan keluhan muskuloskletal terbanyak punggung bawah (38%), leher (28%), upperback (25%). Hasil analisis hubungan didapatkan kemaknaan pada tingkat aktivitas fisik dan kondisi postur (p<0,05). Ditemukan kemaknaan hubungan antara IMT dengan lumbar lordosis, anterior tilt dan genu valgum (p<0,05).

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The trend of behavior changes during lockdown to prevent transmission of the COVID-19 pandemic has an impact on various aspects in Indonesian social activity life, especially in the undergraduate level education, forcing the college students to have online class. This study aims to measure the level of physical activity associated with the condition of body posture, musculoskeletal discomfort and other factors, the subject are college students who experienced 2 years online to face new normal era. The study used a cross-sectional design with a relationship analysis approach, consecutive sampling technique, with instrument IPAQ-SF questionnaire, CMDQ and NYPRS, to analyse primary data with univariate and bivariate analysis. The results (n = 112) variation of posture forward neck (76%), uneven shoulder (76%), kyphosis (68%), prevalence of musculoskeletal discomfort in lower back (38%), neck (28%), upper back (25%). The results of the bivariate analysis significance correlations between physical activity level and NYPRS (p<0.05). BMI and lumbar lordosis, anterior tilt and genu valgum (p<0.05)."

"Penanganan cedera Anterior Cruciate Ligament (ACL) berupa operasi rekonstruksidengan mengambil graft tendon pada tubuh pasien sendiri sebagai pengganti ACL.Peroneus Longus Tendon graft merupakan alternatif graft untuk meminimalisirkomplikasi yang berkaitan dengan penggunaan graft dari area sekitar lutut.Peroneus Longus tendon graft dikatakan memiliki komplikasi pada donor siteantara lain instabilitas ankle serta menurunnya kekuatan fleksi 1st ray dan eversiankle. Penelitian ini mencari perbedaan terkait dengan komplikasi donor sitedengan membandingkan tehnik pengambilan graft dengan dan tanpa penjahitanpada distal stump Peroneus Longus tendon terhadap peroneus brevis tendon.Penelitian ini adalah studi yang mencari hubungan antar variabel dengan desainrandomized controlled trial untuk mengetahui luaran fungsional secara subyektifdan obyektif. Rata-rata usia subyek adalah 26.08 ± 2.4 tahun. Dari 13 subjek, 11laki-laki dan 2 perempuan. Pada kelompok penjahitan didapatkan rerata deltakekuatan otot pre operasi terhadap 6 bulan pasca operasi 0.88±0.22 kg, sedangkanpada kelompok tanpa penjahitan adalah 0.67 (0.33-6) kg. Pada kelompok denganpenjahitan didapatkan rerata Clarke’s angle pasca operasi 6 bulan 39.67± 1.28derajat dan pada kelompok tanpa penjahitan distal stump adalah 39.5± 1.50 derajat.Pada pengukuran subyektif The American Orthopedic Foot and Ankle Score(AOFAS), dan visual analogue scale foot and ankle (VAS-FA), kelompok denganpenjahitan lebih superior daripada tanpa penjahitan dalam hal kenyamanan pasien.Pengambilan graft peroneus longus baik dengan dan tanpa penjahitan distal stumptidak menurunkan kekuatan otot plantarfleksi dan tidak menyebabkan perubahanbentuk arch kaki. Penjahitan distal stump saat pengambilan graft peroneus longusmengurangi kemungkinan komplikasi nyeri baik pada 3 bulan dan 6 bulan pascaoperasi.

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Anterior Cruciate Ligament (ACL) rupture treatment is a reconstructive surgery by

taking a tendon graft on the patient's own body as a substitute for ACL. Peroneus

