bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISTRIBUTION OF KNEE OSTEOARTHRITIS CASES IN PERTAMINA BINTANG AMIN HOSPITAL, BANDAR LAMPUNG
Authors: Suleman Imam , Putra Aswedi 
Published: May 2020

Osteoarthritis is a degenarative joint disease which affects joint cartilage. Almost 80% patients movement are limited and 25 % of them can not evev perform daily activities. Due to its chronic and progressive nature, socio-economic impacts in many developed and developing countries are enormous. This study aimed to determine the distribution of patient with knee osteoarthritis in Pertamina Bintang Amin Hospital Bandar Lampung. Methods: This study is a decriptive cross sectional approach with secondary data taken from medical record. Thirty eight cases were evaluated in this study from January 2019 – Mei 2019. The variables observed include age, sex, body mass index (BMI) and occupations. Results: The result show that 36,8 % of the samples were aged 50-59 years,78,9 % of the samples were female, 71,1 % of the samples had BMI obesity, 60,5 % and 43,2 % were work as housewife. A total of 23 of 38 knee samples had grade III, and 3 of 38 knee samples alsohad grade I, and as many as 7 of the 38 knee samples had a” very severe” clinical gradation. These result may be due to patients who have low grade gradation clinics and have received medical attention at the level I health facility or II. Conclusion: Form the result of this study, it can be concluded that age, sex, BMI, occupations and Kellgren-Lawrence scoring system at Pertamina Bintang Amin Bandar Lampung is in comformity with research that has been done in many places and theories that exist. Reference: Apley, Ag., & Louis Solomon, (2017). Osteoarthritis. In David Warwick (ED). System of Orthopaedics and Trauma (10th Ed., pp. 91-105). London, UK: CRC Press. Fransen M.Bridgett L. March L.Hoy D. Penserga E. Brooks P.The Epidemiolgy os Osteoarthritis in Asia. International Journal of Rheumatic Diseases 2011;14;113-212. Zhang Fu – Quang,Wu Ming – Xia, Liu Xian – Xiang, Gender and Sex distribution of middle and old aged people with osteoarthritis in Fuzhou, Vol II, May 2009. American of Orthopaedic Surgeon, Relatioship of Osteoarthritis and Biochemical Reactions, Journal of Bone and Joint Surgery, 2004 volume II.
AUGMENTATION POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING PERONEAL LONGUS TENDON ON AVULSION PCL : CASE SERIES
Authors: Mulyadi Deri , Rhatomy Sholahudin , Utama Dwikora Novembri 
Published: May 2020

Posterior Cruciate Ligament (PCL) avulsion may mimics PCL rupture with positive posterior drawer test. Treatment of choice to PCL avulsion is vary from open surgery to arthroscopic surgery. This study aims is to evaluate the knee functional score using augmented PCL reconstruction on PCL avulsion using peroneus longus tendon. Presentation of Case: We report 3 cases, 1 male and 2 females. The result of physical examination, X-ray examination, and MRI of the knee showed a PCL avulsion. Posterior drawer test showed grade 2 result. We performed an augmented PCL reconstruction on PCL avulsion using peroneus longus tendon. Knee scoring (IKDC, Modified Cincinnati, TegnerLysholm) collected pre-operative and 2 years post-operative. The result of knee scoring was significant improved in post-operative compare to before surgery. Discussions: The use of conventional screw on thin, small, and comminuted fragments cannot fix the bone and may causes bone fragmentation. Fixation technique using sutures produces unstable results and does not provide maximum pressure to fix the bone. Augmented PCL reconstruction surgery gives excellent result based on knee scoring system. Conclusion: Augmented PCL reconstruction can be considered to be an alternative treatment of PCL avulsion because the procedure has excellent post-operative knee scoring result.
Superior Dislocation of Patella Without Osteophytes – A Rare Case
Authors: Ho Sheung Tung , Chiu Ming Yu 
Published: May 2020

