bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Rare Case: Ganglion Cysts in the Proximal Tibiofibular Joint Causes Lateral Side Knee Pain: A Case Report
Authors: Rawung Rawung. Bayu Valentino , Yanuarso  , Nelwan Bobby Natanel 
Published: February 2023

Introduction: Proximal tibiofibular joint (PTFJ) ganglion cysts are very rare. The pathophysiology remains unclear. Lateral knee pain was present in dominant case, and some cases accompanied with common peroneal nerve symptoms. In cases of chronic trauma, it is sometimes confused with proximal tibiofibular joint instability. Thorough examination and investigations such as MRI are highly recommended. There is no consensus of management, but some studies indication that excision of the ganglion associated with low recurrences number. Method: We report a case of 28 yeara-old woman, with a chief complain of pain on the lateral side of her right knee. Pain increasing on one last year. She had a trauma on her knee in 5 years ago. She was diagnosis with Lateral Instability of her knee by a previous surgeon and refer to our clinic for second opinion. In physical exam we found, tenderness around fibula head, Lachman, McMurray, Lelli’s test was negative. Shuck test was not evident.. MRI was done and showing partial tear of anterior horn of lateral meniscus and partial tear of anterior proximal tibia fibula ligament also a fluid collection around the fibular head. We planned to repair the meniscus through arthroscopic and stabilize the Proximal tibiofibular joint with open surgery. Results: Standard arthroscopic surgery was performed. Tear anterior horn meniscus was repair using inside out technique. In open surgery we found the anterior proximal tibiofibular ligament quite stable, and also we found a ganglion cyst around the PTFJ. We decided to leave the anterior PTFJ ligament, and excise the ganglion until its sac and follow up the case forward. Conclusion: Symptoms of pain caused by ganglion cysts in PTFJ, although rarely, can be very disturbing. The history of chronic trauma obscures this case with instability condition. There for careful diagnosis is required. Excision of the ganglion into the sac is the treatment of choice because of the very low recurrence rate. The complex anatomical composition of the lateral side of the knee can cause pain to arise from various components. The presence of PTFJ ganglion cysts should not be ignored
Do High-Flexion Total Knee Arthroplasty Have More Adverse Events™
Authors: Dusak I Wayan Suryanto , Ciatawi Kartini 
Published: February 2023

Introduction: High-flexion knee prosthesis was proposed to result in better outcomes after knee arthroplasty. However, latest meta-analysis revealed that this implant indeed only produced better range of motion (ROM) and no benefits in other functional outcomes, including weight-bearing flexion. Moreover, recent studies suggested that more complications occurred in high-flexion total knee arthroplasty (TKA) instead. Objectives: This study focuses on the adverse events of high-flexion TKA compared to standard TKA in mid to long term of follow-up. Methods: Systematic search was done in online databases, i.e. Pubmed, ScienceDirect, ClinicalKey. We only included studies with a minimum follow-up duration of 5 years, expecting that this mid to long term follow-up could provide a better picture of the outcomes. Results: Seven studies were included in the final quantitative analyses, involving a total of 2,693 knees in high-flexion TKA and 3,892 knees in standard TKA. High-flexion TKA significantly had higher revision surgery compared to standard TKA (p = 0.03), 41(1.52%) and 53 (1,36%) knees, respectively. Loosening was not statistically different between those groups. Generally, radiolucent line was also more frequently observed in high-flex TKA (p = 0.01), 7.43% V 3.83% at femoral side and 5.69% V 4.41% at tibial side. Although infection and instability were higher in high-flexion knee, only a few studies found the occurrence of these parameters. Four studies evaluated the incidence of osteolysis and none was found in both groups. Conclusion: Considering that high-flexion TKA may only yield on better ROM but carry a bigger risk of adverse events, one has to cautiously weighing up the benefits and risks when planning of delivering a high-flexion TKA.
Medial Patellofemoral Ligament Reconstruction with Quadriceps Autograft for Neglected Unreduced Patellar Subluxation: A Case Report
Authors: Hutami Wintang Dayinta Tanaya , Hasan Jafri 
Published: February 2023

