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"With the time available to surgeons-in-training ever dwindling, there is great emphasis placed on practical learning tools. Mirroring his earlier book on practical procedures in trauma surgery, Prof Giannoudis has produced a reference in more elective techniques. In most medical schools, most emphasis is placed on orthopaedic trauma surgery, with elective techniques often delayed until much later in a surgeon’s training."

"Achieve optimal outcomes for your patients with this new multimedia reference. Organized by tumor then by region, this resource details diagnostic and therapeutic options for primary and malignant spinal tumors. Over 25 key procedures--including minimally invasive surgery--are presented in a concise, stepwise fashion, putting the key information you need right at your fingertips"

"This manual of spine surgery has become necessary as a consequence of the rapid expansion of instrumented spine surgery using different minimally invasive and non-fusion techniques. To do justice to this development, the manual aims to present the different techniques to spinal surgeons (orthopaedic and neurosurgeons) in a clear and instructive way using detailed illustrations. The description of different open, less invasive or minimally invasive techniques will provide the spinal surgeon with useful guidelines for their use. The success of any spinal operation depends on good definition of the indications, consideration of the contraindications, technical and organisational factors, good operating technique and correct preoperative preparation and positioning of the patient. "

"Tujuan : untuk mengetahui kejadian VTE pada pasien Indonesia yang menjalani bedah ortopedi mayor dan tidak menerima tromboprofi laksis.Metode Uji klinik terbuka pada pasien Indonesia yang menjalani bedah ortopedi mayor, dilakukan di 3 senter di Jakarta. Venografi bilateral dilakukan antara 5 dan 8 hari pasca bedah untuk menemukan VTE yang asimptomatik dan memastikan VTE yang simptomatik. Pasien dievaluasi hingga 1 bulan pasca bedah.Hasil Telah diteliti 17 pasien dengan median usia 69 tahun dan 76,5% di antaranya perempuan. Enam belas dari 17 pasien (94,1%) menjalani bedah fraktur panggul. Median waktu antara fraktur dengan tindakan adalah 23 hari (antara 2 sampai 197 hari), median lamanya tindakan bedah 90 menit (antara 60 sampai 255 menit), dan median lamanya imobilisasi 3 hari (antara 1 sampai 44 hari). Tiga belas dari 17 pasien menjalani venografi kontras untuk mendeteksi VTE yang asimtomatik. VTE ditemukan pada 9 dari 13 pasien (69,2%) saat akan keluar dari rumah sakit (RS). VTE yang simtomatik ditemukan pada 3 pasien (23,1%), semuanya dengan tanda-tanda klinis DVT dan tidak seorangpun dengan tanda klinis embolisme paru (PE). Pasien tersebut diobati dengan heparin berat molekul rendah, dilanjutkan dengan antikoagulan oral warfarin. Tidak ada kematian mendadak sampai pasien keluar dari RS. Tidak ada kasus VTE simtomatik baru sejak keluar dari RS sampai 1 bulan kemudian. Tidak ditemukan kematian mendadak, komplikasi pendarahan, ataupun perawatan ulang di RS dalam studi ini.Kesimpulan Insidens VTE asimtomatik sebesar 69,2% dan simtomatik 23,1% setelah bedah ortopedi mayor tanpa tromboprofi laksis. Studi yang lebih besar dibutuhkan untuk memastikan insidens yang benar, dan yang lebih penting, untuk menggunakan tromboprofi laksis pada pasien-pasien ini.

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Aim To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis.

Methods This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confi rm the symptomatic VTE. These patients were followed up to one month after surgery.

Results A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1%) underwent hip fracture surgery (HFS). The median time from injury to surgery was 23 days (range 2 to 197 days), the median duration of surgery was 90 minutes (range 60 to 255 minutes), and the median duration of immobilization was 3 days (range 1 to 44 days). Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2%) at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%), all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study.

Conclusion The incidence of asymptomatic (69.2%) and symptomatic (23.1%) VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA), and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted."

"This book reviews the biomaterials (metallic, non-metallic and bone allografts) used for orthopaedic applications and explains both the engineering and clinical aspects of their use and performance within the human body."