Longus Tendon graft is an alternative graft to minimize complications related to

the use of graft from the area around the knee. Peroneus Longus tendon graft is

said to have complications at donor sites including ankle instability and decreased

flexion strength of 1st ray and ankle eversion. This study looked for differences

related to donor site complications by comparing graft harvest techniques with and

without suturing of the Peroneus Longus tendon distal stump to the peroneus brevis

tendon. This study is a study that looks for relationships between variables with

randomized controlled trial designs to find out functional outcomes subjectively

and objectively. The mean age of the subjects was 26.08 ± 2.4 years. Of the 13

subjects, 11 were male and 2 were female. In the suturing group, the mean preoperative

delta muscle strength of 6 months postoperatively was 0.88 ± 0.22 kg,

whereas in the group without suturing it was 0.67 (0.33-6) kg. In the group with

suturing, the mean Clarke’s angle postoperatively was obtained 6 months 39.67 ±

1.28 degrees and in the group without distal stump suturing was 39.5 ± 1.50

degrees. In the subjective measurements of The American Orthopedic Foot and

Ankle Score (AOFAS), and visual analogue scale foot and ankle (VAS-FA), group

with suturing are superior to those without suturing in terms of patient comfort.

Peroneus longus graft harvesting both with and without distal stump suturing does

not decrease plantarflexion muscle strength and does not cause changes in foot

arch. Distal stump suturing reduces the"

"Latar belakang: Anterior knee pain (AKP) merupakan penyebab utama terjadinyapermasalahan yang persisten paska dilakukannya TKR. Saat ini di Indonesia belumterdapat data mengenai luaran ini untuk mengevaluasi paska dilakukannya operasiTKR, oleh karenanya kami merasa perlu untuk dilakukannya penelitian ini.Metode: Penelitian ini merupakan penelitian kohort retrospektif. Subjek adalahpasien yang menjalani operasi TKR di RS Cipto Mangunkusomo sejak Januari 2011sampai Januari 2019. Pada penelitian ini, didapatkan total 69 lutut dimana 39 lututdilakukan tindakan non-resurfacing sementara 30 lutut dilakukan resurfacing.Pasien dengan revisi TKR, riwayat infeksi sendi lutut atau tumor, implantloosening, riwayat operasi pada sendi lutut sebelumnya di eksklusi dari penelitianini.Hasil: Pada kelompok non-resurfacing terdapat 32 lutut perempuan (82,1%) dan 7lutut laki-laki (17,9%), sementara kelompok resurfacing terdapat 22 lututperempuan (73,3%) dan 8 lutut laki-laki (26,7%). Baik pada kelompok nonresurfacingdan resurfacing, terdapat peningkatan skor paska operatif joint motion(p<0,001) dan expectation (p=0,046) dengan pengukuran KSS, namun nilaisatisfaction dibandingkan preoperative dan paska operatif pada kedua kelompokmenunjukan perbedaan yang tidak bermakna (p=0,314) dibandingkan dengansebelum dilakukannya operasi. Pada penilaian dengan kuesioner Kujala, ditemukanperbedaan bermakna skor total (47 [42-58] vs 55 [45-63]; p < 0,001), limp (3 [3-5]vs 5 [2-5]; p < 0,001), support (3 [3-5] vs 5 [3-5]; p < 0,001), walking (2 [2-3] vs 2[2-5]; p < 0,035), running (0 [0-6] vs 3 [0-8]; p < 0,001), jumping (0 [0-0] vs 3 [0-8]; p = 0,010), dan flexion deficiency (3 [0-3] vs 3 [0-5]; p = 0,021).Kesimpulan: Kami menemukan bahwa TKR non-resurfasing berhubungan dengankejadian AKP. Namun tidak terdapat perbedaan skala nyeri diantara kelompokresurfacing dan non-resurfacing patella. Selain itu, terdapat perbedaan signifikanskor Kujala dan KSS pada kedua kelompok.

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Background: Anterior knee pain (AKP) is a main problem that commonly occurs

after total knee replacement (TKR). In Indonesia, there are no data regarding this

outcome.

Methods: This study aims to evaluate AKP after TKR. This was a retrospective

study. Subjects were patients who underwent TKR from January 2011 to January

2019.

Results: There were 69 knees in this study, in which 39 subjects were nonresurfaced.

