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"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."

"[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."