A 66-year-old woman sustained a “sprain” of her right knee while walking inside a supermarket. She complained of sudden knee pain and was unable to walk or move her right knee. She attended Accident and Emergency Department and was admitted into Orthopaedic ward with a diagnosis of “patella tendon rupture”. Physical examination on admission showed swelling, bruise and local tenderness just below the inferior pole of upward migrated patella bone. The extensor mechanism was loss. Passive knee motion was 0-20 degree only, limited by pain. Plain radiographs showed superior migrated patella. Beside ultrasound showed intact patella tendon. Closed reduction without anaesthesia was done successfully with an immediate regain of knee motion to 0-80 degree. Post-reduction x ray showed reduced patella with no fracture. Follow-up at 6 weeks showed normal active motion knee motion with full quadriceps power. Superior patellar dislocation is a rare condition. At 2016, only 23 cases were reported in English literature. It should be considered as a differential diagnosis of patella tendon rupture or locked knee. Pathognomonic radiographic features include proximal displaced patella with superior pole tilted away from femur and a dimple in skin. Ultrasonography may be used to exclude patella tendon rupture, which is a more common diagnosis in elderly. Most superior dislocations are due to interlocking patella and trochlear osteophyte. This may the second reported case of superior dislocation of patella without osteophytes. Closed reduction may be done without general anaesthesia. After reduction of superior patella dislocation, the functional recovery is rapid.
Gentamycin-Loaded Bone Cement Released Time against Staphylococcus Aureus by using In Vitro Media as the Strategy for the Patient with Prostethic Joint Infection (PJI) after Hip and Knee Joint Arthroplasty
Authors: Pratama Fajar Satria 
Published: May 2020

Introduction: Joint Arthroplasty is the best treatment modality to improves joint function, relieves pain, and increase the quality of life. There were about 0.5% to 0.8% of patients performed primary total knee and hip arthroplasties has been reported with Prostethic Joint Infection (PJI). Staphylococcus aureus is one of the most virulent bacteria which has identified in the isolation caused by PJI. There were increased number of primary arthroplasties. Gentamycin is an antibiotic which has a bactericidal effect for some gram positive and most aerobic and facultative anaerobic gram negative bacteria. They act by inhibiting protein synthesis. Method: This research is an experimental study.The object is Staphylococcus aureus which was treated by Gentamycin-loaded bone cement which were divided into 3 concentrations 5%,10%, and 20%. We have observed the antibacterial effect by measured how was the released time while we put it in agar plates. We controlled them every 2 weeks for observing the inhibition of ring assays which were formed. We were also calculated the diameter of ring assay. Result: Drug release profiles showed for 5%,10%,20% Gentamycin-loaded bone cement displayed a long enough drug release time about 14 weeks. The diameters of ring assay didn’t showed if they were affected by the released time. Discussion: We have been observed about Gentamycin-loaded bone cement released time with Staphylococcus aureus,we found if it can exist more than 14 weeks.There have been no study investigated about it before. In the present study by Gaoyang in 2018,they have been observed with vancomycinloaded bone cement,they had found if vancomisin loaded-bone cement provided sufficient effective antibacterial time at least 8 weeks. Conclusion: The Gentamycin-loaded bone cement released time against Staphylococcus aureus more than about 14 weeks.There is no different result between the length of released with ring assay diameters.
Challenging Knee Reconstruction After Resection of Cavernous Hemangioma in Young Patient – A case Report
Authors: Setiawan A , Mulyadi D , Budi MNS , Tandjung FA 
Published: May 2020

Background: One of the most challenging problem of limb salvage is a large tumour involving knee joint. Large aggressive hemangioma could disrupt soft tissue and bone surrounding. Meticulous wide surgical resection was mandatory perfomed to ensure adequate resection in order to minimized recurrence. Reconstructive procedure should be individualized and aiming functional restoration. Knee Reconstruction using arthroplasty should considered Stability, Range of Motion and Longlive survival. Method: We are presenting a case 19 years girl who had pain, unable to extent the knee and dislocated patella laterally. Valgus knee deformity 30 ֯ with Range of motion limited extension 30֯ and flexion 45֯ Wide resection was done 2 years ago with clinical large of mass at harmstring muscle, pushed patella to lateral and large of cartilage erosions. The patients was prepared second operation for knee reconstruction. Knee reconstruction using standard Posterior Stabilized implant (Implancast) Approach anterior of knee, osteotomy and anteromedialisation tibial tubercle ( Fulkerson procedure) with lateral retincular release to restore patellar tracking. Exposing Joint line very narrow and fully filled with arthrofibrosis, was identified and did osteotomy . Mostly femoral and tibial cartilage has been damaged. Post operation protocol using long leg cast and delayed weight bearing for 3 weeks. Isometric exercise on the bed to maintance and regain muscle power. During 3 – 6 weeks cast was removed and patient was allowed to partial weight bearing using 2 crutches. Extensor muscle strengthening was performed gradually. Followed up until 6 months post operation. Results: After 6 months we evaluate no pain at full weight bearing, x ray no sign of loosening nor progressive deformity, good stability with varus valgus test. Range of motion full extension and 90֯ flexion. Knee Society Score was significantly increase from poor to good. Conclusion: Knee Reconstruction following tumor resection using standard implant Posterior Stabilized (PS) is possible to perfomed as long as using meticulous technique combined with selective procedures as needed to regain functional restoration.
Is This Rapid Destructive Hip Osteoarthritis ?
Authors: Sheung Tung HO , Yeung Yip Kan , Chiu Ming Yu , Hoi Yeung IP 
Published: May 2020

