bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACL Reconstruction for Open Physes Patient
Authors: Utoyo Ghuna Arioharjo 
Published: February 2023

Introduction: Participation of young athletes contributes to increment of ACL tears cases in children and adolescence. Management of ACL tears in that age group remains debatable. Traditionally, patients with immature bone have been treated without surgery or delayed reconstructive surgery to prevent iatrogenic growth retardation due to epiphyseal injury. However, conservative management showed poor results, the patient subsequently developed recurrent knee instability leading to progressive intraarticular damage, including secondary meniscus and chondral injuries. Special reconstruction technique is required to maintain the growth plate. The purpose of this study is to point out reconstruction technique available on managing ACL rupture. Method: This presentation review does systematic evidence based on literature review of management of ACL injury in skeletal immature patient. Results: There are some techniques that can be performed for paediatric patients are physeal sparing, with iliotibial band reconstruction, ACL reconstruction with all-epiphyseal tunnels and post distal fixation, all-epiphyseal tunnels reconstruction and fixation, partial transphyseal technique, and trans-physeal technique. The surgical technique was determined based on maturity and bone age using Tanner staging and hand radiographs. In pre pubertal patients, Tanner stage 1 or 2 (boys 12 years and girls 11 years) was performed using a physeal sparing. Young adolescents are still in their infancy, Tanner stage 3 or 4, boys 13-16 years old, it is better to have ACL reconstruction done with partial transphyseal or transphyseal technique. Older adolescents with physeal closure (males 15 years and girls 14 years) ACL reconstruction were performed as in adult patients. Discussion: The choice of reconstruction technique in pediatric patients is based on the maturity and bone age of the child. In the pre-pubertal period with Tanner stage 1 or 2 experiments can be carried out non-operative measures followed by physeal sparing reconstruction, young adolescents are still in their infancy, transphyseal reconstruction is carried out, reconstruction in older adolescents is carried out as in adults. Some consideration makes decision whether not to operate or operate the patient. Concerns regarding injury to physic, leg length discrepancy, and source of graft led the innovation of the surgical technique to reconstruct the ACL.
Meniscus Surgery in Limited Resources Setting
Authors: Giarso Peter 
Published: February 2023

Introduction: In some rural hospitals with limited resources, most meniscal tears are often untreated. A simple, low-cost option for meniscal repair or partial meniscectomy has been developed as an alternative with good results. Methods: We explain some techniques for meniscus tear treatment based on literature reviews and expert experiences. The techniques include with or without an arthroscopy setting, with or without a meniscus device, and limited supporting infrastructure such as MRI. Conclusion: Meniscus tear can be managed adequately in limited resources setting with some conditions. Good diagnosis and evaluation are important before deciding on the technique.
Understanding Lateral Ankle Instability
Authors: Pitarini Astuti 
Published: February 2023

Lateral ankle sprain is one of the most common sports injuries both in high level and recreational athletes. The frequency of injuries increases in recent years as more sports participations grow. Untreated ankle sprain can lead to deteriorated chronic ankle instability, thus understanding the management is of most important. Surgery for ankle instability can varied from a simple non augmented repair, augmented repair using autograft/allograft/or other choices of internal bracing, and revision cases of failed primary repair. The decision of what surgery is of the surgeon learning curves. However, with a proper diagnosis, a simple non augmented repair is acceptable with high success rate. In certain population and narrow indication, surgeon need other armamentarium such as augmented reconstruction using graft or other technique to avoid failure of primary case that leads to revision. At last, the success of lateral ankle instability surgery is highly dependent on proper phases of rehabilitation period. Understanding all matter that involves in the recovery of ankle ligament repair is of most important for the best outcome of the patients.
Implantless MPFL Reconstruction
Authors: Pontoh Ludwig Andre 
Published: February 2023

The medial patellofemoral ligament (MPFL) acts as primary restraint to lateral patellar dislocation and its rupture has been reported in almost all cases of acute patellar dislocation. Various surgical techniques have been described for MPFL reconstruction, using many femoral and patellar fixation techniques and different grafts. The described method of MPFL reconstruction would avoid any implants. The technique does not use any implants and could be considered when there are limited resources or economic constraints
High tibial osteotomy with ACL reconstruction
Authors: Winata Fahroni Cahyono 
Published: February 2023

