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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
Deded Yudha Pranatha
Isolasi dan kultur sel punca kanker osteosarkoma dengan metode sarcosphere = Isolation and culture of osteosarcoma cancer stem cell with sarcosphere method
"ABSTRAK
Latar Belakang. Sel punca kanker (SPK) osteosarkoma didefinisikan sebagai sebagian kecil populasi sel osteosarkoma yang mempunyai kemampuan memperbaharui diri, menunjukan proliferasi dan mampu berdifferensiasi. SPK diduga bertanggung jawab terhadap resistensi kemoterapi, rekurensi dan metastasis. Studi ini bertujuan untuk melakukan isolasi, kultur dan karakterisasi secara in vitro SPK osteosarkoma manusia
Metode. Penelitian ini merupakan studi in vitro sebagai lanjutan yang memisahkan SPK osteosarkoma dari sel osteosarkoma manusia yang berhasil dikultur secara in vitro. Prosedur isolasi dan kultur SPK osteosarkoma dilakukan dengan metode sphere-forming assay pada ultra low well attachment surface plate. Setelah koloni sarcosphere terbentuk, dilakukan penanaman koloni tersebut pada tissue culture plate dan dilakukan karakterisasi pewarnaan Alizarin Red S, ekspresi penanda gen Nanog, Oct ¾, STAT3 dan CD133 dengan Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) dan ekspresi penanda protein alkali fosfatase, osteokalsin dan CD133 dengan Immunofluorescence Analysis (IFA).
Hasil. Dengan prosedur sphere forming assay dapat ditumbuhkan koloni sarcosphere yang berbentuk bulat, tiga dimensi serta tidak melekat pada substrat. Pada tissue culture plate didapatkan bentuk koloni sarcosphere berbentuk spindel dan melekat pada substrat. Pemeriksaan karakterisasi pewarnaan alizarin red s positif, ekspresi gen Nanog, Oct ¾ dan STAT3 yang dibuktikan dengan RT-PCR serta ekspresi protein alkali fosfatase, osteokalsin dan CD133 dengan metode IFA.
Simpulan. SPK osteosarkoma dapat diisolasi dan dikultur secara in vitro dari sel osteosarkoma manusia dengan metode sphere forming assay.
ABSTRACT
Introduction. Osteosarcoma cancer stem cells (CSCs) are defined as a subpopulation of osteosarcoma cells which have the ability of self-renewal, proliferate and differentiate. CSCs may be responsible for chemotherapy resistance, recurrence and metastasis. This study aims to do isolation, culture and characterization of human osteosarcoma CSCs in vitro.
Method. This study was an in vitro study which extend the differentiation of osteosarcoma CSCs from human osteosarcoma cells that had been successfully cultured in vitro. Osteosarcoma CSCs had been isolated and cultured with sphere-forming assay method on an ultra low well attachment surface plate. After sarcosphere colonies formed, the planting of the colony on the tissue culture plate and Alizarin Red S staining characterization was performed, the expression of marker genes Nanog, Oct ¾, STAT3 and CD133 was obtained by Reverse Transcriptase Poslymerase Chain Reaction (RT-PCR) where as the expression of protein markers alkaline phosphatase, osteocalcin and CD133 was obtained by Immunofluorescence Analysis (IFA).
Result. Sphere-forming assay procedure could develop sarcosphere colonies which were rounded, three-dimensional and not attached to the subtsrate. In tissue culture plate, spindle-shaped sarcosphere colonies attached to the substrate. Alizarin Red S staining characterization was positive, the expression of Nanog, Oct ¾ and STAT3 gene was demonstrated by RT-PCR and protein expression of alkaline phosphatase, osteocalcin and CD133 was demostrated by IFA method.
Consclusion. CSCs in osteosarcoma can be isolated and cultured in vitro from human osteosarcoma cells by sphere-forming assay method.
"
2016
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Ahmad Fauzi
Pengaruh sildenafil terhadap percepatan penyembuhan fraktur dengan delayed union pada tikus sprague dawley = Role of sildenafil in acceleration of delayed union fracture healing on sprague dawley rats model
"Latar belakang : Delayed union merupakan salah satu komplikasi penyembuhan fraktur dengan insiden berkisar antara 4,4% hingga 31%. Penatalaksanaan delayed union dapat menimbulkan masalah ekonomi dan kesehatan pada pasien. Angiogenesis memiliki peran penting dalam penyembuhan fraktur. Sildenafil telah terbukti menjadi stimulator poten angiogenesis melalui peningkatan regulasi faktor pro-angiogenik atau yang dikenal sebagai vascular endothelial growth factor (VEGF). Studi ini akan menentukan apakah sildenafil juga mempengaruhi aktivitas angiogenesis dengan ekspresi VEGF dan mempercepat penyembuhan fraktur dengan delayed union.