Those with revision TKR, history of infected knee joint or tumor,

implant loosening, history of infected knee joint, were excluded from this study. In

the non-resurfaced group, there were 32 (82.1%) women’s knees and 7 (17.9%)

men’s knees. Whereas, in the resurfaced group, there were 22 (73.3%) women’s

knees, and 8 (26.7%) men’s knees. In both the non-resurfaced and resurfacing

groups, there was an increase in joint motion scores (p<0.001) and expectation

(p=0.046) by measuring KSS but satisfaction scores compared to preoperative and

postoperative in both groups showed no significant differences (p=0.314)

compared to before surgery. In the assessment using the Kujala questionnaire,

differences in total score (47 [42-58] vs 55 [45-63]; p <0.001), limping (3 [3-5] vs

5 [2-5]; p <0.001 ), support (3 [3-5] vs 5 [3-5]; p <0.001), walking (2 [2-3] vs 2

[2-5]; p <0.035), running (0 [0- ] 6] vs 3 [0-8]; p <0.001), jump (0 [0-0] vs 3 [0-

8]; p = 0.010), and flexion deficiency (3 [0-3] vs 3 [ 0 -5]; p = 0.021).

Conclusion: We found that non-resurfacing patellar TKR was associated with

AKP. But there was no difference in pain scale between the resurfacing and nonresurfacing

patella groups Moreover, there were significant differences of both

Kujala Score and Knee Society Score in both groups."

"ABSTRAKFluoroquinolon memiliki efek terhadap mekanisme penyembuhan ruptur tendon Achilles. Penelitian ini dilakukan untuk menilai efek siprofloksasin terhadap proses penyembuhan tendon in vivo. Efek obat diperiksa terhadap biomekanik dan histopatologik tendon Achilles tikus. Uji eksperimental ini menggunakan siprofloksasin selama 2 kali/hari selama 15 dan 35 hari berturut-turut. Asesmen pada tendon Achilles mencakup pengukuran ultimate tensile force (UTF) dan skor histopatologik Bonar. Rerata UTF dan skor proliferasi tenosit pada grup kontrol signifikan dibandingkan grup perlakuan pada protokol 15 hari p<0.004 dan p<0,002. Tidak ada perbedaan bermakna pada skor kolagen, ground substance, dan vaskularisasi. Berdasarkan penelitian ini, siprofloksasin terbukti menurunkan kekuatan biomekanik, metabolisme tenosit, kolagen, dan matriks selama proses penyembuhan tendon Achilles model tikus.

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ABSTRACTFluoroquinolon has a side effect on the healing process of Achilles tendon rupture. The purpose of this experimental research is to evaluate ciprofloxacin towards tendon healing (in vivo) in respect to biomechanic and histopathologic of Achilles tendon. Ciprofloxacin is administered 2 times per day within 15 and 35 days follow-up. After that, Achilles tendon is measured for ultimate tensile force (UTF) and Bonar histopathologic score. According to this research, the mean of UTF and tenocyte proliferation score is significant in control group compared to intervention group on day-15 (p<0.004 and p<0.002 consecutively). The statistical significance is narrow in collagen score, ground substance, and vascularization. Based on those foundings, ciprofloxacin has been proven to reduce biomechanical force, tenocyte metabolism, collagen, and matrix during the healing process of Achilles tendon in rat model."

