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"[ABSTRAKLatar belakang : Cedera ligamentum krusiatum anterior merupakan salah satu cedera olahraga yang sering terjadi. Penanganan dengan operasi rekonstruksi diharapkan dapat membantu pasien untuk kembali melakukan aktivitas fisik seperti semula. Tujuan: Mengetahui aktivitas fisik dan kemampuan fungsional pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga, serta faktor-faktor yang mempengaruhinya. Metode: Dikumpulkan 11 subyek dari daftar rumah sakit tempat praktek dokter spesialis bedah ortopedi anggota IHKS dan IOSSMA. Data demografik dan kondisi fungsional subyektif lutut dikumpulkan menggunakan kuesioner IKDC, data aktivitas fisik menggunakan kuesioner aktivitas fisik Tegner, dan data kondisi fungsional obyektif lutut menggunakan tes lompat satu kaki. Hasil: Sebagian besar subyek memiliki indeks massa tubuh di atas normal dan kebiasaan merokok. Seluruh cedera ligamentum krusiatum anterior yang dialami terjadi akibat suatu mekanisme cedera non-kontak dengan biomekanisme yang khas, yaitu: permukaan plantar kaki menempel di lantai dan berada di posisi menjauhi pusat massa tubuh, sendi lutut berada dalam keadaan hampir ekstensi dan valgus, serta batang tubuh bergeser ke lateral. Namun, sebagian besar subyek tidak menjalani program rehabilitasi sebelum operasi rekonstruksi. Hampir seluruh subyek memiliki tingkat aktivitas fisik lebih rendah dibandingkan dengan tingkat aktivitas fisiknya sebelum cedera, dan alasan utamanya adalah karena adanya rasa takut untuk kembali ke aktivitas fisiknya seperti semula. Sebagian besar subyek memiliki kondisi fungsional sendi lutut yang buruk, baik secara subyektif maupun obyektif, dan didapatkan kecenderungan adanya hubungan antara hal tersebut dengan beberapa faktor, yaitu jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum maupun sesudah operasi rekonstruksi. Kesimpulan: Pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga memiliki tingkat aktivitas fisik dan kemampuan fungsional yang rendah. Dan terdapat kecenderungan bahwa hal tersebut dipengaruhi oleh jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum dan sesudah operasi rekonstruksi yang dijalani.

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ABSTRACTBackground: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstruction surgery. It is hoped that the patient can get back to previous physical activity level after the surgery. Objective: To know the physical activity level and functional ability of patients 12-24 months post anterior cruciate ligament reconstruction surgery due to sports injury and their related factors. Methods: Eleven subjects were selected from hospitals where orthopedic surgeons of IHKS and IOSSMA having their practice. The followings data were collected: demographic and subjective functional knee evaluation using IKDC questionnaire, physical activity level using Tegner activity scale, and objective functional knee evaluation using single leg hop test. Results: Most of the subjects had high body mass index and smoking habit. All the anterior cruciate ligament injuries happened due to a non-contact mechanism with a classic biomechanics: plantar surface of the foot planted on the ground and positioned away from the center of mass of the body, valgus and almost fully extended knee, and lateral trunk motion. Unfortunately, most of the subjects did not have pre-surgical rehabilitation program. Almost all the subjects had a lower physical activity level compare to the one before injury, and the main reason was afraid to do their previous physical activity. Most of the subjects also had bad subjective and objective functional knee condition, and there was a possibility that it was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-reconstruction surgery. Conclusion: The patients 12-24 months post ACL reconstruction surgery due to sports injury had low physical activity level and functional ability. There was a propensity that this condition was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery., Background: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstructionsurgery. It is hoped that the patient can get back to previous physical activity levelafter the surgery.Objective: To know the physical activity level and functional ability of patients12-24 months post anterior cruciate ligament reconstruction surgery due to sportsinjury and their related factors.Methods: Eleven subjects were selected from hospitals where orthopedicsurgeons of IHKS and IOSSMA having their practice. The followings data werecollected: demographic and subjective functional knee evaluation using IKDCquestionnaire, physical activity level using Tegner activity scale, and objectivefunctional knee evaluation using single leg hop test.Results: Most of the subjects had high body mass index and smoking habit. Allthe anterior cruciate ligament injuries happened due to a non-contact mechanismwith a classic biomechanics: plantar surface of the foot planted on the ground andpositioned away from the center of mass of the body, valgus and almost fullyextended knee, and lateral trunk motion. Unfortunately, most of the subjects didnot have pre-surgical rehabilitation program. Almost all the subjects had a lowerphysical activity level compare to the one before injury, and the main reason wasafraid to do their previous physical activity. Most of the subjects also had badsubjective and objective functional knee condition, and there was a possibility thatit was affected by the time interval duration between the injury and reconstructionsurgery, and the rehabilitation program given pre- and post-reconstructionsurgery.Conclusion: The patients 12-24 months post ACL reconstruction surgery due tosports injury had low physical activity level and functional ability. There was apropensity that this condition was affected by the time interval duration betweenthe injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery.]"