"[Latar Belakang: Posisi pasien selama tindakan anestesia spinal menentukan keberhasilan penempatan jarum spinal. Traditional sitting position (TSP) merupakan posisi standar untuk anestesia spinal, namun angka keberhasilannya masih cukup rendah. Crossed leg sitting position (CLSP) merupakan salah satu posisi alternatif dalam anestesia spinal yang memiliki kelebihan berupa derajat fleksi lumbal yang lebih besar. Penelitian ini bertujuan untuk membandingkan CLSP dan TSP terhadap keberhasilan penempatan jarum spinal pada pasien bedah urologi. Metode: Penelitian ini adalah uji klinik acak tidak tersamar terhadap pasien yang menjalani anestesia spinal untuk prosedur urologi pada bulan Maret-April 2015 di RSUPN dr. Cipto Mangunkusumo. Setelah mendapatkan persetujuan izin etik dari Komite Etik Penelitian Kesehatan FKUI-RSCM, sebanyak 138 subjek dialokasikan ke dalam dua kelompok posisi penusukan jarum spinal yaitu kelompok CLSP dan TSP. Proporsi keberhasilan penempatan jarum spinal di rongga subarakhnoid, kemudahan perabaan landmark, dan jumlah needle-bone contact pada kedua kelompok kemudian dinilai.Hasil: Enam subjek masuk kriteria pengeluaran berupa kegagalan penempatan jarum spinal setelah lebih dari sembilan kali percobaan. Tersisa 132 subjek, 67 subjek pada kelompok CLSP dan 65 subjek pada kelompok TSP, yang berhasil menyelesaikan penelitian. Keberhasilan penempatan jarum spinal secara one shot pada kelompok CLSP dan TSP tidak berbeda bermakna (64.2% vs 53.8%, p=0.227). Kemudahan perabaan landmark pada kelompok CLSP berbeda bermakna dengan TSP (94% vs 75%, p=0.003). Jumlah needle-bone contact pada kedua kelompok tidak berbeda bermakna (p=0.337). Simpulan: Keberhasilan penempatan jarum spinal pada kelompok CLSP tidak berbeda bermakna dibandingkan dengan keberhasilan penempatan jarum spinal pada kelompok TSP pada pasien bedah urologi.;Background: Patient position during spinal anesthesia plays a major role in determining the success of spinal needle insertion to subarachnoid space. Traditional sitting position (TSP) is a standard position for spinal anesthesia, but the success rate for spinal anesthesia in TSP is still quite low. Crossed leg sitting position (CLSP) is one of the alternative positions in spinal anesthesia, which can increase the degree of lumbar flexion. This study aimed to compare CLSP and TSP to the successful insertion of spinal needle in urologic surgery patients.Methods: This study was a non-blinded randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures between March-April 2015 in RSUPN dr. Cipto Mangunkusumo. After obtaining approval from FKUI-RSCM Ethical Committee, 138 subjects were allocated into two groups, CLSP group and TSP group. The proportion of successful spinal needle insertion to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contact in both groups were then analyzed and assessed.Result: Six subjects met dropout criteria, which was failure of obtaining successful spinal needle insertion after nine consecutive redirections. The remaining 132 subjects, 67 subjects in the CLSP group and 65 subjects in TSP group, successfully completed the study. The proportion of successful spinal needle insertion in a one-time shot, was not significantly different between CLSP and TSP group (64.2% vs. 53.8%, p = 0227). Ease of landmark palpation in CLSP group was significantly different with TSP group (94% vs. 75%, p = 0.003). The number of needle-bone contact in both groups was not significantly different (p = 0337).Conclusion: The proportion of successful spinal needle insertion in CLSP group was not significantly different compared to TSP group for urologic surgery patients.;Background: Patient position during spinal anesthesia plays a major role in determining the success of spinal needle insertion to subarachnoid space. Traditional sitting position (TSP) is a standard position for spinal anesthesia, but the success rate for spinal anesthesia in TSP is still quite low. Crossed leg sitting position (CLSP) is one of the alternative positions in spinal anesthesia, which can increase the degree of lumbar flexion. This study aimed to compare CLSP and TSP to the successful insertion of spinal needle in urologic surgery patients.Methods: This study was a non-blinded randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures between March-April 2015 in RSUPN dr. Cipto Mangunkusumo. After obtaining approval from FKUI-RSCM Ethical Committee, 138 subjects were allocated into two groups, CLSP group and TSP group. The proportion of successful spinal needle insertion to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contact in both groups were then analyzed and assessed.Result: Six subjects met dropout criteria, which was failure of obtaining successful spinal needle insertion after nine consecutive redirections. The remaining 132 subjects, 67 subjects in the CLSP group and 65 subjects in TSP group, successfully completed the study. The proportion of successful spinal needle insertion in a one-time shot, was not significantly different between CLSP and TSP group (64.2% vs. 53.8%, p = 0227). Ease of landmark palpation in CLSP group was significantly different with TSP group (94% vs. 75%, p = 0.003). The number of needle-bone contact in both groups was not significantly different (p = 0337).Conclusion: The proportion of successful spinal needle insertion in CLSP group was not significantly different compared to TSP group for urologic surgery patients., Background: Patient position during spinal anesthesia plays a major role in determining the success of spinal needle insertion to subarachnoid space. Traditional sitting position (TSP) is a standard position for spinal anesthesia, but the success rate for spinal anesthesia in TSP is still quite low. Crossed leg sitting position (CLSP) is one of the alternative positions in spinal anesthesia, which can increase the degree of lumbar flexion. This study aimed to compare CLSP and TSP to the successful insertion of spinal needle in urologic surgery patients.Methods: This study was a non-blinded randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures between March-April 2015 in RSUPN dr. Cipto Mangunkusumo. After obtaining approval from FKUI-RSCM Ethical Committee, 138 subjects were allocated into two groups, CLSP group and TSP group. The proportion of successful spinal needle insertion to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contact in both groups were then analyzed and assessed.Result: Six subjects met dropout criteria, which was failure of obtaining successful spinal needle insertion after nine consecutive redirections. The remaining 132 subjects, 67 subjects in the CLSP group and 65 subjects in TSP group, successfully completed the study. The proportion of successful spinal needle insertion in a one-time shot, was not significantly different between CLSP and TSP group (64.2% vs. 53.8%, p = 0227). Ease of landmark palpation in CLSP group was significantly different with TSP group (94% vs. 75%, p = 0.003). The number of needle-bone contact in both groups was not significantly different (p = 0337).Conclusion: The proportion of successful spinal needle insertion in CLSP group was not significantly different compared to TSP group for urologic surgery patients.]"