Introduction: The medial patellofemoral ligament is the primary stabilizer of the patellofemoral joint. Over the past decade, reconstruction has been recommended in adults with patellar instability. However, the reconstruction methods have not been standardized. The best graft and reconstruction methods have not yet been identified Methods: A 44-year-old female patient with knee unable to flex with pain following trauma. Patient underwent medial patellofemoral ligament reconstruction with quadriceps autograft. Arthroscopy was performed on anterolateral and anteromedial of the patella, obtained elongation and titling of the patella with medial articular surface defect, debridement was conduct. The MPFL reconstruction was done with the superficial quad graft technique, the end of the graft was sutured and measured, drilled the femur on the Schottle point using C-Arm guide according to the graft diameter. The graft is placed in the subvastus space, fixation of the graft with superior to inferior side switches, examined to ensure the stabilisation of the flexion and extension tension and fixated with screw Results: After the operation, the patient is able to perform regular daily activities without any complaints Conclusion: This study has found that medial patellofemoral ligament reconstruction using quadriceps autograft leads to an acceptable functional outcome for treating neglected unreduced patellar subluxation
A Modified Mason – Allen Suture Bridge for Musculotendinous Rotator Cuff Repair in Elderly Patient: A case report
Authors: Prasetia Renaldi , Whitiana Greesea Dinamaria , Rasyid Hermawan Nagar 
Published: February 2023

Introduction: As geriatric patient remains active, high functional outcomes is expected, treating rotator cuff in geriatric patient is usual nowadays. But, compromised vascularity and healing potential of soft tissue in older patients contributes to high incidence of re-rupture. Factor could be improved for decreasing the possibility of re-rupture is the suture technique. Modified Mason-Allen technique provides better biomechanical strength which offer high fixation strength, minimal gap formation and tendon strangulation and mechanical stability until tendon healing. Case Presentation: A 62-year-old female evaluated for 1 year history of pain around her right shoulder with history of trauma 1 year prior. From the physical examination, she reported significant decrease passive and active range of movement of the shoulder, particularly on abduction which less than 90 degrees. Neer test was positive with positive on Job test and Hawkins test. MRI showed a picture of massive rotator cuff tear. Corticosteroid injection and physical therapy were performed but pain and functional limitation still persisted. We decided to perform arthroscopy. We found subscapularis longitudinal tear, LHBT tear, humeral head bone defect, subacromial bursitis and massive supraspinatus tear. We perform acromioplasty, bursectomy, subacromial decompression, subscapular repair, debridement of supraspinatus footprint and anchor placement as modified Mason-Allen suture bridge. Clinical Discussion: In order to prevent re-tears, tendon fixation to bone and footprint reconstruction are important. Trans osseous-equivalent (suture bridge) was giving better biomechanical properties for the repaired tendon. In Modified Mason- Allen techniques, combination of horizontal matrass as a rip stops and vertical simple sutures as main holding power. This suture bridge was giving a compressive mechanism for enthesis to footprint enhancing healing. Several advantages of Mason – Allen suture bridge are very strong tissue holding property, rip stop which prevent tendon pull-out and less possibility strangulation, impingement or irritation. Conclusion: Modified Mason – Allen technique provides better biomechanical strength and restoration of footprint which allow the repaired tendon to heal and decrease the incidence of re-rupture.
Characteristics of Ruptured Anterior Cruciate Ligament (ACL) Patients at Hasan Sadikin Hospital Bandung
Authors: Utoyo Ghuna Arioharjo , AS Marsahala 
Published: February 2023