"Pendahuluan: Personel militer memiliki resiko yang tinggi mengalami cedera anterior cruciate ligamen (ACL) dibandingkan pada populasi secara umum. Cedera ACL yang tidak ditangani akan menyebabkan terhambatnya jenjang karir dan mengurangi kekuatan personel militer. Rekonstruksi ACL merupakan standar emas dalam penanganan ruptur ACL. Prosedur rekonstruksi ACL terbagi dua yaitu rekonstruksi ACL tanpa / non internal brace dan rekonstruksi ACL menggunakan internal brace, yaitu tambahan pita (polyethylene terephthlate) MersileneTMTujuan: Menganalisis perbandingan luaran fungsional prosedur rekonstruksi anterior cruciate ligament dengan metode internal brace dibandingkan non internal brace pada prajurit TNI usia produktif serta menilai hubungan lama waktu pasca operasi dengan luaran fungsional.Metode: Studi analitik kohot retrospektif ini dilakukan pada Prajurit TNI usia 18-33 tahun yang menjalani rekonstruksi ACL non internal brace atau internal brace pada tahun 2018-2023 minimum 1 tahun pasca operasi. Masing-masing subjek pada kedua kelompok menjawab 4 buah kuesioner (penilaian subjektif) yaitu IKDC, Lysholm, Tegner dan ACL-RSI dan menjalani pemeriksaan translasi anterior menggunakan Rolimeter (panilaian objektif). Data dianalisis untuk menilai perbandingan luaran fungsional pada kedua kelompok rekonstruksi ACL.Hasil: Sebanyak 53 subjek secara lengkap telah menjawab 4 kuesioner dan menjalani pemeriksaan Rolimeter yaitu 39 subjek pada kelompok internal brace dan 14 subjek pada kelompok non internal brace. Analisis menggunakan uji statistik Mann-Whitnney menunjukan bahwa luaran fungsional subjektif maupun objektif tidak signifikan berbeda antara kelompok non internal brace dan internal brace. Dikarenakan penyebaran jumlah subjek pada masing-masing tahun tidak merata, maka analitik terkait lama waktu pasca operasi dibagi menjadi 2 periode yaitu minimal 1 tahun pasca operasi (2023) dan lebih dari 1 tahun pasca operasi (2018-2022) dan didapatkan luaran fungsional pada kedua periode waktu tidak signifikan berbeda. Hasil pemeriksaan luaran fungsional secara objektif menggunakan Rolimeter, sebagian besar bernilai normal (81,11%) akan tetapi hasil pemeriksaan secara subjektif (kuesioner) didapatkan pada kedua kelompok sebanyak 62,2% menjawab kuesioner IKDC dengan hasil abnormal, 49% menjawab kuesioner Lysholm dengan hasil jelek, 37,73% menjawab kuesioner Tegner dengan hasil abnormal, dan 37,74% menjawab ACL-RSI dengan hasil buruk.Simpulan: Luaran fungsional subjektif maupun objektif antara prosedur rekontruksi ACL non internal brace dan internal brace tidak signifikan berbeda. Tidak ditemukan perbedaan yang signifikan antara lama waktu pasca operasi dengan luaran fungsional baik pada prosedur rekonstruksi non internal brace maupun internal brace. Hasil pemeriksaan luaran fungsional subjektif bisa saja berbanding terbalik dengan hasil luaran objektif

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Introduction: Military personnel are at a higher risk of anterior cruciate ligament (ACL) injuries compared to the general population. Untreated ACL injuries can hinder career advancement and reduce the strength and operational readiness of military personnel. ACL reconstruction is the gold standard for managing ACL ruptures. ACL reconstruction procedures are divided into two categories: non-internal brace ACL reconstruction and ACL reconstruction using an internal brace, which involves an additional band (polyethylene terephthalate) Mersilene™.