"ABSTRAKPendahuluan Penggunaan tandur tulang lokal saat ini masih menjadi pilihan utama dalam tatalaksana fusi posterolateral pada kasus spondilosis lumbal di negara berkembang. Rendahnya tingkat fusi yang dihasilkan oleh tindakan ini mendorong penggunaan alternatif material lain. Penambahan aspirat sumsum tulang pada tandur tulang lokal dapat menjadi pilihan yang efektif dalam tatalaksana fusi posterolateral pada pasien spondilosis lumbal, namun saat ini belum ada data mengenai luaran klinis dari tatalaksana jenis ini di Indonesia. Metode Penelitian ini merupakan metode Kohort Retrospektif pada 38 pasien dengan tatalaksana fusi posterolateral dengan menggunakan tandur tulang lokal yang terbagi atas 19 pasien kelompok dengan penambahan aspirat sumsum tulang dan 19 pasien kelompok tanpa penambahan aspirat sumsum tulang. Seluruh pasien mendapatkan tindakan operasi setelah tindakan konservatif gagal dalam mengatasi keluhan nyeri. Evaluasi klinis pada masing-masing kelompok menggunakan skor IDO dinilai sebelum operasi, bulan ke-3 dan ke-6 setelah operasi. Hasil Tiga orang Ahli Orthopaedi Divisi Tulang Belakang melakukan operasi fusi posterolateral dan stabilisasi posterior. Perbandingan skor IDO sebelum operasi di antara kedua kelompok tidak menunjukan perbedaan yang bermakna. Tidak terdapat perbedaan bermakna rerata skor IDO pada kedua kelompok hingga bulan ketiga. Namun, perbandingan skor IDO pre operasi dan 6 bulan paska operasi menunjukkan kelompok dengan penambahan aspirat sumsum tulang akan menghasilkan rerata skor IDO lebih baik. Kesimpulan Luaran klinis pasien spondilosis lumbal yang menjalani fusi posteralateral menggunakan tandur tulang lokal dengan penambahan aspirat sumsum tulang menunjukkan hasil yang baik. Penambahan aspirat sumsum tulang pada fusi posterolateral menggunakan tandur tulang lokal dapat dipertimbangkan sebagai alternatif bagi pasien spondilosis lumbal yang diindikasikan untuk tindakan operatif.

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ABSTRACTIntroduction The use of local bone graft still a mainstay in posterolateral fusion surgery for lumbar spondylosis cases in developing countries. Low rates of fusion encourage the alternative use of other materials. The addition of bone marrow aspirates in the local bone graft may be an option in the treatment of posterolateral fusion in the lumbar spondylosis patients, however there is no data on the clinical outcomes of treatment of this procedure in indonesia. Methods A retrospective cohort study was conducted in 38 patients treated by posterolateral fusion using local autograft that were divided into 19 patients with addition of bone marrow aspirates and 19 patients without addition of bone marrow aspirates. All patients received surgery after conservative treatments failed to address the complaint of pain. Clinical evaluation in each group using ODI score assessed preoperatively, 3rd, and 6th month postoperatively. Results Three Orthopedic Spine Surgeon performed posterolateral fusion and posterior stabilization. Comparison of preoperative ODI score between the two groups showed no significant difference. There were no significant differences in ODI score mean in both groups in 3 months after surgery. However, the bone marrow aspirate group produced a better mean difference of ODI score after 6 months. Conclusions The clinical outcomes of lumbal spondylosis patients undergoing posteralateral fusion using local autograft with addition of bone marrow aspirate showed good results. The addition of bone marrow aspirates in posterolateral fusion using local bone graft can be considered as an alternative for lumbar spondylosis patients who are indicated for surgery. "

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Spesialisasi cabang olahraga didefinisikan sebagai latihan yang intensif sepanjang tahun dan banyak dilakukan pada anak dan remaja. Latihan intensif dengan jumlah jam latihan yang tinggi akan meningkatkan risiko cedera. Salah satu cedera di lutut pada atlet remaja adalah Tibial Tubercle Apophysitis (TTA). Desain penelitian ini adalah potong lintang pada 168 atlet remaja berusia 10-15 tahun (rata-rata usia 14,5 ± 1,10) yang melakukan spesialisasi pada 18 cabang olahraga di Pusat Pelatihan Olahraga Pelajar (PPOP) di Jakarta. Akan dicatat usia, jenis kelamin, indeks massa tubuh (IMT), lama berlatih di PPOP, jumlah jam latihan/minggu yang melibatkan sendi lutut dan pemeriksaan kebugaran (fleksibilitas otot kuadrisep, hamstring, dan kekuatan otot tungkai) untuk kemudian dianalis dengan kejadian TTA. Didapatkan 22 dari 168 subjek dengan TTA pada 11 dari 18 cabang olahraga dengan Prevalensi 13,1%. Terdapat hubungan jumlah jam latihan per minggu dan TTA dengan nilai median 20 jam. Selain itu  juga terdapat hubungan fleksibilitas yang kurang dengan TTA. Tidak didapatkan hubungan antara usia, jenis kelamin, IMT, lama berlatih, dan kekuatan otot tungkai dengan TTA. Selama program latihan, jumlah jam latihan/minggu lebih dari 20 jam dan adanya fleksibilitas kuadrisep yang kurang perlu dipantau serta dievaluasi untuk kemungkinan terjadinya TTA pada atlet remaja yang melakukan spesialisasi cabang olahraga.

