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Abstrak :
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. ......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.

Abstrak :
This 2nd edition is a complete revision with an update of the methods that have been investigated recently and that are now fully accepted by the adhesion community. Themes that are now treated in more detail include for example hybrid adhesives used for automotive applications, ecofriendly surface treatments, damage mechanics, joint durability prediction and functionally graded joints. There is also a new chapter related to the application of adhesives in the oil industry. Besides these content changes, there has been a complete revision of all chapters in terms of text, figures, tables and references for a more didactic character of this reference book. The Handbook of Adhesion Technology is intended to be the definitive reference in the field. Essential information is provided for all those concerned with adhesion, which is a phenomenon of interest in diverse scientific disciplines and of importance in a wide range of technologies. Therefore, this book includes the background science (physics, chemistry and materials science), engineering aspects and industry-specific applications. It is arranged in a user-friendly format with ten main sections: theory of adhesion, surface treatments, adhesive and sealant materials, testing of adhesive properties, joint design, durability, manufacture, quality control, applications and emerging areas. Each section contains about five chapters written by internationally renowned authors who are authorities in their fields. This book offers a quick, but authoritative, description of topics in the field of adhesion and the practical use of adhesives and sealants. Scientists and engineers of many different backgrounds who need to have an understanding of various aspects of adhesion technology will find it highly valuable. These will include those working in research or design, as well as others involved with marketing services. Graduate students in materials, processes and manufacturing will also want to consult it.