Objective: To analyze the comparison of functional outcomes between anterior cruciate ligament reconstruction procedures using the internal brace method and the non-internal brace method in productive-age Indonesian National Army (TNI), and to evaluate the relationship between post-operative time span and functional outcomes.

Methods: This cohort retrospective analytic study was conducted on Indonesian National Army (TNI) aged 18-33 years who underwent ACL reconstruction with either a non-internal brace or an internal brace from 2018 to 2023, with a minimum of 1 year post-operation. Each subject in both groups completed four subjective questionnaires — IKDC, Lysholm, Tegner, and ACL-RSI — and underwent an objective anterior translation examination using a Rolimeter. The data were analyzed to assess the comparison of functional outcomes in the two ACL reconstruction groups.

Results: A total of 53 subjects fully completed the four questionnaires and underwent Rolimeter examination — 39 subjects in the internal brace group and 14 in the non-internal brace group. Statistical analysis using the Mann-Whitney test showed that there was no significant difference in both subjective and objective functional outcomes between the non-internal brace and internal brace groups. Due to unequal subject distribution per year, the postoperative duration analysis was divided into two periods: a minimum of 1 year post-operation (2023) and more than 1 year post-operation (2018-2022). The functional outcomes between these two time periods also showed no significant difference. Objective functional outcome examination using a Rolimeter showed that the majority (81.11%) had normal results, whereas the subjective questionnaire results revealed that in both groups, 62.2% had abnormal IKDC scores, 49% had poor Lysholm scores, 37.73% had abnormal Tegner scores, and 37.74% had poor ACL-RSI scores.

Conclusion: There is no significant difference in both subjective and objective functional outcomes between ACL reconstruction procedures using non-internal brace and internal brace methods. No significant difference was found between post-operative time span and functional outcomes for either reconstruction procedure. Subjective functional outcome assessments may contradict objective outcome results."

"ABSTRAKOperasi Total knee replacement (TKR) adalah prosedur pilihan pada penanganan osteoartritis berat. Terdapat dua jenis prostesis yang umum digunakan, yaitu cruciate retaining (CR) dan cruciate substituting (CS). Belum ada kesepakatan ahli mengenai mana prostesis yang lebih baik. Penelitian ini bertujuan untuk membandingkan luaran fungsional pasien yang menjalani TKR menggunakan dua jenis prostesis tersebut. Penelitian ini merupakan uji klinis acak tersamar ganda. Pasien dengan osteoartritis berat dibagi 2 kelompok dan dinilai luaran fungsional 3 bulan dan 6 bulan pasca-TKR. Hasilnya sudut fleksi lutut kelompok CS lebih baik 13,1 derajat setelah 3 bulan dan 12,9 derajat setelah 6 bulan. Penilaian subjektif menggunakan skor IKDC tidak terdapat perbedaan bermakna antara kedua kelompok.

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ABSTRACTTotal knee replacement (TKR) is a procedure of choice in the management of severe osteoarthritis. Currently two types of prosthesis are widely used, cruciate retaining (CR) and cruciate substituting (CS). Experts has not yet reached agreement regarding which one is better. This study aims to compare functional outcome between the two types of prosthesis. This study was a randomized double-blind clinical trial. Patients with severe osteoarthritis were divided into two groups, and evaluated in 3 and 6 months after operation. Result of this study were that flexion angle of CS group was 13,1 degrees better in 3 months and 12,9 degrees in 6 months. Subjective evaluation using IKDC score did not show significant differences between two groups."

"Pendahuluan: Penurunan kekuatan otot quadriceps femoris dan otot hamstring merupakan komplikasi yang terjadi pada pasien post rekonstruksi Anterior Cruciate Ligament ACL jika rehabilitasi tidak dijalankan dengan tepat. Modalitas latihan di darat dan di air merupakan salah satu program rehabilitasi yang bermanfaat untuk meningkatkan kekuatan otot quadriceps femoris dan hamtring. Penelitian ini bertujuan untuk mengetahui efektifitas modalitas latihan di darat dan di air terhadap peningkatan kekuatan otot quadriceps dan hamstring pada pasien rehabilitasi post rekonstruksi ACL phase 3. Metode: Penelitian ini menggunakan quasi-experimental design dengan pendekatan pre-post test design pada 38 responden n kontrol= n perlakukan= 19. Latihan diberikan selama 60 menit dalam 12 kali pertemuan. Hasil: Terdapat perbedaan yang bermakna rerata kekuatan otot quadriceps femoris dan hamstring di darat p=0.000 dan p=0.000; alpha=0.05 ; di air p=0.000 dan p=0.000; alpa=0.05. Tidak ada perbedaan yang bermakna rerata kekuatan otot quadriceps femoris dan hamstring setelah diberikan latihan phase 3di darat dan di air p=0.146 dan p=0.231; alpha=0.05.