Rapid destructive hip osteoarthritis is a diagnosis by exclusion. It should be differentiated from septic arthritis, osteonecrosis, neuropathic arthritis and other aetiologies causing rapid bone resorption or destruction around the hip. The present study aims to review the incidence of rapid destructive hip osteoarthritis among those patients who request total hip arthroplasty for end stage arthrosis. A retrospective review of radiographs of all patients who scheduled for total hip arthroplasty from January 2010 to March 2019 were analysed by 3 orthopaedic fellows. Of 174 hips of 146 patients, 35 hips of 29 patients were considered by at least 2 orthopaedic fellows to have rapid destructive hip osteoarthritis based on radiographic criteria of rapid joint space narrowing or rapid destruction of femoral head with or without acetabular involvement. Clinical history and physical finding, blood biochemistry, cultures and pathology with or without frozen section are reviewed. Early total hip arthroplasty, rather than routine operation in the long waiting list, is recommended for rapid destructive hip osteoarthritis to prevent technical difficulty in dealing with the bone loss or defect associated with rapid destructive hip osteoarthritis. However, one must exclude septic arthritis before proceeding to total hip arthroplasty. In clinically highly suspected cases, staged total hip arthroplasty was done despite of normal initial blood investigationsand negative hip aspiration with equivocal frozen section on table. In one such patient, the culture was initially negative, but became positive only after extended period of culture. On the other hand, rapid destruction of acetabulum requiring impaction bone grafting and acetabular augmentation for total hip arthroplasty was needed in one patient. Malignancy was suspected in another patient, but there was no evidence of malignancy or infection in the femoral head and tissue obtained by excisional arthroplasty of hip. One patient with hip pain and bilateral hip involvement was found to have Charcot joint. Rapid destruction hip osteoarthritis represents an uncommon subset of arthrosis with rapid progression. A delicate balance between correct diagnosis and timely early operation should be exercised to prevent rapid loss of bone stock making delayed total hip arthroplasty become technical difficult with possible compromised outcomes.
Isolated Triplane Fracture Of Distal Tibia In Adolescent
Authors: Safie Shaqirin , Shamsudin Zulfahrizzat , Alias Azzamuddin , Ahmad Abdul Rauf 
Published: May 2020

Introduction: Triplane fracture is a traumatic ankle fracture seen in children 10-17 years of age. Name derives from the fact that the fracture exists in the frontal, lateral, and transverse planes and considered as transitional injuries because occur during the period of distal tibial physeal closure. It results from supinationexternal rotation injury, same as tillaux fracture. Report: We presented a case of 14 years old male with right ankle pain after fall with twisted position while running. Examination revealed tenderness on his right ankle, and radiograph showed Salter-Harris IV of tibial epiphysis. CT scan was performed to determine fracture configurations. Open reduction and internal fixation was done using posterolateral approach using T buttress plate 6 holes to fix the metaphysis fracture. Subsequently anterolateral incision was done to assess epiphysis fracture however fracture site not displaced thus lag screw was abandoned. Postoperatively, the ankle was protected in a backslab for 2week; thereafter, the ankle was mobilized and subjected to progressively increasing motion. Weight bearing was allowed to resume at 6 weeks postoperatively. A normal gait had been achieved by 12 weeks postoperatively. The diagnosis of Triplane fracture poses a diagnostic challenge and often missed in healthcare centres. On standard AP and lateral radiographs, the fractures cannot be easily detected because of superimposition as radiographic sensitivity for Triplane fracture is only 50%. CT scan of the ankle is recommended if clinical findings are suggestive. The treatment of the Tillaux fragment with compression screws in the case of displacement of >2 mm which achieves anatomical reduction, rigid fixation and early mobilization gives good prognosis. [Figure: see text][Figure: see text][Figure: see text] Conclusion: Displacement of >2 mm in any plane is an indication for surgery for both triplane and tillaux fracture, to prevent persistent pain and osteoarthritis in the future. CT scan of the ankle is necessary prior to surgery. References: Crawford, Alvin H Triplane and Tillaux fracture : Journal of Pediatric Orthopaedics : June 2012 - volume 32 pg S69-S73
Patella Fracture Fixation Via Wide Awake Local Anesthesia No Tourniquet (Walant) Technique
Authors: Shamsudin Z , Ahmad AA , Ahmad AR 
Published: May 2020