Metode : Penelitian ini merupakan penelitian eksperimental dengan post test only control group design, yang dilakukan pada model delayed union tikus Sprague dawley menggunakan analisis histomorfometri dan imunohistokimia. Penelitian ini diawali dengan studi pendahuluan untuk menentukan model delayed union yang hasilnya akan digunakan sebagai kontrol pada penelitian selanjutnya. Tikus dibagi secara acak menjadi empat kelompok : kelompok delayed union (n=6), kelompok dengan pemberian sildenafil 3,5 mg/kgbb (n=6), sildenafil 5 mg/kgbb (n=6) dan sildenafil 7,5 mg/kgbb (n=6). Parameter yang dievaluasi meliputi luas total kalus, area tulang rawan, area penulangan, jaringan fibrosa dan ekspresi VEGF. Pengukuran dilakukan pada minggu ke-2 dan ke-4 setelah intervensi.
Hasil : Setelah dua minggu kondisi delayed union, sildenafil secara signifikan meningkatkan parameter penyembuhan fraktur. Terjadi peningkatan yang signifikan pada total luas kalus (p=0,004), area tulang rawan (p=0,015), area penulangan (p=0,001), jaringan fibrosa (p=0,005) dan ekspresi VEGF (p=0,037). Setelah empat minggu, perbedaan yang signifikan hanya terjadi pada area penulangan (p=0,015) dan jaringan fibrosa (p=0,001).
Diskusi : Analisis histomorfometri dan imunohistokimia menunjukkan peningkatan yang signifikan pada parameter penyembuhan fraktur dan ekspresi VEGF. Hal ini menunjukkan terjadinya percepatan penyembuhan fraktur dan peningkatan pembentukan pembuluh darah. Semakin sedikitnya area kalus dan berkurangnya area tulang rawan serta meningkatnya area penulangan menunjukkan percepatan proses penyembuhan fraktur. Sildenafil meningkatkan aktivitas angiogenesis dengan meningkatnya ekspresi VEGF dan perbaikan vaskularisasi. Perbaikan vaskularisasi pada fraktur tidak hanya memperbaiki oksigenasi dan nutrisi jaringan, tetapi juga menyediakan suplai mesenchymal stem cells (MSCs) pada jaringan fraktur.
Simpulan : Sildenafil terbukti mempercepat penyembuhan fraktur dan meningkatkan ekspresi VEGF pada fraktur dengan delayed union.
Introduction : Inspite of various methods of management to achieve optimum fracture healing, delayed union remains a major problem. The incidence of delayed union ranging from 4.4% to 31%. The management of such problem include secondary operative intervention, which results in economic impact and patient morbidity. Angiogenesis plays an important role in fracture healing. Sildenafil has been shown to be a potent stimulator of angiogenesis through upregulation of pro-angiogenic factors or known as vascular endothelial growth factor (VEGF). This study will evaluate whether sildenafil also influences VEGF expression and bone formation during the process of healing in delayed union fracture.
Method : This study was an experimental study with post test only control group design. It was performed ina delayed union femur fracture model of Sprague Dawley rats using histomorphometric and immunohistochemistry evaluation. A pilot study was initiated previously to determine the model for delayed union fracture healing, and the results were used as the control. Rats were randomized into four groups : delayed union (n=6), administration of sildenafil 3.5 mg/kgbw (n=6), sildenafil 5 mg/kgbw (n=6) and sildenafil 7.5 mg/kgbw (n=6). The parameters evaluated include total area of callus, cartilage area, total osseous tissue, fibrous tissue and VEGF expression. The measurement was carried out at 2 and 4 weeks after intervention.
Results : After two weeks of delayed union fracture healing, sildenafil significantly increased the parameter of fracture healing. The results showed a significant increase of total area of callus (p=0.004), cartilage area (p=0.015), total osseous tissue (p=0.001), fibrous tissue (p=0.005) and VEGF expression (p=0.037). After four weeks, the results were still significant in total osseous tissue (p=0.015) and fibrous tissue (p=0.001).
Discussion : Histomorphometric and immunohistochemistry analysis showed a significant increase of fracture healing parameter and higher expression of the proangiogenic factors (VEGF). Such result confirmed the increase of bone and vascular formation. A smaller callus area with a slightly reduced amount of cartilaginous tissue and increased osseous tissue indicated an accelerated healing process. Sildenafil improves the expression of VEGF and vascularization repair. The vascular invasion in a fracture not only provide oxygen and nutrients needed to repair the injured tissue cells, but also provide an additional source of MSCs.
Conclusion : Sildenafil is proven to effectively accelerate fracture healing and increase VEGF expression in delayed union fracture."