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Introduction Desreased strength of the quadriceps and hamstring muscles becomes a complication that occurs in post reconstruction patients Anterior Cruciate Ligament ACL if rehabilitation is not ecexuted properly. Modalities of exercise on land and in water is one of the programs that is beneficial for improving the muscle strength of quads and hamstring. This study aims to determine the effectiveness of training modalities on land and in water to increase the strength of quadriceps femoris and hamstring muscles in post reconstruction rehabilitation patients ACL phase 3. Method This study used quasi experimental design with pre post test design approach on 38 respondents n control n treatment 19. Exercises are given for 60 menutes in 12 meetings. Results There was asignificat difference mean of quadriceps femoris and hamstring muscle strength on land p 0.000 and p 0.000 alpha 0.05 in water p 0.000 and p 0.000 alpha 0.05. There was no significant difference in mean quadriceps femoris and hamstring muscle strength after phase 3 exercises on land and in water p 0.146 and p 0.231 alpha 0.05."

"Teknik rekonstruksi double bundle ACL (DBACL) atau single bundle ACL (SBACL) adalah cara operasi untuk memperbaiki putusnya anterior cruciate ligament (ACL), namun teknik rekonstruksi terbaik masih menjadi perdebatan. Tes Lachman, tes Pivot, dan rolimeter memberikan gambaran stabilitas anterior dan rotasi sendi lutut sedangkan biomarker cartilage oligomeric matrix protein cairan sinovium lutut (sfCOMP) dan MRI T2-map dapat menggambarkan integritas kartilago sendi. Tujuan penelitian ini adalah menganalisis stabilitas sendi dan integritas kartilago untuk mengetahui teknik rekonstruksi ACL yang terbaik, DBACL atau SBACL.Dilakukan uji klinis acak tersamar tunggal pada pasien Rumah Sakit Pusat Angkatan Darat Gatot Soebroto Jakarta yang menjalani operasi rekonstruksi ACL pada Januari 2019– Januari 2022. Pada kedua kelompok dilakukan tes Lachman, tes pivot, dan rolimeter, serta penilaian sfCOMP dan p MRI T2-map. Uji statistik beda dua kelompok dilakukan setelah uji normalitas pada karakteristik subjek penelitian, luaran stabilitas dan integritas sendi pada saat sebelum operasi, setelah tiga dan enam bulan operasi. Seluruh data diuji normalitas sebarannya dengan menggunakan uji Shapiro-Wilk atau Kolmogorov-Smirnov. Analisis bivariat dilakukan dengan uji T tidak berpasangan atau Mann-Whitney, analisis data kategorik menggunakan uji Chi square, analisis berpasangan dengan menggunakan Friedman dan tes Wilcoxon. Uji korelasi menggunakan Spearman. Batas kemaknaan yang dianggap bermakna adalah p < 0,05.Dari 43 pasien yang dianalisis, sebanyak 22 pasien masuk kelompok SBACL dan 21 pasien kelompok DBACL. Tidak terdapat perbedaan bermakna pada tes Lachman (p = 0,849, p = 0,126, dan p = 0,466), tes pivot (p = 0,877, p = 0,678, p = 0,904), rolimeter (p = 0,395, p = 0,566, p = 0,455), sfCOMP (p = 0,375, p = 0,990, p = 0,409), MRI T2-map (p = 0,846, p = 0,106, p >0,999), dan MRI T2-map semikuantitatif (p = 0,970, p = 0,643, p = 0,190) pada kedua kelompok sebelum operasi serta setelah tiga bulan dan enam bulan operasi. Rerata pemeriksan stabilitas sendi setiap kelompok mengalami perbaikan dari sebelum operasi, setelah tiga bulan dan enam bulan operasi (p < 0,05). Kelompok SBACL dan DBACL tidak memiliki perbedaan bermakna pada nilai sfCOMP (SBACL, p = 0,58; DBACL, p = 0,084), MRI T2-map (SBACL, p = 0,055; DBACL, p = 0,717) dan MRI T2-map semikuantitatif (SBACL, p = 0,05; DBACL, p = 0,06) saat setelah tiga bulan dan enam bulan operasi. Biomarker sfCOMP menurun setelah tiga bulan dan tidak menunjukkan perbaikan setelah enam bulan pada kedua kelompok. Pemeriksaan rolimeter tidak memiliki perbedaan bermakna dengan penanda integritas kartilago sfCOMP dan MRI T2-map. Disimpulkan rekonstruksi DBACL memberikan luaran klinis, biokimia, dan radiologis setara dengan SBACL ditinjau dari tes Lachman, tes pivot, rolimeter, serta pengukuran sfCOMP dan penilaian MRI T2-map. Tidak ada perbedaan bermakna antara stabilitas sendi dengan kadar sfCOMP dan MRI T2-map, setelah operasi rekonstruksi SBACL dan DBACL.