Knee malalignment in coronal and sagittal can alter knee biomechanics especially in anterior cruciate ligament (ACL) deficient knee that easily underdiagnosed and can endangered the reconstructed ACL to failure. Varus deformity is one of the coronal knee malalignment that shown increased tension on ACL and contribute to medial compartment degeneration. Sagittal malalignment also shown related effects on native ACL and reconstructed one. Increased posterior tibial slope will increase anterior tibia translation in weight-bearing and increase stress received by the reconstructed ACL. Eventually will leads to failure of the reconstructed ACL. High tibial osteotomy (HTO) can be utilized for deformity correction to create more biomechanically stable knee. ACL reconstruction can be performed simultaneously with HTO to achieve better outcomes and reduce re-tear rate of the reconstructed ACL.
Correlation between Leg Length Discrepancies (LLD) with ITB Syndrome: A Systematic Review
Authors: Nurfadhilah Muhammad Iqbal , Yudhistira Jaka Fitria 
Published: February 2023

Backgrounds: Iliotibial band syndrome (ITBS) is one of the many different causes of lateral knee pain. The iliotibial band (ITB) is the distal fascial continuation of the tensor fascia lata, gluteus medius, and gluteal maximus. It traverses superficial to the vastus lateralis and inserts on the Gerdy tubercle of the lateral tibial plateau and partially to the supracondylar ridge of the lateral femur. The etiology of ITBS is controversial and likely multifactorial. One theory advocates that repetitive friction of the ITB and the lateral epicondyle during flexion and extension lead to inflammation of the contact area of the ITB. The discrepancy in leg length has long been a source of controversy in the research and clinical environment. It disagrees on many aspects, such as its effect on various neuro musculoskeletal disorders and the evaluation of different measurement methods. Several orthopaedic disorders have also been associated with LLD, including low back pain, iliotibial band syndrome, hip osteoarthritis, intervertebral disc disease, and stress fractures of the femur, tibia, fibula, and metatarsal bones. Methods: Our trial was an international, expertise-based, randomized, controlled trial. Details of the trial objectives and design have been published previously. To identify studies about correlation between leg length discrepancy with ITB Syndrome, we reviewed the Cochrane, Pubmed, Embase databases for relevant articles published up to June 2022. Following the PICOS (Participants, Interventions, Comparisons, Outcomes and Study design) principle, the key search terms included (P) patients with ITB syndrome; (I) Leg length discrepancy; (C/O) the comparisons between ITB syndrome with leg length discrepancy thant without leg length discrepancy; (S) RCT, cohort study, or case-control study. Results: This study results Literature search through The flow diagram of study selection that shown in Figure 1. A total of RCT, cohort and case control study, meta analysis and systematic review about correlation between leg length dicrepancy with ITB Syndrome.Discussions: There can be a predisposition to developing IT band syndrome. Anatomy issues may include leg length discrepancy, an abnormal tilt to the pelvis, or bowed legs (genu varum). These situations can cause the IT band to become excessively tight, leading to increased friction and irritation as the band crosses over the femoral condyle with movement. leg length discrepancy, which can also increase ITB tightness. Leg length discrepancy can make an impact to biomechanical abnormalities. ITBS is usually caused by biomechanical abnormalities, often combined with overtraining. Conclusions: This confirms that may be leg length discrepancy also a factor that contributes to iliotibial band syndrome (ITBS).
Return to Activities after Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis
Authors: Kholinne Erica , Marsetio Aldo Fransiskus , Singjie Leonard Christianto , Jeon In-Ho 
Published: February 2023