Background: ACL injury is the most common injury in sports knee injuries. An ACL injury can be a stretch to the ligament or it can be completely torn. The ACL ligament is one of the main ligaments in the knee region. Discussions about ligaments in the knee joint are still rarely heard, especially in Indonesia. So there is little knowledge for the community. The discussion of literature originating from Indonesia is still small and makes it difficult for the public to obtain information related to this ligament rupture. Cases in Indonesia are quite numerous and varied, so a better understanding of ACL rupture injuries is needed. In the last 5 years, 187 cases were found at Hasan Sadikin Hospital, Bandung, with a variety of cases and different treatments, especially using the arthroscopy method. Methods: This study was conducted to determine the characteristics of ACL injured patients at Hasan Sadikin Hospital, Bandung Period January 2017 to December 2021. The inclusion criteria in this study were all patients with ACL injuries from January 2017 to December 2021 with complete medical record data. Results: The results of this study showed that the age range of ACL patients was 14-64 years, with an average age of 24.5 years. male to female is 4.67:1. There were 10 patients who were athletes. The type of ACL injury was partial, there were 39 patients and the total was 148 patients. Other comorbidities Hoffa syndrome 18 patients. Plica syndrome 30 patients. Joint flexibility 19 people, who do not have joint flexibility 168 patients. Management of patients with remnant resurface as many as 163 patients and 23 patients who underwent augmentation. Other problems after ACL surgery were 18 patients underwent menisectomy and 6 patients underwent meniscus repair Conclusion: From the results of this study, the characteristics of patients with ACL rupture were found to be on average at the age of 24.5 years, male gender, college students. 10 professional athletes suffered ACL ruptures. More patients suffered total rupture than partial. Treatment for ACL patients is more often with remnant surfaces. After ACL treatment, complications such as menisectomy could occur as many as 38 patients and 16 patients underwent meniscus repair
Anatomic Acromioclavicular Joint Reconstruction Using Semitendinosus Graft with Internal Bracing in Chronic Acromioclavicular Joint Dislocation: Case Series
Authors: Adisthanaya Surya , Febyan  , Artha Ida Ayu Ratna Dewi Arrisna , Astawa Putu 
Published: February 2023

Introduction: Acromioclavicular joint dislocations represent a frequent condition, affecting a very specific and generally active population and accounting for around 9% of all shoulder injuries. Case Presentation: We present a series of patients who underwent AC Joint reconstruction using Semitendinosus graft with internal bracing. The beach chair position is used for acromioclavicular reconstruction surgery. In this technique, we restore the anatomy, reconstruct the coracoclavicular ligament, and reinforced the acromioclavicular ligament. And it is reliable for chronic acromioclavicular joint injury. At final follow up we found excellent results with average pain score of 1.6, and average ROM of 160° of forward flexion and abduction, 70° of external rotation, and internal rotation level at T11. Postoperative function also showed great improvements with average ASES of 85 points, an average Constant Score of 89 points. This technique also achieved acceptable radiographic results, with an average coracoclavicular distance increase of 1.4 mm Discussion & Conclusion: The loss of AC joint congruence with the Weaver Dunn procedure suggested that possibly the problem wasn’t only biological. This technique seems to be especially advantageous as it allows for an anatomic, biological, and minimally invasive procedure while avoiding some of the inconveniences described in other reports. Although demanding, it can be reproducibly performed arthroscopically, and good clinical outcomes should be expected.
Interposition elbow arthroplasty clinical and functional outcomes: A Systematic review
Authors: Adhimulia Kevin Jonathan , Aminata Iman Widya , Mangasah Holong , Nugroho Johanes Jethro 
Published: February 2023