"Latar Belakang: Kualitas pemulihan pascaoperasi merupakan indikator penting dalam mengevaluasi keberhasilan tindakan pembedahan dan pelayanan keperawatan perioperatif. Namun, masih terbatas penelitian yang mengidentifikasi faktor-faktor prediktif terhadap kualitas pemulihan pada pasien pasca bedah ortopedi berdasarkan waktu pengukuran yang beragam. Tujuan: Mengetahui faktor-faktor prediktif terhadap kualitas pemulihan pasien pasca bedah ortopedi menggunakan instrumen Quality of Recovery-15 (QoR-15) yang diukur pada hari ke-2 (H+2), hari ke-7 (H+7), dan hari ke-30 (H+30) pascaoperasi. Metode: Penelitian ini menggunakan desain retrospektif analitik dengan pendekatan kuantitatif. Sampel berjumlah 117 pasien yang menjalani pembedahan ortopedi di rumah sakit universitas Indonesia.. Data dikumpulkan melalui rekam medis dan kuesioner QoR-15 pada tiga titik waktu pemulihan (H+2, H+7, H+30). Skor QoR-15 dikategorikan menjadi baik dan buruk berdasarkan nilai mean. Analisis dilakukan menggunakan regresi logistik berganda untuk mengidentifikasi faktor-faktor prediktif. Hasil: Hasil menunjukkan peningkatan rerata skor QoR-15 dari H+2 ke H+30. Pada hari ke-30, empat variabel terbukti secara signifikan berhubungan dengan kualitas pemulihan, yaitu kepuasan terhadap edukasi perioperatif (p = 0,018), komorbiditas (p = 0,008), jumlah perdarahan intraoperatif (p = 0,018). Kesimpulan: Faktor-faktor perioperatif yang dapat dimodifikasi seperti edukasi, manajemen nyeri, dan pencegahan komplikasi postoperatif terbukti menjadi prediktor utama kualitas pemulihan. Temuan ini memiliki implikasi penting dalam pengembangan intervensi keperawatan berbasis bukti untuk meningkatkan pemulihan pasien ortopedi.

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Background: Postoperative recovery quality is a key indicator in evaluating the success of surgical procedures and perioperative nursing care. However, there is still limited research identifying predictive factors of recovery quality in orthopedic postoperative patients across different time points. 

Objective: To identify the predictive factors associated with postoperative recovery quality in orthopedic patients using the Quality of Recovery-15 (QoR-15) instrument measured on postoperative day 2 (H+2), day 7 (H+7), and day 30 (H+30). 

Methods: This study employed a retrospective analytic design with a quantitative approach. A total of 117 patients who underwent orthopedic surgery at the University of Indonesia Hospital were included. Data were collected from medical records and the QoR-15 questionnaire at three recovery time points (H+2, H+7, H+30). QoR-15 scores were categorized as good or poor based on the mean score. Multivariate logistic regression was used to identify predictive factors. 

Results: The findings showed a gradual increase in the mean QoR-15 scores from H+2 to H+30. On postoperative day 30, four variables were significantly associated with recovery quality: satisfaction with perioperative education (p = 0.018), comorbidities (p = 0.008), intraoperative blood loss (p = 0.018). 

Conclusion: Modifiable perioperative factors such as patient education, pain management, and prevention of postoperative complications were found to be key predictors of recovery quality. These findings are essential for developing evidence-based nursing interventions to enhance postoperative recovery in orthopedic patients. "