Introduction: Rotator cuff tear is one of the most common disorders in orthopedic surgery. When conservative treatment fails, arthroscopic rotator cuff repair has become the most common procedure to achieve a functional shoulder. Objectives: The articles on return to activities following arthroscopic rotator cuff repair have not been collectively analyzed and investigated. We aimed to review systematically and perform a meta-analysis of studies on the return to activities which consist of the return to work, return to sports, and return to daily activities following arthroscopic rotator cuff repair. Methods: Articles regarding return-to-activities were systematically searched using databases of PubMed, MEDLINE via EBSCO, ScienceDirect, and ProQuest. The review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. The study protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews [ID: CRD42022318293]. Studies with a level of evidence 1-4 that examined the rate of return to activities after arthroscopic rotator cuff repair were included and analyzed. Results: Fifteen studies published between 2005 and 2021 were included, with 1065 patients. The patient populations are workers and athletes. The meta-analysis on the combined effect of a return to activities using the random-effects model was 88.5% (83.8% on return to work, 88.2% on return to sport, and 97.3% on return to daily activities). The mean duration for return to activities is 6.59 months. The return to activities is positively influenced by the female population, heavy workers, longer duration of symptoms, surgery in the dominant arm, and massive tear may have negatively affected the ability to RTA. Conclusion: As much as 88.5% of patients were able to return to activities after arthroscopic rotator cuff repair with a mean duration of 6.59 months. Preoperative factors may contribute to the rate and duration of return to sports. Clinical Relevance: Clinicians can educate the patients regarding the rate, duration, and factors that contribute to return to activities (return to work, sport, and daily activities) after arthroscopic surgery rotator cuff repair.
Functional Outcomes of ACL Reconstruction with Lateral Extra-articular Tenodesis Using Modified Lemaire Procedure Versus Modified MacIntosh Procedure: A Systematic Review
Authors: Laksana I Komang Mahendra , Aryana IGN Wien , Pratistha Indra Rukmana Tri 
Published: February 2023

Introduction: There is a wide variety of operating procedures for the treatment of ACL rupture with a variety of different functional outcomes. The purpose of this study was to systematically review the functional outcomes between two lateral extraarticular tenodesis (LET) procedures compared to Anterior Cruciate Ligament Reconstruction (ACLR) alone in studies with high levels of evidence. Two LET procedure was Modified Lemaire procedure and MacIntosh modified by Cocker-Arnold procedure. Methods: We performed a literature search for clinical studies comparing the two LET as an augmentation to ACL reconstruction with ACL reconstruction alone. The primary outcomes were the International Knee Documentation Committee (IKDC) score, the Lysholm score, and graft failures. We filtered all literature use inclusion and exclusion criteria to get the best quality literature that match with purpose of this study. Result: A systematic literature search was conducted online in July 2022. A total of 123 records were excluded, based on abstract and title screening. This selection process resulted in the final 6 articles for inclusion in the systematic review. The best functional outcomes were obtained from the ACL reconstruction procedure with the addition of the LET procedure, whereas between the two LET procedures did not give different results. Conclusion: ACL reconstruction with the addition of the LET procedure can maintain better rotational stability so as to reduce the incidence of graft failure and will provide better functional results compared to ACL reconstruction alone. However, the two LET procedures do not show different functional outcomes because they have the same role, which is to increase the rotational stability of the knee joint.
Quadriceps Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A literature Review
Authors: Rawung Rangga Bayu Valentino , Lubis Andri Maruli Tua , Reksoprodjo Adisa Yusuf , Baghi Raynald 
Published: February 2023

Introduction: Reconstruction of Anterior Cruciate Ligament (RACL) is a procedure to restore stability to the knee thereby protecting against the risk of damage to the meniscus and cartilage that can lead to early knee osteoarthritis. There are three popular autografts in RACL, namely Bone patellar tendon bone (BPTB), Hamstring tendon (HT), and Quadriceps tendon (QT). BPTB is the first choice in RACL, especially for professional athletes and high demand patient, while in Asian populations, HT is the most popular RACL. In Indonesia, Quadriceps tendon is less popular graft, but the use of the quadriceps tendon autograft (QTA) for RACL has received increased attention in recent times. The purpose of this review is to impart knowledge that QT actually is a suitable graft with some advantages for RACL procedure Method: This is a review article using relevant literature collected from literature searches in PubMed, reference lists in existing reviews and papers, and conference presentations on the main topic of Quadriceps Tendon Autograft and Cruciate Ligament Reconstruction. We present profile of the graft, Patient Reported Outcome, Clinical Outcome, and complication Results: we found there are similar functional results between QT and BPTB and HT in regard of post ACL stability, Range of motion, Patient Reported Outcome Measures, flexion and extension strength, graft rupture, and donor site morbidity. QT also is a versatile graft, providing many options for operators Conclusion: QT should be a good alternative graft for RACL in Indonesia
Neglected Patellar Fracture Treated Using Ipsilateral Hamstring Autograft Augmentation: A Case Report
Authors: Indrayanti Putu Mira , Lubis Andri Maruli Tua 
Published: February 2023