Introduction: Fractures of the patella constitute an estimated 1% of all acute orthopaedic fractures. The fracture fixation is usually performed under general or spinal anesthesia with tourniquet use. We describe a novel approach of anaesthesia for patella fracture fixation using the WALANT technique. Methods: We presented a case of 22 years old male with right knee pain following a road traffic accident. Examination revealed tenderness on his right knee with extensor mechanism failure, and radiograph showed comminuted 3 parts patella fracture, requiring fixation. Adequate information regarding WALANT was given and he agreed. Results: Open reduction and internal fixation were done using tension band wiring (TBW) technique and screw fixation. WALANT mixture was given 30 minutes prior to skin incision. Visual analog score (VAS) was 0 throughout the surgery. He was able to do active range of movement (ROM) of the knee intraoperatively after the fixation. Discussion: The solution used was mixture of 50ml lignocaine 2% (for local anesthesia), 1ml of adrenaline 0.18% (for hemostasis), 10ml of sodium bicarbonate 8.4% (to buffer the solution) and diluted with 50ml normal saline for tumescent anesthesia effect. Safe dosage of lignocaine with adrenaline is 7mg/kg. 10ml of mixture injected subcutaneously over mid-axial longitudinal incision site and 30 ml of mixture injected at patella borders and fracture site subperiosteally. We waited 30 minutes to allow adrenaline to reach maximal vasoconstriction and provide dry operative field. Without usage of tourniquet, we avoid complications such as hematoma and post operation swelling. WALANT also permits active motion of knee intraoperatively, which is particularly helpful in post TBW patella patient. [Figure: see text][Figure: see text][Figure: see text][Figure: see text] Conclusion: WALANT is a safe option for patients undergoing patella fracture fixation. It gave a painless surgical experience to the patient and offer another option for high risk patients for general / spinal anaesthesia. References: Lalonde D. Wide Awake Hand Surgey (2016): pg 3-32
MIS THR using anterolateral approach – the game changer in Indian scenario, early functional and radiological outcomes
Authors: Patnaik Sanjeev 
Published: May 2020

Background: Minimally invasive surgery has become a trend in the last decade in all aspects of Orthopaedic surgery, including Total Hip Replacement. The debates and the interest generated in MIS THR is considerable and several approaches have been advocated. The potential benefits include lower surgical morbidity, less pain and peri-operative blood loss, quicker rehabilitation, shorter in-patient stay and improved cosmesis. On the other hand, deficient peer-reviewed literature, a steep learning curve, increased rate of complications due to inadequate visualization, component mal-position, neurovascular injuries, dislocation and intra-operative fractures have drawn criticism. Objectives: To present the various surgical tips and tricks and early functional and radiological results of MIS THR by anterolateral approach. Study designs & Methods: The retrospective analysis of the records of patients undergoing Anterolateral MIS THR between January 2013 and January 2019 was the basis of this study. 72 hips of 70 patients were included in the study. The length of incision , duration of surgery, peri-operative blood loss, were studied. Functional assessment by Harris Hip Score, pain assessment by VAS score and radiological assessment for acetabular component and femoral stem positions were measured on plane X-rays. Data on preoperative and postoperative hemoglobin and hematocrit values, number of blood transfusions,time to ambulate as well as duration of hospital stay was studied. Results: We had no major complications in the form of mortality, fatal Pulmonary embolism , temporary femoral nerve neuropraxia was seen in 1 case, component mal-position in 3 cases , superficial infection 1 case and a non displaced proximal femoral fracture line was evident on the early postoperative X-ray of 1 case. Functional assessment by Harris Hip Score (HHS )improved from pre-operative 42 (range:26-46) to postoperative 95 (range:72-98) at 1 yr. Radiologic analysis was carried out at post-operative 6weeks, 3months,6months and 1year. Femoral stem varus alignment was seen in 3 cases, Average Acetabular cup abduction angle was 43degrees (range: 40-55 degrees). Average acetabular cup ante-version angle was 17 degrees (range: 12-25 degrees). Of the 72hips, 64 were within the Lewinnek safe zone. The average postoperative hemoglobin value was 9.7 g/dl ( range: 8.5-12.3g/dl) and the average postoperative hematocrit value was 29.8% (range: 28.1-30.6%). Conclusions: The MIS anterolateral approach allows adequate exposure for component placement, less perioperative blood loss and pain in immediate post-op period , earlier discharge from hospital along with early return to function , good cosmesis with better patient satisfaction.
Characteristics Of Neglected Fractures In Ujung Berung General Hospital, Bandung, January-December 2018
Authors: Putra Dimas Harendra S , Gardea G R. Dadan 
Published: May 2020