Objective: Painful and stiff elbow, especially in young patients, results in severe impairment in daily activities. Persistent pain and stiffness despite conservative treatment indicate surgical arthroplasty. Total elbow arthroplasty (TEA) is relatively contraindicated in young patients with high activity due to the risk of early prosthetic loosening. Furthermore, TEA is relatively expensive and inaccessible, especially in developing countries. Interposition elbow arthroplasty has been an alternative to TEA with the possibility of further reconstruction and lower cost. This study aimed to conduct a systematic review of literature evaluating clinical and functional outcomes of various interposition elbow arthroplasty. Methods: We conducted a systematic review to obtain outcomes of interposition elbow arthroplasty. Literature searching was conducted in PubMed, Cochrane Library, and ScienceDirect. We included clinical studies, case series, or case reports related to interposition elbow arthroplasty. Relevant studies were critically appraised by Oxford Central for Evidence-Based Medicine (CEBM) critical appraisal tool. Relevant data including functional outcome, pain, and range of motion (ROM) was then pooled and analyzed. Results: We selected 15 relevant studies including nine retrospective clinical studies, three case series, and three case reports. All studies showed significant improvement of range of motion (ROM) and Mayo Elbow Performance Score (MEPS). The pain score of MEPS also showed improvement in several studies. Pooled study analysis showed an overall Z score of 20.4 (p<0,001) for ROM with a mean difference of 55.5°, Z score of 16.28 (p<0,001) for MEPS, and 9.30 (p<0,001) for MEPS pain score. Conclusion: Interposition elbow arthroplasty significantly improved clinical and functional outcomes postoperatively in patients with stiff and painful elbows.
Comparison of Autografts vs Allografts for Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Current Perspective
Authors: Adisthanaya Surya , Febyan  , Astawa Putu 
Published: February 2023

Objective: To describe the outcomes of autografts and allografts in anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction with respect to instrumented laxity measurements, patient-reported outcome scores, complications, and graft failure risk. Methods: We searched PubMed, Cochrane Library, and EMBASE for published randomized controlled trials (RCT) and case controlled trials (CCTs) to compare the outcomes of the autografts versus allografts after cruciate ligament reconstruction. Data analyses were performed using Cochrane Collaboration RevMan 5.0. Results: Nine studies were identified from the literature review. Of these studies, three studies compared the results of bone–patellar tendon–bone (BPTB) and ligament augmentation and reconstruction system (LARS), while six studies compared the results of four-strand hamstring tendon graft (4SHG) and LARS. The comparative study showed no difference in Lysholm score and failure risk between autografts and synthetics. Discussion: The combined results of the meta-analysis indicated that there was a significantly lower rate of side-to-side difference > 3 mm (Odds Ratio [OR] 2.46, 95% confidence intervals [CI] 1.44–4.22, P = 0.001), overall IKDC (OR 0.40, 95% CI 0.19–0.83, P = 0.01), complications (OR 2.54, 95% CI 1.26–5.14, P = 0.009), and Tegner score (OR −0.31, 95% CI −0.52–0.10, P = 0.004) in the allografts group than in the autografts group. Conclusion: This systematic review comparing long-term outcomes after cruciate ligament reconstruction with either autograft or allografts suggests no significant differences in failure risk. Autografts were inferior to allografts with respect to restoring knee joint stability and patient-reported outcome scores, and were also associated with more postoperative complications.
Arthroscopy Revision of Medial Meniscus Posterior Root (MMPR) Reconstruction Using Gracillis Tendon Graft. A Case Report
Authors: Setyawan Wahyu , Artha Arrisna 
Published: February 2023

The techniques for medial meniscal posterior roots (MMPR) repair can vary in relationship to the surgical approach, type of suture, device used, and fixation technique. Anatomic reduction, meniscal root fixation, and prevent extursion are possible by the trans-tibial pull-out repair procedure for MMPR tears. But it has been found that it has a substantially weaker than the natural root with unsactisfactory healing rates. Objective: We purposed this technique to reduce the failure of meniscus repair with a more anatomical, better healing and reproducible outcome Case Presentation: A 60-year-old female patient with Medial Meniscus Posterior Root tear LaPrade classification type 2. She had arthroscopic transtibial pull-out meniscal root repair using Ethibond No. 5 non-absorbable suture material. Six months after surgery, she had retear on MMPR and we performed the arthroscopic MMPR reconstruction with gracilis tendon graft. 3 months after surgery, patient has a good function and MRI evaluation. Conclusion: This arthroscopic medial meniscus posterior root reconstruction using gracilis graft is provide an anatomical repair, a more strong with a biological healing than previous repair techniques.
Outcomes Arthroscopic Partial Menisectomy Compared with Arthroscopic Meniscal Repair on Meniscal Tears : A Systematic Review
Authors: Wisnawan I Made Yedi , Aryana IGN Wien 
Published: February 2023