Introduction: Inferior pole patellar fractures occur in relatively young patients after eccentric contraction of the quadriceps or direct trauma. Early diagnosis and adequate treatment lead to excellent outcomes and prevent tendon retraction and scarring. The aim of surgical treatment is to restore of extensor mechanism rather than anatomical articular reduction. We propose a cerclage wire technique using ipsilateral hamstring augmentation for the patellar tracking restoration. Case Description: A forty nine-year-old female, presented to our sport clinic with chief complaint of pain in the left knee and difficulty in walking and standing in long period of time following a direct trauma falling from the stairs to the knee one year back. Clinical examination revealed gap in the left knee cap and the patient could not able to straighten the knee actively. Plain radiographs of knee were taken in anteroposterior and lateral views show fracture of the inferior pole of the left patella. Magnetic resonance imaging (MRI) of the knee confirmed inferior pole patellar fracture with the proximal migration of patella with no other intraarticular injuries with partial tear of left patellar tendon. Patellar tendon reconstruction was planned using ipsilateral semitendinosus (ST) and Gracillis (G) autograft and ORIF cerclage wire augmentation. Follow-up was performed after one month post-operation. Patient was able to straighten the left knee and fully weight bearing mobilized without any pain. Range of motion was 0/100 compared to the contralateral knee. Muscle atrophy was not found. Xray was performed and shows callus formation with stable fixation. Conclusion: Neglected patellar fracture is a rare occurrence, the treatment of which is a difficult challenge for orthopaedic surgeons. Therefore, the goal of surgical treatment of inferior pole fractures is restoration of extensor mechanism rather than anatomical articular reduction. In inferior pole fracture of the patella, comminution in fractured distal fragment is common and secure fixation to allow early motion is difficult to achieve. The advantage of the described technique is the possibility of immediate weightbearing and early mobilization. A parallel could be drawn with the biological augment for patellar tendon repair, in which semitendinosus augmentation allows immediate postoperative mobilization with excellent functional results. This allows patients with early functional exercise and has a positive significance for the smooth recovery of the articular surface of the patella and recovery of knee extensor device function. Functional impairment of the extensor mechanism and postoperative complications triggers the quest for finding the ideal technique.
Peroneous Longus Tendon Versus Hamstring Tendon Autograft On Anterior Cruciate Ligament Reconstruction: A Meta-Analysis and Systematic Review
Authors: Aryana I Gusti Ngurah Wien , Pramana I Gusti Ngurah Bagus Andhika , Prayudi Ida Bagus Deny , Dwipayana Anak Agung Krisna , Kristian Adiet Wahyu 
Published: February 2023

