Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 12 dokumen yang sesuai dengan query
cover
Muhammad Budimansyah
Perbandingan luaran fungsional Autograft tulang tendon patella dengan teknik Press-Fit fiksasi tanpa implan dan autograft hamstring dengan implan pada arthroskopi rekonstruksi ligamen cruciatum anterior = Functional outcome comparison of implantless bone patellar tendon autografts using press fit fixation technique and hamstring autografts using implant in arthroscopic acl reconstruction
"Pendahuluan: Rekonstruksi ACL merupakan salah satu operasi orthopaedi yang paling sering dilakukan. Beratnya cedera, mahalnya harga implan dan teknik yang cukup sulit menimbulkan masalah sosial dan ekonomi yang cukup besar pada pasien dengan cedera ACL. Rekonstruksi ACL tanpa implan dengan teknik pressfit femoral dapat menjadi alternatif untuk pasien cedera ACL. Penelitian ini bertujuan untuk mengetahui apakah rekonstruksi ACL tanpa implan memberikan luaran fungsional objektif dan subjektif setara (non-inferior) dengan metode implan.
Metode Penelitian: Duabelas pasien menjalani rekonstruksi ACL tanpa implan dengan teknik press-fit femoral dan 24 pasien menjalani rekonstruksi ACL dengan implan selama Maret 2013-Maret 2014 di RSPAD Gatot Subroto, Jakarta. Seluruh pasien diikuti mulai dari praoperasi dengan minimal follow-up 6 bulan paska operasi (cohort prospective). Luaran objektif berupa pengukuran rolimeter, serta luaran subjektif berupa skor IKDC, Tegner-Lysholm dan KOOS dinilai pada saat praoperasi, serta 1 bulan, 3 bulan dan 6 bulan pascaoperasi.
Temuan Penelitian dan Diskusi: Tidak didapatkan perbedaan yang bermakna pada luaran fungsional objektif dan subjektif antara kelompok tanpa implan dan kelompok implan pada pengukuran praoperasi, serta 1 bulan, 3 bulan dan 6 bulan pascaoperasi. Didapatkan rerata hasil pengukuran rolimeter sebagai luaran fungsional objektif pada 6 bulan pascaoperasi dengan hasil lebih tinggi pada kelompok tanpa implan (95% IK) sebesar 0,82 (-0,09-1,73) milimeter (p=0,075). Nilai rolimeter 6 bulan pascaoperasi antara lutut yang cedera dan lutut yang sehat (side to side diference) menunjukkan median rentang antar kuartil (RAK) 1,00 (0,067-2,08) dan 1,34 (0,33-1,92) milimeter (p=0,779). Median (RAK) rolimeter praoperasi dan 6 bulan pascaoperasi (time to time diference) 5,17 (3,41-6,17) dan 5,00 (4,08-6,00) pada kelompok tanpa implan dan implan (p=0,882). Median (RAK) skor Tegner-Lysholm pada 6 bulan pascaoperasi untuk kelompok tanpa implan dan kelompok implan adalah 95.00 (87.00-100,00) dan 95,00 (90.00- 100,00) dengan p=0,989. Rerata (simpang baku) skor IKDC pada 6 bulan pascaoperasi untuk kelompok tanpa impan dan kelompok implan 73.47 (10.473) dan 69,65 (10.286) (p=0.303). Penilaian KOOS 6-bulan pascaoperasi pada kelompok tanpa implan dan kelompok implan memiliki median (RAK) 90,20 (81.13-90.95) dan 88,10 (84.65-93.35) dengan p=0,999. Non-inferioritas diperiksa secara parametrik dan batas non- inferioritas selisih rerata d=8 poin untuk skor IKDC dan d=10 poin untuk skor KOOS dan Tegner, tidak terlampaui.
Simpulan: Luaran fungsional objektif dan subjektif pasien yang menjalani rekonstruksi ACL tanpa implan dengan teknik press-fit femoral menunjukkan hasil yang non-inferior dibandingkan dengan yang menggunakan implan dalam evaluasi yang dilakukan selama 6 bulan (short-term follow up).
Introduction: ACL reconstruction is one of the most common procedures performed by many orthopedic surgeons. The severity of injury, cost of implants and high demanding technique operation leave enormous social and economic issues for the patient. Implantless ACL reconstruction with press-fit femoral fixation technique is one of the alternatives to solve the problems. The aim of this study was to find whether implantless ACL reconstruction gave comparable functional outcome (non-inferior) objectively and subjectively compared to the ACL reconstruction using implant technique.
Methods: Twelve patients underwent implantless ACL reconstruction with pressfit femoral technique and 24 patients underwent ACL reconstruction with implant between March 2013 and March 2014 at Gatot Soebroto Army Hospital, Jakarta. All patients were followed from preoperative until minimum of 6 months follow up post operatively (cohort prospective). Objective functional outcome were measured using rolimeter, and subjective functional outcome were measured according to IKDC, Tegner-Lysholm and KOOS.
Result and Discussion: There were no significant differences in objective and subjective functional outcome between implantless group compared to implant group at the preoperative measurement, as well as at 1 month, 3 months, and 6 months post operative. Mean rolimeter measurement result is obtained as objective functional outcome at 6 months post operative with higher result in implantless group (95%CI) of 0,82 (-0,09-1,73) millimeter (p=0,075). Rolimeter measurement in 6 months post operation between the injured knee and the healthy knee (side to side difference) showed a median inter-quartile range (IQR) 1,00 (0,067-2,08) and 1,34 (0,33-1,92) millimeter with p value 0,799. Median (IQR) for Tegner-Lysholm score at 6 months post operation for implantless group and implant group were 95.00 (87.00-100,00) and 95,00 (90.00-100,00) respectively with p value = 0,989. Mean (Standard Deviation) IKDC score at 6 months post operative in implantless group and implant group were 73.47 (10.473) and 69,65 (10.286) respectively with p value = 0.303. KOOS assessment at 6 month post operative in implant less group and implant group have median (IQR) 90,20 (81.13-90.95) and 88,10 (84.65-93.35) respectively, with p value = 0,999. Noninferiority was checked parametrically with non-inferiority border difference mean d = 8 points for IKDC score and d = 10 points for KOOS and Tegner score, were not concede.