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The double bundle ACL (DBACL) or single bundle ACL (SBACL) reconstruction technique is a surgical technique to repair the ruptured anterior cruciate ligament (ACL). Examination of the Lachman test, Pivot test, and rolimeter represent the anterior and rotational stability of the knee joint. In addition, the biomarker cartilage oligomeric matrix protein in synovial fluid of the knee (sfCOMP) and MRI T2-map can be used to provide an overview of joint cartilage integrity. Therefore, the best ACL reconstruction technique, DBACL or SBACL, can be identified by analyzing changes in joint stability and cartilage integrity.

A single-blind randomized clinical trial was conducted to determine whether DBACL reconstruction surgery is superior to SBACL reconstruction in terms of subclinical measurements of joint stability and cartilage integrity. Lachman test, pivot test, and rolimeter, as well as the sfCOMP measurement and the MRI T2-map assessment, were evaluated on both groups. In addition, normality tests on the characteristics of the study subjects on each outcome of joint stability and joint integrity were conducted, followed by paired and unpaired statistical tests of both groups.

Of the 43 patients analyzed, 22 were allocated to the SBACL group and 21 to the DBACL group. No significant difference was found on the Lachman test (p = 0.849, p = 0.126, and p = 0.466), pivot test (p = 0.877, p = 0.678, p = 0.904), and rolimeter (p = 0.395, p = 0.566, p = 0.455), as well as sfCOMP (p = 0.375, p = 0.990, p = 0.409), MRI T2-map (p = 0.846, p = 0.106, p > 0.999), and MRI T2-map semiquantitative (p = 0.970, p = 0.643, p = 0.190) in both groups before surgery, after three months and after six months postoperative. The mean value of the joint stability examination for each group improved from before surgery, after three months, and after six months postoperative (p < 0.05). The SBACL and DBACL groups had no significant difference in sfCOMP (SBACL, p = 0.58; DBACL, p = 0.084), MRI T2-map (SBACL, p = 0.055; DBACL, p = 0.717) and MRI T2-map semiquantitative (SBACL, p = 0.05; DBACL, p = 0.06) at three months and six months. The sfCOMP biomarker showed a decrease in values after three months and did not show further improvement after six months in both groups. Rolimeter examination did not significantly correlate with the cartilage integrity marker sfCOMP and MRI T2-map. DBACL reconstruction provides results that are equivalent to SBACL in terms of Lachman tests, pivot tests, and rolimeters, as well as sfCOMP measurements and MRI T2-map assessments. No significant relationship between joint stability and sfCOMP levels and MRI T2-map, both after SBACL and DBACL reconstructive surgery."