Introduction: The high mobility of Indonesian people in their daily lives increases the risk of accidents that can cause fractures. However, the people still believe in the handling of fractures by bone setter. Patients come with various complications,mild to severe. It also has an effect on the high total cost of care. This study aims to determine the characteristics and prevalence of neglected fractures in Ujung Berung General Hospital, Bandung, January-December 2018. Method: This study is a descriptive retrospective study, data taken from medical records of neglected fractures patients treated in Ujung Berung General Hospital in Bandung in 2018. Results: Neglected fractures sufferers treated in Ujung Berung General Hospital in Bandung in 2018 were more prevalent in men 68% and productive age 76%. With a low education level of 8%, and got the handling of a bone setter 68%. The cause of a fracture is a traffic accident 76% with the location of the most neglected fractures being the femur bone 36%. With a 3-6 day length of stay of 64%, there are 84% of patients using the BPJS payment system. Conclusion: The characteristics found in neglected fractures sufferers are more inmen, productive age, secondary education level, have been handled by bone setter, causes of fractures due to traffic accidents and femurs are the bones that have the most neglected fractures, with a maximum period of 3-6 days and BPJS payment system is most widely used by the patients.
Kinematic Analysis of Total Knee Arthroplasty using Verasense: Genesis-II prosthesis versus Anthem prosthesis
Authors: Choi Ik-sun , Na Seung-Min , Seon Jong-Keun , Song Eun-Kyoo 
Published: May 2020

Purpose The purpose of this study was to elucidate kinematic change according to the implant’s specific femoral rotation by using orthosensor (Verasense) implant with three degrees external rotation of femoral rotation rebuilt (Genesis-II) and traditional TKA implant without rebuilt of the femoral rotation (Anthem). Methods Twenty-eight patients (34 knees) underwent TKA using Anthem (Smith &Nephew, Memphis, TN, USA) and 16 patients (22 knees) underwent TKA using Genesis-II (Smith & Nephew, Memphis, TN, USA). Patients were followed up for at least 1 year. Mean age of patients was 71.1 years (range, 60 to 80 years) at the time of surgery. After implantation of femur and tibial components, we applied Verasense, the orthosensor system, to evaluate femoral rollback of the new artificial joint. Femoral rollback was analyzed using digitized screenshot function of Verasense. Results Overall femoral tracking proportion regardless of implants was significantly higher on the medial compartment compared to that on the lateral compartment (13.3 ±8.4% vs. 6.3 ± 5.0%, p < 0.001). Regarding femoral tracking according to each compartment, Genesis-II and Anthem showed 12.1 ± 8.2% and 14.2 ± 8.6% ( p = 0.371) on the medial compartment and 8.0 ± 5.8% and 5.2 ± 4.2% ( p = 0.059) on the lateral compartment, respectively. Conclusion Our study showed reverse femoral roll-back movement with higher tracking distance on the lateral compartment during TKA. Genesis-II TKA system with femoral component 3-degree rebuilt showed less roll-back difference between medial and lateral compartments compared to traditional TKA system. Fortunately, both TKA systems had excellent short-term clinical outcomes without having significant difference between the two. With longer follow-up and larger cohort, the advantage and effectiveness of femoral component rotation can be elucidated in the future.