Conclusion: Objective and subjective functional outcome of patient who underwent implantless ACL reconstruction using press-fit femoral fixation showed a non-inferior result compared to patients who underwent ACL reconstruction using implant in 6 months of short term follow up."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Lubis, Mohammad Fachry
Luaran fraktur pelvis kompleks pasca-fiksasi interna di Rumah Sakit Cipto Mangunkusumo = The outcome of complex pelvic fracture after internal fixation surgery in Cipto Mangunkusumo Hospital
"Fraktur pelvis kompleks merupakan fraktur yang tidak stabil pada lingkar pelvis yang disertai dengan cedera jaringan lunak sekitarnya dan dapat disertai dengan gangguan hemodinamik. Fraktur ini terdapat pada 10% fraktur pelvis. Tingkat mortalitas pada fraktur pelvis kompleks mencapai 33%. Menurut data di RSCM pada tahun 2011, insidensi terjadinya fraktur pelvis sebesar tiga persen. Manajemen utama pada pasien dengan fraktur pelvis kompleks ialah manajemen perdarahan, restorasi hemodinamik, diagnosis, stabilisasi lingkar pelvis, serta penanganan yang sesegera mungkin. Hasil terbaik dicapai dengan fiksasi interna sesegera mungkin pada segmen anterior dan posterior pelvis. Morbiditas yang ditemukan ialah nyeri kronis, disfungsi seksual, infeksi, dan nonunion fraktur. Penting sekali dilakukan penelitian mengenai luaran fraktur pelvis kompleks di RSCM untuk menilai keberhasilan terapi, sehingga dapat meyempurnakan tatalaksana fraktur pelvis dan mengurangi tingkat morbiditas dan mortalitas.
Penelitian ini merupakan penelitian analitik dengan desain cross sectional. Sampel adalah semua pasien dengan fraktur pelvis kompleks yang sudah diterapi dengan ORIF pada tahun 2011-2014, kriteria inklusi penelitian ini ialah pasien dengan fraktur pelvis terbuka atau fraktur pelvis Tile tipe B atau C yang telah menjalani operasi ORIF dengan follow up lebih dari 6 bulan. Setelah itu dilakukan evaluasi morbiditas yang ditemui dan dinilai dengan skor Majeed dan Hannover. Untuk analisa univariat hubungan fraktur pelvis kompleks dengan morbidatas yang terjadi dan skor fungsionalnya dilakukan dengan menggunakan uji Fischer, sedangkan uji multivariate dengan menggunakan uji regresi logistik.
Jumlah sampel pada penelitian ini sebanyak 26 pasien. Rerata umur pasien ialah 30,54 tahun, rerata Injury Severity Score (ISS) ialah 27,2, rerata lama follow up ialah 25 bulan. Sembilan pasien merupakan pasien politrauma. Fraktur pelvis terbuka ditemukan pada tujuh pasien, sedangkan 19 pasien merupakan fraktur pelvis tertutup. Fraktur pelvis Tile tipe B ditemukan pada 15 pasien dan dengan Tile tipe C sebanyak 11 pasien. Berdasarkan skor majeed pada Tile tipe B, skor excellent ditemukan pada 73,3% kasus, skor good ditemukan pada 20 % kasus, dan skor fair ditemukan pada 6,7% kasus. Pada Tile tipe C, skor excellent hanya sebanyak 45,5%, skor good ditemukan juga sebanyak 45,5 %, dan skor fair ditemukan sebanyak pada 9% kasus. Berdasarkan skor Hannover, pada Tile tipe B skor very good ditemukan sebanyak 33.3% kasus, skor good ditemukan pada 53,3% kasus dan skor fair ditemukan pada sebanyak 6,67% kasus. Pada Tile tipe C, skor very good ditemukan pada 18,2 % kasus, skor good ditemukan pada 72,7% kasus, dan skor fair ditemukan pada 9 % kasus. Infeksi lebih sering ditemukan pada fraktur pelvis terbuka (42,9%) dari kasus fraktur pelvis terbuka. Dengan uji regresi didapatkan bahwa tipe fraktur tidak berhubungan dengan disfungsi seksual yang timbul (p>0,05), tetapi ditemukan hubungan cedera urogenital pada fraktur pelvis kompleks dengan disfungsi seksual (p=0,005). Melalui studi ini juga ditemukan hubungan tipe fraktur pelvis Tile tipe B dan C dengan terjadinya nyeri kronis (p=0,017)
Luaran fraktur pelvis kompleks di RSCM baik karena lebih dari 90% pasien memiliki skor fungsional excellent dan good (Majeed) dan skor very good dan good (Hannover). Rerata skor Majeed pada studi ini ialah 85.9. Infeksi lebih banyak ditemukan pada fraktur pelvis terbuka. Tipe fraktur tidak memiliki hubungan dengan terjadinya disfungsi seksual. Namun, tipe fraktur pelvis memiliki hubungan dengan timbulnya nyeri kronis.
Complex pelvic fracture is unstable pelvic fracture associated with soft tissue injury in pelvic region and with haemodynamic instability. This fractures only represent 10% of pelvic fracture. In 2011, the incidence of pelvic fracture in Cipto Mangunkusumo hospital is 3 %. Main management of complex pelvic fracture is bleeding management, haemodynamic restoration, pelvic ring stabilization, and early treatment. Best outcome can be achieved by performing early internal fixation of anterior dan posterior part of the pelvis. It is very important to evaluate the outcome of this type of fracture to evaluate the effectiveness of the management and to reduce the mortality and morbidity rates.
This is an analitical study with cross sectional design. The inclusion criteria are patients with open pelvic fracture, unstable Tile type B or C pelvic fracture that had already undergone ORIF between 2011-2014 and had been followed for minimum 6 months. Then mobidities and functional score were evaluated. The functional score was evaluated using Majeed and Hannover pelvic score. This study was analyzed using Fischer test and logistic regression test.
There were 26 samples with mean age 30.54, mean ISS score was 27.2, mean follow up was 25 months. Nine patients were polytrauma patients. There were seven open pelvic fractures and 19 closed pelvic fractures. There were 15 Tile Type B and 11 Tile type C pelvic fractures. According to majeed pelvic score, In type B, there was 73.3% excellent score, 20% good score, and only 6.7% fair score. In type C, there were lower patients with excellent. There was 45,5% excellent score, 45.5% good score, and 9 % fair score. According to Hannover pelvic score, in type B there was 33.3 % very good score, 53.3% good score, and only 6.67% fair score. In Tile type C, there were 18.2 % very good score, 72.7% good score, and 9% fair score. Infection occur higher in open pelvic fracture (42.9%). There was association between chronic pain and fracture type (p=0.017). There was no association between fracture type and sexual dysfunction (p>0.05), but there was association between urogenital injury and sexual dysfunction (p<0.005).