"Aktivitas fisik merupakan secondary prevention yang dapat menurunkan angka kematian dan re-admission pada pasien STEMI. Tujuan penelitian ini adalah untuk mengidentifikasi faktor-faktor yang berhubungan dengan aktivitas fisik pasien STEMI pasca peawatan. Penelitian ini menggunakan metode cross sectional. Sebanyak 150 pasien STEMI dipilih menggunakan teknik purposive sampling. Hasil penelitian menunjukkan bahwa mayoritas pasien STEMI pasca perawatan memiliki aktivitas fisik ringan (85%). Faktor-faktor yang berhubungan dengan aktivitas fisik pasien STEMI pasca perawatan adalah usia (p=0,002), jenis kelamin (p=0,0001), lama hari pasca rawat (p=0,032), penyakit penyerta (p=0,015), depresi (p=0,003), self-efficacy (p=0,0001), dan dukungan sosial (p=0,0001). Hasil analisis multivariat menunjukkan faktor yang paling dominan berhubungan adalah self-efficacy dengan nilai OR 44,471 (CI:95%=8,816; 224,323). Penelitian ini dapat dikembangkan untuk membuat program rehabilitasi jantung berbasis komunitas sehingga meningkatkan aktivitas fisik pasien STEMI pasca perawatan.

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Physical activity is a secondary prevention in reducing mortality and re-admission in STEMI patients. The purpose of this study was to identify factors related to physical activity of after discharge STEMI patients. This study uses a cross sectional method. A total of 150 STEMI patients were selected using a purposive sampling technique. The results showed that the majority of after discharge of STEMI patients have mild physical activity (85%). Factors related to physical activity of after discharge STEMI patients were age (p = 0.002), sex (p = 0.0001), length of day after treatment (p = 0.032), comorbidities (p = 0.015), depression ( p = 0.003), self-efficacy (p = 0.0001), and social support (p = 0,0001). Multivariate analysis showed the most dominant factor is self-efficacy with OR 44.471 (95% CI = 8.816; 224.323). This research can be developed to create a community-based cardiac rehabilitation program that increases the physical activity of after discharge STEMI patients."

"ABSTRAKTotal Hip Replacement THR merupakan salah satu tindakan bedah rekonstruktif penggantian sendi panggul akibat gangguan anatomi, fungsi tubuh yang mengganggu dan berpengaruh terhadap status fungsional. Tujuan penelitian teridentifikasinya faktor-faktor yang berhubungan dengan status fungsional pasien paska operasi THR. Penelitian ini menggunakan desain case control. Penetapan jumlah sampel menggunakan nonprobability sampling dengan metoda consecutive sampling. Hasil penelitian didapatkan distribusi frekuensi status fungsional dengan menggunakan Hip Haris Score HHS proporsi responden yang mengalami gangguan status fungsional mencapai 24,4 kelompok kasus dimana diantara variabel yang mempunyai hubungan yaitu usia, program rehabilitasi dan lama rawat dengan status fungsional pasien paska operasi THR. Pada kelompok kasus usia merupakan faktor paling besar mempengaruhi status fungsional setelah dikontrol oleh program rehabilitasi dan lama rawat dengan nilai odd ratio OR usia 31,30 p value =0,031, program rehabilitasi OR 28,21, p value=0,056 dan lama rawat OR 12,99 dengan p value=0,093. Pada kelompok case penelitian ini merekomendasikan melakukan latihan meningkatkan status fungsional terintegrasi dengan memperhatikan kemampuan dan kelompok usia.

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ABSTRACTAbstractTotal Hip Replacement THR is one of the reconstructive surgery of hip joint replacements which is done due to anatomic disorder, disturbing body function and effect on functional status. The purpose of the study is to identify the factors associated with the functional status of patients post THR surgery. This research uses case control design. Nonprobability sampling with consecutive sampling method is used to determine a number of samples. The result of this research shows that the functional status of frequency distribution using Hip Haris Score HHS proportion of respondents who have functional status disorder reached 24,4 case group where among variables possess age relationship, rehabilitation program and length of stay with functional status of patient after THR surgery. In the age group, it was the greatest factor affected functional status after controlled by rehabilitation program and length of stay with the value of odd ratio OR age 31,30 p value 0,031, rehabilitation program OR 28,21, p value 0,056 and length of treatment OR 12,99, p value 0,018. Based on the result, this case study group recommends for further research to do exercise enhancing functional status integrated with attention to ability and age group."