Introduction: Anterior Cruciate Ligament (ACL) injury is one of the most common knee injuries. ACL reconstruction is the current gold standard to restore functional of the knee. Graft selection is important for satisfactory outcomes. Currently, most used autograft are hamstring tendon (HT) and bone patellar tendon bone (BPTB) grafts. This study aims to thoroughly evaluate and review an alternative autograft for ACL reconstruction, which is peroneus longus tendon (PLT). Method: Systematic review and meta-analysis was conducted using PRISMA guidelines. Literature was searched through PubMed, Google Scholar, Science Direct and Cochrane Library using Boolean operators. This study included original articles reporting on (1) clinical studies of ACL reconstruction (single-bundle or double-bundle) using PLT autograft (anterior-half, posterior half, or full-thickness); and (2) studies directly comparing outcomes of PLT versus HT. All procedures were primary ligament reconstructions performed for symptomatic acute or chronic ACL injury, with or without meniscal injury. The outcomes assessed included clinical and functional outcome, namely IKDC score, AOFAS scale and FADI. Results: From 247 studies obtained, after full-text review, 4 studies met all eligibility criteria. A total of 259 patients were included in this study. No significant differences was found in IKDC score (p = 0.99) and FADI score (p = 0.11) but significant differences was found in the mean of AOFAS score in favor of HT autograft (p = 0.03). Conclusion: PLT autograft is a suitable alternative graft choice from the others for the knee of patients undergoing ACL reconstruction.
Modified Reconstruction of The Proximal Tibiofibular Joint Using Iliotibial Band: A Case Report
Authors: Siregar Eryanda Aulia 
Published: February 2023

Introduction: Instability of the proximal tibiofibular joint is a rare condition and may present with an atypical presentation due to its location and symptoms. Recent techniques and graft has allowed to repair tibiofibular joint. Iliotibial band autograft might be used as a choice for this case as its characteristic, cost effectiveness, minimal invasive graft harvesting procedure, and long term outcome bring consideration to use as choice for the treatment. Objective: To introduce the new technique for PTFJ instability by using ITB graft Case report: A 21-year-old office worker male came to our clinic with discomfort on lateral aspect of right knee. He injured his right knee after he externally twist his right knee when he was going to wake up (stand up) from bed. He experienced immediate lateral pain and swelling lateral knee pain persisted until 1 week before admitted to the hospital. Discussion: In our case, patient is a office worker without an adequate energy cause the joint becoming sublux. For the surgical technique , we took the graft form the center side of ITB with the intentional purpose of preventing Kaplan Fiber. For the reaming procedure we took place directly behind the fibula and keep the posterior capsule intact to prevent further damage and infection on surgical site. We choose to use biomaterial implant for this study because the use of biomaterial screw itself has a low complication rate compare to metallic screw with no significant different in outcome (6). This technique overall has a satisfaction result with improvement of Lyshom score Conclusion: Iliotibial band is an alternative graft that can be used for reconstruction in tibiofibular joint. For its minimal invasive technique and cost effectiveness and satisfy long term outcome coud be a consideration for the treatment in tibiofibular instability.
A Comparison of Implant Failure Incidence in Simple Fracture of the Femoral Shaft which Operated by Nailing and Plate and Screw at Hasan Sadikin General Hospital period 2019-2021
Authors: Mas’ud Mohammad Syarif , Ismiarto Yoyos Dias 
Published: February 2023

Introduction: The number of fracture incidence in Indonesia has been reported by 5,5%, which was the biggest incidence in Southeast Asia. Femur fracture was the most often case of fracture in lower extremity (39%). The treatment that often used for femur fracture was with nailing and plate and screw. The purpose of this study was to compare the implant failure incidence in simple fracture of the femoral shaft which operated by nailing and plate and screw at Hasan Sadikin General hospital Bandung period 2019 – 2021. Methods: This study used a descriptive retrospective design, obtained from medical records at Hasan Sadikin General Hospital Bandung period 2019 – 2021, the study used a total sampling. The data was chosen by inclusion and exclusion criteria. The data was processed using Microsoft Excel and SPSS then represented as research results. Results: The overall 24 patients were chosen in this study, 5 (21%) patients with implant failure in simple fracture of the femoral shaft were treated by nailing and 19 (79%) patients were treated by plate and screw. In 5 patients that operated by nailing, 4 patients were malunion fracture cases with open reduction procedure and 1 patient was fresh fracture with closed reduction procedure. All of 19 patients that operated by plate and screw were fresh fracture cases with open reduction procedure. The p-value result in comparison of incidence in implant failure with nailing and plate and screw was 0.007 which smaller than alpha (0.05). Conclusions: The incidence of implant failure in simple fracture of the femoral shaft which operated by plate and screw has higher number than nailing. P-value result was statistically indicated significant difference of incidence in implant failure between nailing and plate and screw.