The functional outcome of complex pelvic fracture after ORIF in Cipto Mangunkusumo hospital are satisfying. There were more than 90% patients that have excellent and good score (Majeed) and very good and good (Hannover). Mean majeed score was 85.9. Infection occurred higher in open pelvic fracture. There was no association between fracture type and sexual dysfunction, but there was association between fracture type and chronic pain."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Siagian, Carles
Efek Pemberian Kombinasi Glukosamin-Kondroitin Sulfat, Kombinasi Glukosamin-Kondroitin Sulfat- Methylsulfonylmethane, dan Plasebo pada Pasien Osteoartritis Sendi Lutut Derajat Kellgren Lawrence I dan II: Uji Klinis Acak Tersamar Ganda
"Pendahuluan. Glukosamin, Kondroitin sulfat dan Methylsufonylmethane (MSM) merupakan suplemen yang sering diberikan pada pasien osteoarhritis (OA) derajat I dan II. Organisasi kedokteran seperti AAOS, OARSI, EULAR memberikan rekomendasi yang berbeda tentang penggunaannya. Studi ini bertujuan untuk menilai efektivitas Glukosamin-Kondroitin sulfat (GK) dan GKM terhadap perbaikan klinis pasien OA sendi lutut.
Bahan dan Cara Kerja. Studi ini merupakan uji klinis acak tersamar ganda pada 147 pasien dengan OA lutut derajat Kellgren-Lawrence I atau II. Subjek dipilih dengan metode randomisasi dengan blok permutasi ke tiga kelompok yaitu GK (n=49), GKM (n=50) dan plasebo (n=48). Obat-obatan ini diberikan sekali sehari selama 3 bulan berturut-turut. Skor VAS dan WOMAC dinilai sebelum pemberian suplemen, kemudian minggu ke 4, 8, dan 12.
Hasil. Rata-rata usia pasien adalah 61 tahun, dimana 67,3% pasien adalah perempuan. Bila dibandingkan terhadap Skor WOMAC pada kelompok Plasebo, kelompok GKM menurunkan skor WOMAC secara signifikan (perbedaan rerata 7.15, IK 12.06-2.23, p=0.005). Kelompok GK menurunkan Skor WOMAC secara signifikan (perbedaan rerata 8.17, IK 13.49-2.84, p=0.003). Sementara itu pada penilaian Skor VAS, kelompok GKM menurunkan skor secara signifikan terhadap dua kelompok lain, yaitu terhadap kelompok GK secara signifikan (perbedaan rerata 0.68, IK 1.18-0.19, p=0.007), dan Plasebo (perbedaan rerata 0.86, IK 1.37-0.35, p=0.001).
Simpulan. Kombinasi suplemen GKM lebih efektif dalam menurunkan nyeri dan meningkatkan fungsi pada pasien OA sendi lutut derajat I dan II dibandingkan dengan GK dan plasebo. Sedangkan suplemen GK secara keseluruhan tidak lebih baik dibandingkan dengan plasebo dalam memberikan perbaikan klinis pada pasien OA sendi lutut derajat Kellgren Lawrence I-II.
Introduction. Glucosamine-Chondroitin sulfate-Methylsufonylmethane (MSM) as combination are the most popular supplements for patients with knee osteoarthritis (OA). There are emerging controversies and also different recomendation from many medical associations such as AAOS, OARSI, and EULAR regarding the effectiveness of these supplements. This current study evaluated the efficacy of Glucosamine-Chondroitin sulfate (GC), Glucosamine-Chondroitin-MSM (GCM), and placebo on clinical improvement of patients with knee OA Kellgren Lawrence gr I-II.
Material and Methods. This study was a double blind, randomized controlled clinical trial on 147 patients with knee OA Kellgren-Lawrence grade I-II. Subjects were allocated by permuted block randomization to three groups, either GC (n=49), or GCM (n=50), or placebo (n=48). VAS and WOMAC score were measured before treatment, then at 4 th, 8 th and 12th week after treatment.
Result. Mean age of patients was 61 years, and 67,3% were woman. As compared with Placebo group, WOMAC score in GCM group was significantly lower (MD 7.15, CI 12.06-2.23, p=0.005), and in GC group WOMAC Score was also lower (mean difference 8.17, CI 13.49-2.84, p=0.003). Whereas VAS score in GCM group was significantly lower compared to that in GC group (MD 0.18, CI 1.18-0.19, p=0.007) and also compared with Placebo group (MD 0.86, CI 1.37-0.35, p=0.001).
Conclusions. Combinations of GCM made a clinical improvement in patients with knee OA Kellgren Lawrence gr I-II compared with GC and Placebo. GC did not make clinical improvement in overall groups of patients with knee OA Kellgren Lawrence gr I-II."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Astuti Pitarini
Luaran onkologi dan fungsional tata laksana tumor tulang yang dilakukan prosedur Limb salvage surgery (Lss) dengan megaprostesis di RS Cipto Mangunkusumo Jakarta = Oncological and functional outcome of Limb salvage surgery (Lss) in bone tumor with megaprosthesis at Cipto Mangunkusumo Hospital Jakarta
"ABSTRAK
Pendahuluan Penggunaan megaprostesis sebagai pilihan dalam manajemen LSS
memberikan harapan baru bagi pasien tumor tulang di Indonesia. Namun, sampai
saat ini belum ada data hasil luaran dari tata laksana ini.
Metode Penelitian ini merupakan prospektif observational pada 34 pasien tumor
tulang di RS Cipto Mangunkusumo pada tahun 2011-2015. Diagnosis ditegakkan
melalui Clinical Pathological Conference. Evaluasi pascaoperasi dilakukan pada
bulan ke-3, 6, 9, 12, 24, 36, dan 48 dengan menggunakan skoring dari MSTS.
Luaran onkologi dievaluasi dengan adanya rekurensi dan metastasis jauh.
Komplikasi berupa infeksi, dislokasi, cedera saraf dan pembuluh darah, serta
gangguan mekanisme ekstensor juga dievaluasi.
Hasil Dua orang ahli bedah muskuloskeletal onkologi melakukan operasi LSS dan
rekonstruksi dengan megaprostesis. Dua pasien dieksklusi karena keputusan
intraoperatif untuk memakai non modular endoprostesis. Kehilangan darah
intraoperatif memiliki median (RAK) 890,0 (700,0?1200,0) ml. Skor MSTS
sebagian besar pasien menunjukkan kategori baik dan sangat baik, yaitu 67.9%
baik pada MSTS 6 bulan, 79,2% baik pada MSTS 9 bulan, 63.4% sangat baik
pada 12 bulan, 90% sangat baik pada 24 bulan dan 100% sangat baik pada MSTS
36 bulan. Terdapat hubungan bermakna antara karakteristik pasien yaitu jenis
tumor (p=0,001), usia (p=0,039), jenis kelamin (p=0,049), dan hasil laboratorium
ALP (p=0,031) dengan luaran fungsional MSTS 3 bulan. Terdapat hubungan
bermakna antara karakteristik pasien yaitu perdarahan intraoperatif (p=0,013) dan
ALP (p=0,009) dengan mortalitas; dan juga antara tumor tulang yang menjalani
rekonstruksi jaringan lunak ekstensif dengan komplikasi (p=0,019) namun antara
lokasi tumor dan komplikasi tidak terdapat hubungan bermakna.