Introduction: Meniscal tears is one of the most common injury in knee. The surgical management of meniscal tears has seen an increasing trend towards meniscal repair from partial meniscectomy. The purpose of this study is to evaluate and review the comparison of the results between arthroscopic partial menisectomy with meniscal repair on meniscal tears by evaluating clinical outcomes and radiological outcomes. 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. The outcomes assessed by Lysholm, Tegner IKDC, KOOS score and osteoarthritis radiological outcomes. Results: Six studies included in the systematic review. Five are retrospective cohort studies and one is prospective cohort study. Total sample size were around 527 patients, with 308 patients undergoing APM procedure and the rest 219 patients had meniscal repair. Discussion: Most studies showed meniscal repair had better outcomes compared to APM with significant difference in almost all outcomes measurement. Only one study reported APM better than meniscal tear in KOOS score. Conclusion: There are significant difference between APM and meniscal repair in the patients reported outcome and also in the OA radiologic outcomes. There is only one study that showed APM have better clinical outcomes compared with meniscal repair. The choice of which procedure to perform relies on the surgeon’s preference and the patient condition.
Blood Flow Restriction Following ACL Reconstruction
Authors: Johns William , Wiafe Bright M. , Hammoud Sommer 
Published: February 2023

Background: Blood flow restriction (BFR) therapy is a technique that uses partial occlusion of arterial blood flow in tandem with low-load resistance training to promote an environment of metabolic stress within muscle tissue. It is hypothesized that such therapy can facilitate protein synthesis and muscle hypertrophy even in the setting of age, injury, or postoperative rehabilitation—conditions which are marred by muscle atrophy and progressive loss of function. Therefore, BFR may be a successful option to facilitate strength gains even in patients unable to perform traditional high-load resistance training. Indications: BFR therapy has been shown to be efficacious when used in healthy athletes, the elderly, or in postoperative patients undergoing rehabilitation after upper or lower extremity procedures. More specifically, BFR application in patients undergoing knee surgery has been shown to reduce muscle atrophy post operatively. Technique Description: BFR involves application of a tourniquet or occlusion cuff at 70% of the determined arterial occlusion pressure (commonly 150-180 mm Hg). The arterial occlusion pressure is calculated by observing the loss of Doppler ultrasonography signal at the pedal pulses with sequential inflation of a blood pressure cuff. This cuff should be applied as proximal as possible at the affected extremity. The patient subsequently performs 5 exercises, including 3 sets of 15 repetitions of each exercise, with 30 seconds of rest in between sets. The cuff remains inflated for all 5 exercises. Results: BFR in tandem with low-load resistance training has been shown to be effective in improving lower extremity muscle torque and mass of the quadriceps and hamstring muscles when used after knee surgery, specifically anterior cruciate ligament (ACL) reconstruction. The most commonly reported adverse outcomes after BFR include muscle soreness and sensory paresthesias; however, BFR is generally believed to be safe and acceptable for use in a broad spectrum of patients. Discussion/Conclusion: Muscle atrophy and loss of strength are hallmarks of aging, injured, and postoperative patients. Traditional means of high-intensity strength training is not feasible in these patient populations, and the use of BFR in tandem with lower intensity strength training shows promise in its ability to promote improvements in muscle strength and hypertrophy. However, more high-level research into the long-term effects, complications, and optimal BFR training regimen is warranted. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.