 

 

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Sports specialization is defined as intense and year-round training in children and adolescents and widely adopted as a process to form elite athletes. Intense training with a high number of weekly training hours can increased risk of injury. One of the injuries in adolescent athlete is Tibial Tubercle Apophysitis (TTA). A cross-sectional study was conducted in 168 adolescent athletes specializing in sports with age ranged between 10 and 15 years (mean 14,5 ± 1,10). from 18 sports in Student Sports Training Center (PPOP) in Jakarta. Age, sex, Body Mass Index (BMI), period of training in PPOP, weekly training hours involving the knee joint, flexibility (quadriceps & hamstring) and leg muscle strength are recorded for later analysis. From 168 subjects, 22 were found with TTA in 11 sports with a prevalence of 13.1%. There is association between weekly training hours and TTA with a median value of 20 hours. There is also association of poor quadriceps muscle flexibility with TTA. There was no association between age, sex, BMI, period of training, and leg muscle strength with TTA. More than 20 hours of weekly training and poor quadriceps flexibility during periodization needs to be monitored and evaluated for the possibility of TTA occurrence in adolescent athletes who specialize in single sports.

 

 

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"Latar belakang. Cedera olahraga di bagian lutut yang paling sering ditemukan adalah cedera meniscus dan ligamentum cruciatum anterius. Selama cedera terjadi penurunan tingkat kebugaran fisik. Untuk dapat kembali ke olahraga dengan optimal, olahragawan membutuhkan kebugaran fisik yang baik. Ini adalah penelitian pertama melihat gambaran sosiodemografik dan kebugaran fisik terkait kesehatan pada olahragawan pasca reconditioning yang menjalani tindakan rekonstruksi ligamentum cruciatum anterius di Indonesia. Metode. Penelitian ini merupakan studi potong lintang dengan pendekatan deskriptif analitik yang menggunakan sumber data sekunder berupa rekam medis RS di Tangerang Selatan selama periode dua tahun. Hasil. Karakteristik sosiodemografik memperlihatkan sebagian besar subyek mempunyai jenis kelamin laki-laki dengan usia di atas 25 tahun, memiliki tingkat pendidikan dasar-menengah, merupakan olahragawan amatir yang menekuni cabang olahraga kontak, mengalami cedera pada saat latihan dengan mekanisme non kontak, memiliki jenis cedera lutut tunggal, dan tingkat kepatuhan latihan baik. Sebagian besar subyek mencapai hasil kebugaran fisik pasca reconditioning yang baik, meliputi komponen daya tahan kardiorespirasi, kekuatan otot, daya tahan otot, dan fleksibilitas. Tingkat kepatuhan merupakan variabel yang berkontribusi besar terhadap kekuatan otot dan daya tahan otot. Kesimpulan. Program reconditioning di RS X memberikan hasil tingkat kebugaran fisik yang baik dan faktor yang paling berkontribusi adalah tingkat kepatuhan latihan.

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Background. Meniscus and anterior cruciate ligament (ACL) are the most common knee sports injuries. During the injury there is a decrease in the level of physical fitness. Athletes need good physical fitness to be able to return to sports optimally. This is the first study to look at sociodemographic and health-related physical fitness post-reconditioning in athletes undergoing ACL reconstruction in Indonesia. Method. This is a cross-sectional study with an analytic descriptive approach using secondary data sources in the form of hospital medical records in South Tangerang for a period of two years. Results. Sociodemographic characteristics show that most of the subjects are male, aged over 25 years, have a primary-secondary level of education, are amateur sportsmen who pursue contact sports, experience injuries during non-contact training, have a single knee injury, and the level of exercise compliance is good. Most of the subjects achieved good post-reconditioning physical fitness, including components of cardiorespiratory endurance, muscle strength, muscle endurance, and flexibility. The level of compliance is a variable that contributes greatly to muscle strength and muscle endurance. Conclusion. The reconditioning program at Hospital X provide a good level of physical fitness and the most contributing factor was the exercise compliance level"