Kesimpulan Luaran fungsional pada pasien yang dilakukan rekonstruksi
megaprostesis adalah baik dan sangat baik sehingga dapat menjadi tatalaksana
pilihan bagi pasien tumor tulang yang akan menjalani LSS. Luaran onkologi pada
pasien yang dilakukan prosedur LSS baik dengan rendahnya rekurensi lokal, metastasi, dan komplikasi. ABSTRACT
Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence.;Introduction Advancement in bone tumor management has elaborated surgeon?s
choice of treatment not merely sentenced the patients into a limb ablation.
Likewise, patients with bone tumors, regardless its malignant nature and limited
survival time, had an equal privileges to opt for LSS to experience a better quality
of life. In this study, we manage to evaluate the functional and oncologic outcome
of lower extremity bone tumors following a LSS using megaprosthesis.
Methods Thirty-four patients with lower extremity bone tumors were
prospectively reviewed between 2011 and 2015 in a tertiary referral general
hospital. All patients were managed through a Clinical Pathology Conference.
Functional outcome was evaluated using MSTS score and follow up was recorded
at 3, 6, 12 months; and 2, 3, 4 years.
Results Two orthopedic musculoskeletal oncologic surgeons were performing the
surgeries. Two patients were excluded because the final instruments used were
not a modular type. The final result of functional score was good to excellent with
67.9% good at 6 months, 79,2% good at 9 months, 63.4% excellent at 12 months,
90% excellent at 24 months and 100% excellent at 36 months. Complications
occurred and varied. A statistical significant result was found between age
(p=0,001), age (p=0,039), gender (p=0,049), SAP (p=0,031) and 3 months
functional outcome; between intraoperative blood loss (p=0,013) and mortality,
as well as SAP with mortality (p=0,009); between tumor that underwent extensive
soft tissue reconstruction procedure and complication (p=0,019).
Conclusion Megaprosthesis reconstruction in bone tumors gives a good and
excellent result, which provides orthopaedic oncologic surgeons a rationalization
to make a selective decision-making in tumor cases regardless its survival and
tumor type. Oncologic outcome as well gave out good result with low incidence of far metastasis and local recurrence."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Riza Aprizal
Evaluasi penyembuhan tulang dan perbandingan luaran fungsional pasca tindakan injeksi perkutaneus steroid dan kuretase dengan hidroksiapatit pada simple bone cyst = Evaluation of bone healing and comparison of functional outcome of simple bone csyt after percutaneus steroid injection and curretage with hydorxyapatite
"ABSTRAK
Latar Belakang: Simple bone cyst (SBC) adalah tumor tulang jinak, berisi cairan.
Tujuan utama terapi SBC adalah mendapatkan penyembuhan tulang, mencegah
fraktur patologis, dan manajemen gejala khususnya nyeri. Terdapat berbagai
metode pengobatan SBC, namun saat ini masih kontroversial karena angka
kesembuhan dan tingkat invasi operasi. Terapi injeksi perkutaneus steroid
merupakan metode operasi dengan tingkat invasi rendah sehingga penyembuhan
tulang dan luaran fungsional lebih baik.
Metode: Total terdapat 10 pasien (6 laki-laki, 4 perempuan, rerata usia13 tahun)
SBC yang terbagi dalam dua kelompok. 5 pasien (proksimal femur 3; proksimal
humerus 1; calcaneus 1) dilakukan terapi injeksi perkutaneus steroid dan 5 pasien
(proksimal femur 2; proksimal humerus 2, radius 1) terapi kurease dengan
hidroksiapatit. Injeksi perkutaneus steroid dilakukan sebanyak tiga kali dengan
interval waktu tiap satu bulan. Rerata follow up adalah 12-26 bulan. Evaluasi
penyembuhan tulang dinilai secara radiologi dengan kriteria Chang dkk. Luaran
fungsional dinilai berdasarkan skor MSTS.
Hasil: Penyembuhan tulang komplit didapatkan pada kedua kelompok, namun
solid union lebih cepat terjadi pada kelompok terapi injeksi perkutaneus steroid.
Luaran fungsional didapatkan nilai yang lebih baik pada kelompok injeksi
perkutaneus steroid terutama pada bulan ke-3 (55%) dan ke-6 (84%) pasca operasi
berdasarkan skor MSTS dibandingkan terapi kuretase dengan hidroksiapatit
(bulan ke-3 47% dan ke-6 69,3%).
Simpulan: Terapi injeksi perkutaneus steroid masih tetap menjadi pilihan utama
metode terapi SBC dengan solid union lebih cepat, tingkat prosedur operasi invasi rendah, lebih mudah, efektif, dan aman.
ABSTRACT
Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main
goals of the therapy are to get the bone healing, prevent pathological fractures, and
management of pain symptom. There are various methods of the SBC treatment, however
still remains controversial because of their healing rate and invasiveness of surgery.
Steroid injection therapy is a surgical procedure with a low level of invasiveness so that
better bone healing and functional outcomes.
Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided
into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)
performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2
proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.
Percutaneous steroid injection was performed three times at intervals of each month. The
mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by
Chang criteria and the functional outcome by MSTS score.
Results: Complete bone healing was found in both group, but solid union occurred faster
in steroid injection theraphy group. The functional outcomes found better value in the
steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than
curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post
operation based on MSTS score.
Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC
treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main
goals of the therapy are to get the bone healing, prevent pathological fractures, and
management of pain symptom. There are various methods of the SBC treatment, however
still remains controversial because of their healing rate and invasiveness of surgery.
Steroid injection therapy is a surgical procedure with a low level of invasiveness so that
better bone healing and functional outcomes.
Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided
into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)
performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2
proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.
Percutaneous steroid injection was performed three times at intervals of each month. The
mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by
Chang criteria and the functional outcome by MSTS score.
Results: Complete bone healing was found in both group, but solid union occurred faster
in steroid injection theraphy group. The functional outcomes found better value in the
steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than
curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post
operation based on MSTS score.
Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC
treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The main
goals of the therapy are to get the bone healing, prevent pathological fractures, and
management of pain symptom. There are various methods of the SBC treatment, however
still remains controversial because of their healing rate and invasiveness of surgery.
Steroid injection therapy is a surgical procedure with a low level of invasiveness so that
better bone healing and functional outcomes.
Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were divided
into two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)
performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2
proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.
Percutaneous steroid injection was performed three times at intervals of each month. The
mean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed by
Chang criteria and the functional outcome by MSTS score.
Results: Complete bone healing was found in both group, but solid union occurred faster
in steroid injection theraphy group. The functional outcomes found better value in the
steroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) than
curettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) post
operation based on MSTS score.