"Latar Belakang: Cedera ligamen krusiatum anterior (ACL) yang meliputi regangan, robekan sebagian maupun robekan total pada lutut sering diderita atlet baik professional maupun amatir. Rekonstruksi ACL merupakan pengobatan standar robekan total ACL. Salah satu kunci keberhasilan rekonstruksi ACL adalah kestabilan fiksasi graft. Penggunaan fixed loop device (FLD) dan adjustable loop device (ALD) sebagai fiksasi graft mempunyai potensi terjadinya pergeseran/slippage loop graft. Penelitian ini bertujuan untuk menunjukkan adakah perbedaan bermakna slippage loop graft pada ALD dibanding FLD pada rekonstruksi ligamen krusiatum anterior di sisi femoral.              Metode: Penelitian ini adalah studi eksperimen kadaver di laboratorium forensik RS Polri Dr Soekanto dengan memakai graft tendon peroneus longus sebagai pengganti ACL. FLD menggunakan femobutton (FB), sedangkan ALD menggunakan 3 produk berbeda, lift loop (LL), ultrabutton (UB) dan infinity (IF). Dengan menggunakan 16 lutut pada 8 kadaver, masing-masing alat menggunakan 4 lutut. Pengukuran slippage dilakukan dengan penandaan ke-1 di pangkal graft tunnel tibia, setelah dilakukan pumping pada sendi lutut kemudian dilakukan penandaan ke-2 di pangkal graft tunnel tibia. Perbedaan antara penandaan ke-1 dengan ke-2 merupakan slippage loop graft yang diukur dengan pengukur. Slippage yang terjadi dilakukan pengukuran dan dilakukan perbandingan pada ALD dan FLD.                                                                                                                            Hasil: Hasil penelitian didapatkan slippage 1 mm pada FLD, sedangkan pada ALD didapatkan slippage > 1 mm. Analisis slippage tunnel tibia (rerata + SD) pada kelompok FLD=1,0±0,0 mm lebih pendek dibandingkan dengan kelompok ALD=1,6±0,2 mm (p<0,001). Berdasarkan jenis ALD diperoleh slippage (rerata + SD) yang terjadi pada kelompok IF, UB, dan LL masing-masing adalah 1,5±0,1 mm, 1,6±0,1 mm, 1,9±0,2 mm (p<0,001). Analisis post hoc menunjukkan hanya antara UB dengan IF (p>0,05) yang ukuran slippage tidak bermakna secara statistik.Kesimpulan: Penelitian ini menunjukkan perbedaan yang bermakna pada pergeseran/slippage loop graft antara penggunaan ALD dengan FLD. Dan juga perbedaan bermakna ukuran slippage antar jenis ALD. Pemanfaatan FLD sebagai alat fiksasi pada rekonstruksi ACL lebih sesuai berdasarkan ukuran slippage loop graft.

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Background: Anterior cruciate ligament (ACL) injuries which include strains, partial tears or total tears in the knee are often suffered by athletes, both professional and amateur. ACL reconstruction is the standard treatment for a total ACL tear. One of the keys to successful ACL reconstruction is the stability of graft fixation. The use of fixed loop devices (FLD) and adjustable loop devices (ALD) as graft fixation has the potential for slippage loop graft. This study aims to show whether there is a significant difference slippage loop graft in ALD compared to FLD in reconstruction of the anterior cruciate ligament on the femoral side.         

Method: This research is an experimental study of cadavers in the forensic laboratory of Dr Soekanto Police Hospital using a peroneus longus tendon graft as a replacement for the ACL. FLD uses a femobutton (FB), while ALD uses 3 different products, lift loop (LL), ultrabutton (UB) and infinity (IF). Using 16 knees on 8 cadavers, each tool uses 4 knees. Slippage measurements were carried out with the 1st marking at the base of the tibial tunnel graft, after pumping the knee joint, then the 2nd marking was carried out at the base of the tibial tunnel graft. The difference between the 1st and 2nd markings is slippage loop graft. The slippage that occurs is measured and a comparison is made between ALD and FLD.                                       

Results: The research results showed that slippage was 1 mm on FLD, while on ALD slippage was > 1 mm. Analysis of tibial tunnel slippage (mean + SD) in the FLD group = 1.0 ± 0.0 mm was shorter than in the ALD group = 1.6 ± 0.2 mm (p < 0.001). Based on the type of ALD, the slippage (mean + SD) that occurred in the IF, UB, and LL groups was 1.5 ± 0.1 mm, 1.6 ± 0.1 mm, 1.9 ± 0.2 mm, respectively. (p<0.001). Post hoc analysis showed that only between UB and IF (p>0.05) the slippage measure was not statistically significant.           

Conclusion: This study shows a significant difference slippage loop graft between the use of ALD and FLD. And also significant differences in slippage size between ALD types. The use of FLD as a fixation tool in ACL reconstruction is more appropriate based on the size of the slippage loop graft."