Conclusions: Percutaneus steroid injection therapy is still the main choice of SBC
treatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Siahaan, Othdeh Samuel Halomoan
Peran dosis Bmp-2 terhadap penyembuhan fraktur dengan defek tulang luas pada rattus novergicus strain sprague dawley = Bmp-2 dosage on fracture healing with large bone defect in rattus novergicus strain sprague dawley
"ABSTRAK
Pendahuluan. Kesulitan dalam tatalaksana defek tulang yang luas merupakan salah satu tantangan dewasa ini. Selain tatalaksananya yang kompleks juga dapat memberikan dampak jangka panjang negatif yang berat. Penggunaan BMP-2 dalam tatalaksana fraktur dengan defek tulang yang luas memegang peranan penting. BMP-2 berperan pada proses osteogenesis dan chondrogenesis dan menghambat osteoclastogenesis melalui RANKL signaling. Penelitian ini bertujuan untuk mengetahui efek dari perbedaan dosis BMP-2 terhadap penyembuhan fraktur dengan defek tulang yang luas.
Metode. Penelitian dilakukan di Laboratorium Animal Gizi di FKUI dan Laboratorium Patologi Anatomi FKUI-RSCM, pada bulan Juli hingga September 2015. Desain penelitian adalah randomized post test control group. Sejumlah 25 ekor tikus putih Sprague Dawley dengan usia 3-4 bulan dan berat badan antara 250 ? 350 gram, dibagi secara acak menjadi kelompok kontrol hidroksiapatit (HA) saja dan kelompok kombinasi HA + BMP-2 1 μg/ml, HA + BMP-2 5 μg/ml, HA + BMP-2 10 μg/ml, HA + BMP-2 20 µg/ml. Tiap kelompok dilakukan tindakan berupa frakturisasi dengan defek tulang 10mm pada femur kanan dan dilakukan fiksasi interna dengan menggunakan intramedullary k-wire ukuran 1,4 mm secara retrograd. Setelah 6 minggu dilakukan penilaian secara histomorfometri, radiologis dan Scanning Electron Microscope (SEM).
Hasil. Berdasarkan hasil penelitian secara histomorfometri ditemukan terdapat perbedaan rerata total area kalus yang bermakna diantara kelompok penelitian (p<0,001),terdapat perbedaan bermakna rerata area penulangan antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,009, p=0,016, p=0,009 dan p=0,016), terdapat perbedaan bermakna rerata area kartilago antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,009, p=0,009, p=0,009 dan p=0,028), terdapat perbedaan bermakna rerata area fibrosis antara kelompok kontrol dengan kelompok 1 μg/ml dengan kelompok kontrol dan 10 μg/ml(masing-masing p=0,047 dan p=0,009).Secara radiologis dengan RUST score didapatkan perbedaan bermakna antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,005, p=0,006, p=0,005 dan p=0,006). Dengan SEM didapatkan gambaran kalus yang lebih homogen dan padat pada kelompok 10μg/ml dibandingkan dengan 5 μg/ml dan 20 μg/ml.
Kesimpulan: Pemberian BMP-2 dapat menstimulasi proses penyembuhan fraktur pada defek tulang luas (critical bone defect) yang bermakna secara statistik, histomorfometri, radiologis maupun secara kualitatif dengan SEM. Terdapat dosis optimal dalam pemberian BMP-2.ABSTRACT
Introduction: Difficulties in the management of extensive bone defects is one of today's challenges. It is not only complex treatment but also can provide long-term negative severe effects. The use of BMP-2 in the treatment of fractures with extensive bone defect plays an important role. BMP-2 plays a role in the process of osteogenesis and chondrogenesis and inhibits osteoclastogenesis via the RANKL signaling. This study aims to determine the effect of differences in doses of BMP-2 on the healing of the fracture with extensive bone defects.
Methods: The study was conducted at the Laboratory of Animal Nutrition at the Faculty of Medicine University of Indonesia (FMUI) in July until September 2015. The study design was randomized posttest control group. A number of 25 Sprague Dawley rats aged 3-4 months and bodyweight between 250-350 grams, were randomly divided into a control group of hydroxyapatite (HA) alone and HA+BMP-2 1 µg / ml, HA+BMP -2 5 ug / ml, HA + BMP-2 10 µg / ml, HA + BMP-2 20 ug / ml. Each group carried out fracturization with 10mm bone defect in right femur and internal fixation by using intramedullary K-wire size of 1.4 mm retrograde. After 6 weeks we did histomorfometri assessment, radiological and Scanning Electron Microscope (SEM).
Results: Based on the research results histomorfometrcally found there are differences in the mean total area of ​​callus significantly between the study group (p <0.001), there were significant differences in the mean area of ​​woven bone between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.016, p = 0.009 and p = 0.016), there were significant differences in the average area of ​​the cartilage between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.009, p = 0.009 and p = 0.028), there were significant differences in the average area of ​​fibrosis between the control group with group 1 ug / ml in the control group and 10 mg / ml (respectively -masing p = 0.047 and p = 0.009) .In radiologist assessment with RUST scores obtained significant differences between the control group and group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 µg / ml (respectively p = 0.005 , p = 0.006, p = 0.005 and p = 0.006). SEM features with callus more homogeneous and dense in the group of 10μg / mL compared with 5 ug / ml and 20 µg / ml.
Conclusion: Administration of BMP-2 could stimulate the process of fracture healing in large bone defects (critical bone defect) which was statistically significant with histomorfometri assestment, radiological and qualitatively with the SEM. There is an optimal dose in the administration of BMP-2.;Introduction: Difficulties in the management of extensive bone defects is one of today's challenges. It is not only complex treatment but also can provide long-term negative severe effects. The use of BMP-2 in the treatment of fractures with extensive bone defect plays an important role. BMP-2 plays a role in the process of osteogenesis and chondrogenesis and inhibits osteoclastogenesis via the RANKL signaling. This study aims to determine the effect of differences in doses of BMP-2 on the healing of the fracture with extensive bone defects.
Methods: The study was conducted at the Laboratory of Animal Nutrition at the Faculty of Medicine University of Indonesia (FMUI) in July until September 2015. The study design was randomized posttest control group. A number of 25 Sprague Dawley rats aged 3-4 months and bodyweight between 250-350 grams, were randomly divided into a control group of hydroxyapatite (HA) alone and HA+BMP-2 1 µg / ml, HA+BMP -2 5 ug / ml, HA + BMP-2 10 µg / ml, HA + BMP-2 20 ug / ml. Each group carried out fracturization with 10mm bone defect in right femur and internal fixation by using intramedullary K-wire size of 1.4 mm retrograde. After 6 weeks we did histomorfometri assessment, radiological and Scanning Electron Microscope (SEM).
Results: Based on the research results histomorfometrcally found there are differences in the mean total area of ​​callus significantly between the study group (p <0.001), there were significant differences in the mean area of ​​woven bone between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.016, p = 0.009 and p = 0.016), there were significant differences in the average area of ​​the cartilage between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.009, p = 0.009 and p = 0.028), there were significant differences in the average area of ​​fibrosis between the control group with group 1 ug / ml in the control group and 10 mg / ml (respectively -masing p = 0.047 and p = 0.009) .In radiologist assessment with RUST scores obtained significant differences between the control group and group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 µg / ml (respectively p = 0.005 , p = 0.006, p = 0.005 and p = 0.006). SEM features with callus more homogeneous and dense in the group of 10μg / mL compared with 5 ug / ml and 20 µg / ml.
Conclusion: Administration of BMP-2 could stimulate the process of fracture healing in large bone defects (critical bone defect) which was statistically significant with histomorfometri assestment, radiological and qualitatively with the SEM. There is an optimal dose in the administration of BMP-2."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Yudistira Prama Tirta
Korelasi antara luaran parameter sagital spinopelvik dan luaran ido pada pasien pasca operasi fusi dan stabilisasi tulang belakang torakal dan lumbal di Rumah Sakit dr. Cipto Mangunkusumo Jakarta pada tahun 2012-2014 = Correlation between sagittal spinopelvic parameters outcome and ido outcome of post thoracal and lumbar vertebrae stabilization and fusion patient in dr. Cipto Mangunkusumo Hospital Jakarta 2012-2014
"ABSTRAK
Pendahuluan. Parameter spinopelvik merupakan parameter untuk mengukur
keseimbangan poros tulang belakang terhadap ekstrimitas bawah pada penampang
sagital. Parameter ini terdiri dari sagittal vertical axis (SVA), pelvic incidence
(PI), pelvic tilt (PT), pelvic incidence (PI) dan diukur melalui X-ray whole spine
lateral view dalam keadaan berdiri. Pengukuran parameter ini penting sebagai
dasar analisa keseimbangan sagital dalam operasi rekonstruktif tulang belakang,
karena dengan tidak adanya keseimbangan pada penampang sagital ini akan
berakibat timbulnya adjacent segment degeneration yang akan memengaruhi
luaran klinis. Hingga saat ini belum ada studi yang mengevaluasi hubungan antara
luaran parameter spinopelvik dengan luaran klinis di indonesia.
Metode Penelitian. Penelitian ini adalah penelitian analitik potong lintang dengan
subyek 19 pasien dewasa pasca operasi stabilisasi dan fusi tulang belakang torakal
dan lumbal di Rumah Sakit Dr. Ciptomangunkusumo (RSCM) Jakarta pada tahun
2012-2014. Pasien tersebut dilakukan evaluasi X-ray parameter spinopelvik SVA,
PI, PT, dan SS dilakukan penilaian skor Indeks Disabilitas Oswestry (IDO) pada
saat 1 tahun pasca operasi. Lalu dilakukan analisis statistik dengan menggunakan
uji hipotesis komparatif numerik dengan menggunakan pearson dimana
dibandingkan luaran parameter spinopelvik SVA, PI, PT, dan SS dengan luaran
fungsional skor IDO.
Temuan dan Diskusi Penelitian. Didapatkan hasil korelasi antara IDO dan SVA
(p<0,001) (r=0,866). Korelasi antara IDO dan PI (p=0,006) (r=0,603). Korelasi
antara IDO dan PT (p=0,107) (r=0,382). Korelasi IDO dan SS (p=0,051)
(r=0,454).
Simpulan. Didapatkan korelasi kuat antara IDO dan SVA serta IDO dan PI.
Tidak didapatkan korelasi antara IDO dan PT serta IDO dan SS. SVA dan PI
merupakan parameter spinopelvik yang berpengaruh pada luaran pasca operasi fusi tulang belakang torakal dan lumbal.
ABSTRACT
Introduction. Spinopelvic parameter is a parameter that used to measure the
sagital balance of vertebrae in congruency with lower extrimity in sagital plane.
This parametr is consist of sagittal vertical axis (SVA), pelvic incidence (PI),
pelvic tilt (PT), pelvic incidence (PI) dan diukur melalui X-ray whole spine lateral
view in standing position. Measurement of this parameter is important as basic
analysis for achieve sagital balance in reconstructive operation of the vertebrae,
because if the sagital balance is interupted will cause the adjacent segment
degeneration that will influence the clinical outcomes. Up until now, there is no
study that evaluate the spinopelvic parameter with the clinical outcomes in
Indonesia.
Methods. This study is a cross-sectional analytic with 19 subject of adult patient
that had undergo thoracal and lumbar fusion and stabilization in Rumah Sakit Dr.
Ciptomangunkusumo (RSCM) Jakarta in 2012-2014. The subject was underwent
x-ray evaluation of SVA, PI, PT, and SS. The patient also underwent evaluation
of Indeks Disabilitas Oswestry (IDO) score in 1 year after operation. Then the
statistical work was done with numeric comparative pearson test analysis to
determine whether there is correlation between SVA, PI, PT, and SS with IDO
score.
Result and Discussion. There is strong correlation between IDO and SVA
(p<0,001) (r=0,866). Strong correlation between IDO and PI (p=0,006) (r=0,603).
No correlation between IDO and PT (p=0,107) (r=0,382). No correlation between
IDO and SS (p=0,051) (r=0,454).
Conclusion. Strong correlation is indicated in IDO and SVA, also in IDO and PI.
There is no correlation between IDO and PT, also in IDO and SS. SVA and PI are
the important spinopelvic parameter that have influence on clinical outcome in
post thoracal and lumbar fusion and stabilization patient.
;Introduction. Spinopelvic parameter is a parameter that used to measure the
sagital balance of vertebrae in congruency with lower extrimity in sagital plane.
This parametr is consist of sagittal vertical axis (SVA), pelvic incidence (PI),
pelvic tilt (PT), pelvic incidence (PI) dan diukur melalui X-ray whole spine lateral
view in standing position. Measurement of this parameter is important as basic
analysis for achieve sagital balance in reconstructive operation of the vertebrae,
because if the sagital balance is interupted will cause the adjacent segment
degeneration that will influence the clinical outcomes. Up until now, there is no
study that evaluate the spinopelvic parameter with the clinical outcomes in
Indonesia.
Methods. This study is a cross-sectional analytic with 19 subject of adult patient
that had undergo thoracal and lumbar fusion and stabilization in Rumah Sakit Dr.
Ciptomangunkusumo (RSCM) Jakarta in 2012-2014. The subject was underwent
x-ray evaluation of SVA, PI, PT, and SS. The patient also underwent evaluation
of Indeks Disabilitas Oswestry (IDO) score in 1 year after operation. Then the
statistical work was done with numeric comparative pearson test analysis to
determine whether there is correlation between SVA, PI, PT, and SS with IDO
score.
Result and Discussion. There is strong correlation between IDO and SVA
(p<0,001) (r=0,866). Strong correlation between IDO and PI (p=0,006) (r=0,603).
No correlation between IDO and PT (p=0,107) (r=0,382). No correlation between
IDO and SS (p=0,051) (r=0,454).
Conclusion. Strong correlation is indicated in IDO and SVA, also in IDO and PI.
There is no correlation between IDO and PT, also in IDO and SS. SVA and PI are
the important spinopelvic parameter that have influence on clinical outcome in
post thoracal and lumbar fusion and stabilization patient.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Peter Giarso
Ketepatan diagnosis biopsi jarum inti pada lesi muskuloskeletal di RSUPN Cipto Mangunkusumo Jakarta = Accuracy core needle biopsy for musculoskeletal lesion in Cipto Mangunkusumo Hospital Jakarta
"ABSTRAK
Pendahuluan: Biopsi jarum inti dianggap memiliki hasil akurasi yang sama
dengan biopsi terbuka dan telah menjadi prosedur rutin untuk menegakkan
diagnosis lesi muskuloskeletal. Namun demikian uji diagnostik biopsi jarum inti
di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN CM)
belum dilaporkan. Tujuan dari analisis retrospektif ini adalah untuk mendapatkan
nilai ketepatan diagnosis biopsi jarum inti pada lesi muskuloskeletal.
Metode: Dari Januari 2011 hingga Agustus 2015, semua pasien dengan lesi
muskuloskeletal di RSUPN CM yang menjalani biopsi jarum inti dan eksisi tumor
diidentifikasi dan diambil datanya. Ketepatan diagnosis dianalisis baik untuk
kesimpulan histopatologi maupun kesimpulan clinical pathology conference
(CPC).
Hasil: Sebanyak 86 sampel dikumpulkan dalam penelitian ini. Ketepatan
diagnosis biopsi jarum inti dibandingkan dengan spesimen pasca eksisi adalah
74,4%. Setelah dilakukan CPC, nilai ketepatan menjadi 83,7% dengan sensitivitas
98%, spesifisitas 59%, NDP 87%, NDN 93% (p = 0.00). Ketepatan biopsi jarum
inti setelah pulasan imunohistokimia naik menjadi 84,9% (p = 0,438). Ketepatan
untuk membedakan lesi jinak dan ganas adalah 97,1% (jinak) dan 82,7% (ganas)
(p = 0.00). Ketepatan untuk membedakan lesi primer dan metastasis adalah 97,2%
(primer) dan 85,7% (metastasis) (p = 0.00).
Diskusi: Kami mendapatkan nilai ketepatan biopsi jarum inti yang sedikit lebih
rendah karena dalam penelitian ini dituntut untuk membuat diagnosis sampai
tingkat morfologi (ICD O dan ICD X). Namun demikian, dengan modalitas lain
seperti imunohistokimia dan kesimpulan CPC, ketepatan menjadi meningkat.
Ketepatan diagnosis untuk membedakan lesi jinak-ganas dan primer-metastasis tinggi. Biopsi jarum inti direkomendasikan untuk penegakkan diagnosis lesi muskuloskeletal.ABSTRACT
Introduction: Core needle biopsy is considered to have similar results with open
biopsy in accuracy and already become a routine procedure to establish the
diagnosis of musculoskeletal lesion. However, diagnostic test of core needle
biopsy application in Cipto Mangunkusumo Hospital has not been reported.
Therefore, the aim of this retrospective analysis was to attain the accuracy of
musculoskeletal lesion diagnosis using core needle biopsy.
Methods: From January 2011 to August 2015, all patients with musculoskeletal
lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and
subsequent tumour excision were indentified and enrolled. Diagnostic accuracy
were calculated for both histopathology and clinical pathology conference (CPC)
conclusion.
Results: A total of 86 samples were indentified and enrolled in this study. The
accuracy of core needle biopsy compared to subsequent excision is 74.4%. With
CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,
PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is
84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is
97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish
primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=
0.00).
Discussion: We found slightly inferior results for core needle biopsy accuracy
compared to literature due to high specificity diagnosis obligatory (ICD O and
ICD X morphology) in our study. However, with other modalities such as
immunohistochemistry and CPC, the accuracy is increased. The accuracy to
distinguish between benign vs malignant and primary vs metastatic lesion is high.
Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.
;Introduction: Core needle biopsy is considered to have similar results with open
biopsy in accuracy and already become a routine procedure to establish the
diagnosis of musculoskeletal lesion. However, diagnostic test of core needle
biopsy application in Cipto Mangunkusumo Hospital has not been reported.
Therefore, the aim of this retrospective analysis was to attain the accuracy of
musculoskeletal lesion diagnosis using core needle biopsy.
Methods: From January 2011 to August 2015, all patients with musculoskeletal
lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and
subsequent tumour excision were indentified and enrolled. Diagnostic accuracy
were calculated for both histopathology and clinical pathology conference (CPC)
conclusion.
Results: A total of 86 samples were indentified and enrolled in this study. The
accuracy of core needle biopsy compared to subsequent excision is 74.4%. With
CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,
PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is
84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is
97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish
primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=
0.00).
Discussion: We found slightly inferior results for core needle biopsy accuracy
compared to literature due to high specificity diagnosis obligatory (ICD O and
ICD X morphology) in our study. However, with other modalities such as
immunohistochemistry and CPC, the accuracy is increased. The accuracy to
distinguish between benign vs malignant and primary vs metastatic lesion is high.
Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.
;Introduction: Core needle biopsy is considered to have similar results with open
biopsy in accuracy and already become a routine procedure to establish the
diagnosis of musculoskeletal lesion. However, diagnostic test of core needle
biopsy application in Cipto Mangunkusumo Hospital has not been reported.
Therefore, the aim of this retrospective analysis was to attain the accuracy of
musculoskeletal lesion diagnosis using core needle biopsy.
Methods: From January 2011 to August 2015, all patients with musculoskeletal
lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and
subsequent tumour excision were indentified and enrolled. Diagnostic accuracy
were calculated for both histopathology and clinical pathology conference (CPC)
conclusion.
Results: A total of 86 samples were indentified and enrolled in this study. The
accuracy of core needle biopsy compared to subsequent excision is 74.4%. With
CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,
PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is
84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is
97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish
primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=
0.00).
Discussion: We found slightly inferior results for core needle biopsy accuracy
compared to literature due to high specificity diagnosis obligatory (ICD O and
ICD X morphology) in our study. However, with other modalities such as
immunohistochemistry and CPC, the accuracy is increased. The accuracy to
distinguish between benign vs malignant and primary vs metastatic lesion is high.
Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Reza Rahmat
Hubungan antara kejadian CTEV dengan timbulnya DDH pada anak usia 6 bulan sampai 5 tahun = The association between CTEV incidence and DDH in children from 6 months until 5 years old
"Pendahuluan: Congenital Talipes Equinovarus(CTEV) dan Developmental Dysplasia of the Hip (DDH) merupakan salah satu kelainan kongenital tersering dalam sistem muskuloskeletal. Pada patogenesis CTEV dan DDH, terdapat persamaan kemungkinan etiologi yaitu pada gaya mekanik intra-uterin panggul dan kaki yang menimbulkan gangguan perkembangan. Tujuan penelitian ini adalah untuk mengetahui prevalensi pasien CTEV yang menderita DDH, serta hubungan antara CTEV dengan timbulnya DDH.
Metode Penelitian: Penelitian ini adalah penelitian deskriptif analitik dengan desain studi potong lintang. Dari data registrasi CTEV di Poliklinik Orthopaedi Rumah Sakit Cipto Mangunkusumo tahun 2011-2012 ditemukan 91 orang anak dengan CTEV primer. Dilakukan skrining dengan anamnesis dan pemeriksaan fisik untuk mengeksklusi pasien di luar rentang usia 6 bulan hingga 5 tahun, pasien dengan gangguan neuromuskular, dan kelainan kongenital. Terdapat 22 orang pasien yang memenuhi kriteria tersebut dan dilakukan pemeriksaan foto polos panggul untuk mengukur Indeks Acetabular (IA). IA<25° dinyatakan normal, 25-30° dinyatakan borderline DDH, dan >30° dinyatakan displasia berat.
Temuan dan Diskusi Penelitian: Terdapat distribusi pasien yang homogen secara jenis kelamin (50% laki-laki, 50% perempuan), dan lokasi CTEV (50% bilateral, 50% unilateral). Didapatkan 19 subyek dengan IA di bawah 250 dan 1 subyek dengan IA antara 25-300. Didapatkan 2 subyek (9%) yang memiliki dysplastic hip dengan IA di atas nilai normal 300, kedua subyek tersebut memiliki bilateral CTEV dan menjalani serial casting ≥ 8 kali. Tidak terdapat hubungan yang bermakna secara statistik antara prevalensi DDH dengan rentang usia (p = 1), dengan jenis kelamin (p = 0.89), dengan lokasi CTEV (p = 0.89), dan dengan frekuensi casting (p = 0.05). Walaupun begitu, prevalensi hip dysplasia pada CTEV cenderung terjadi pada anak dengan CTEV bilateral dan menjalani serial casting ≥ 10 kali sehingga temuan ini dapat menjadi makna yang penting secara klinis.
Simpulan: Prevalensi displasia panggul pada anak CTEV berusia 6 bulan hingga 5 tahun pada penelitian ini adalah 9% dan cenderung dialami oleh anak dengan CTEV bilateral dan menjalani serial casting 8 kali atau lebih.
Introduction: Congenital Talipes Equinovarus (CTEV) and Developmental Dysplasia of the Hip (DDH) are one of the most common pediatric orthopaedic problems ini musculoskeletal system. There is similar pathogenesis between CTEV and DDH in mechanical force that causes developmental disorders. The goals of this research are to determine the prevalence of CTEV that will suffer DDH in later time, and the relationship between CTEV and DDH.
Methods: This is a descriptive analytic study with cross sectional design. Ninety one patients with primary CTEV were registered in Orthopaedic Clinic at Cipto Mangunkusumo Hospital between 2011 and 2012. To exclude patients with neuromuscular disorders and congenital problems; screening is performed by conducting historical and physical examination. Patients between age 6 months and 5 years were included in this study. Twenty two patients met the criteria and pelvic x-ray was performed to measure the Acetabular Index (AI). AI<250 was considered normal; AI 25-300 was borderline DDH; and AI >300 was considered severe dysplasia.
Result and Discussion: Patient distribution was homogenous in gender (50% are boys, 50% are girls), and the location of CTEV (50% bilateral and 50%). There were 19 subjects with AI lower than 250 and 1 subject with AI between 250-300. Both subjects underwent ≥ 8 times serial casting. There was no significant difference between DDH prevalence with age range (p = 1), with gender (p = 0.89), with CTEV location (p = 0.89), and with casting frequency (p = 0.05). However, dysplastic hip prevalence in CTEV tend to occur in bilateral CTEV with serial casting ≥ 10 times which could be important on clinical setting.
Conclusion: Hip dysplasia prevalence on children with CTEV aged 6 months to 5 years was 9% and tend to occur in children with bilateral CTEV underwent ≥ 10 times serial casting."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Wildan Latief
Hubungan antara orientasi komponen prostesis dan luaran fungsional pasien pasca-total hip replacement di RSUPN Cipto Mangunkusumo apakah sudut safe zone meningkatkan Harris Hip Score? = The association between THR prosthesis component orientation and post THR functional outcome in RSUPN Cipto Mangunkusumo does the safe zone angle improve Harris Hip Score?
"Studi ini mengevaluasi pengaruh orientasi komponen (safe dan non-safe zone) THR, yang diwakilkan oleh sudut abduksi acetabulum, anteversi acetabulum, anteversi femur, ataupun kombinasinya terhadap luaran fungsional pasien. Penelitian analitik cross sectional ini melibatkan pasien dengan prosedur THR periode Januari 2008-Mei 2014. Tidak ditemukan hubungan bermakna antara sudut orientasi komponen prostesis THR dengan luaran fungsional HHS pasca-THR(<80 dan >80); sudut abduksi acetabulum, anteversi acetabulum, & sudut kombinasi anteversi(p>0,05). Aplikasi safe dan non-safe zone memberikan luaran fungsional yang sama. Posisi attahiyat dan squatting yang lebih tidak bisa dilakukan oleh kelompok safe zone sudut abduksi acetabulum bukan karena pengaruh sudut orientasi komponen THR. Skor HHS pasca-THR memiliki perbedaan bermakna: HHS pra-THR(p=0,001).
This study evaluates whether total hip replacement (THR) prosthesis component orientation influence hip functional outcome. This is an analytical cross-sectional study involving post-THR patients in RSUPN Cipto Mangunkusumo in January 2008- May 2014. The component orientation angle (safe zone dan non-safe zone) are not related significantly with post-THR HHS (<80 dan >80); the acetabular abduction angle, the acetabular anteversion angle, the combined anteversion angle (p>0.05). There is no difference in outcome in both safe and non-safe zone groups. There is no influence of THR component orientation angle in patient’s ability to perform “attahiyat” and squatting position."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
<<   1 2   >>