Depok: Fakultas Kedokteran Universitas Indonesia, 2014
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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
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Alfian Tegar Prakasa
Kesiapan Kota Depok dalam menerapkan konsep Smart City (studi pada infrastructure, governance, dan people Kota Depok) = Readiness of Depok City to implement Smart City concept (study of infrastructure, governance, and people in Depok City) / Alfian Tegar Prakasa
"ABSTRAK
Penelitian ini bertujuan untuk mengetahui apakah Kota Depok siap menerapkan konsep "Kota Cerdas". Kota Depok terkenal memiliki wilayah yang sangat strategis karena terletak dekat dengan wilayah khusus Jakarta. Pertumbuhan potensi kota Depok telah mendorong pemerintah daerah untuk menerapkan konsep kota pintar. Peneliti menggunakan tiga enabler dalam "Garuda Smart City Model" sebagai dimensi untuk mengukur kesiapan Kota Depok dalam mengimplementasikan konsep "Smart City". Penelitian ini menggunakan pendekatan penelitian kuantitatif. Metode campuran digunakan sebagai teknik pengambilan sampel, terdiri dari survei dengan teknik pengambilan sampel kuota non-probabilita, wawancara mendalam, dan tinjauan literatur. Penelitian ini melibatkan penduduk Kota Depok yang berusia 17-65 tahun, telah menetap di Kota Depok selama lebih dari setahun, dan telah mengetahui informasi tentang "Kota Cerdas", sebagai sampel. Hasil penelitian ini menunjukkan bahwa Kota Depok belum siap untuk menerapkan konsep "Kota Cerdas". Skor kesiapan tertinggi ditemukan pada dimensi Infrastruktur Cerdas, Teknologi, dan Lingkungan, diikuti oleh dimensi Orang Cerdas, dan Tata Kelola Cerdas secara berurutan. Hasil penelitian ini dapat menjadi referensi untuk penelitian lebih lanjut dan bagi pemerintah Kota Depok untuk meningkatkan kesiapan Kota Depok dalam mengimplementasikan Konsep "Kota Cerdas".
ABSTRACT
This study aims to determine whether Depok City is ready to apply the concept of "Smart Cities". The city of Depok is famous for having a very strategic area because it is located close to a special area of ​​Jakarta. The growing potential of the city of Depok has encouraged local governments to apply the concept of smart cities. The researcher used three enablers in the "Garuda Smart City Model" as a dimension to measure the readiness of Depok City in implementing the "Smart City" concept. This research uses a quantitative research approach. The mixed method is used as a sampling technique, consisting of surveys with non-probability quota sampling techniques, in-depth interviews, and literature review. This study involved Depok City residents aged 17-65 years, who had lived in Depok City for more than a year, and had known information about "Smart Cities", as a sample. The results of this study indicate that the City of Depok is not ready to apply the concept of "Smart Cities". The highest preparedness scores were found in the Intelligent Infrastructure, Technology and Environment dimensions, followed by the Smart People dimension, and Smart Governance sequentially. The results of this study can be a reference for further research and for the government of the City of Depok to improve the readiness of the City of Depok in implementing the "Smart Cities" Concept."
2019
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Radi Muharris Mulyana
Perbandingan luaran fungsional Total Knee Replacement Prostesis Cruciate Retaining dan Cruiciate Substituting di RS Cipto Mangunkusumo periode Januari 2011-Februari 2012 = Comparison of functional outcome of Total Knee Replacement between Cruciate Retaining and Cruciate Substituting Prosthesis in Cipto Mangunkusumo Hospital from January 2011-February 2012 / Radi Muharris Mulyana
"ABSTRAK
Operasi 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.
ABSTRACT
Total 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."
Fakultas Kedokteran Universitas Indonesia, 2012
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Rizki Notario Haryanto Putro
Efek Artroplasti Distraksi pada sendi lutut dengan Osteoarthritis terhadap Kartilago Artikular : penelitian pada kambing = Effect of Distraction Arthroplasty on Osteoarthritic Knees towards the Articular Cartilage : a study on goats / Rizki Notario Haryanto Putro
"ABSTRAK
Osteoarthritis (OA) adalah kelainan sendi lutut degeneratif tersering. Artroplasti distraksi adalah sebuah alternatif tata laksana OA. Penelitian dilakukan pada 32 lutut kambing diinduksi secara mekanis menjadi OA dengan menisektomi lateral. Dalam penelitian 6 kambing mati. Arthroplasti distraksi dilaksanakan pada 10 lutut selama 4 minggu, dan 10 lutut kontralateral dibiarkan, kemudian diperiksa anatomi dan histopatologinya. Terdapat perburukan anatomis dan histopatologis pada lutut yang diberikan perlakuan. Perbandingan anatomis menggunakan staging ICRS berbeda bermakna (p <0,002) dan histopatologis menggunakan scoring OARSI berbeda bermakna (p<0,002). Arthroplasti distraksi masih memerlukan penelitian lebih lanjut pada hewan coba sebelum dapat diterapkan ke uji klinis kepada manusia.
ABSTRACT
Osteoarthritis (OA) is the most common knee degenerative disease. Distraction arthroplasty is a an alternatif for OA management. On this study 32 goat stiffle joints were mechanically induced to OA by lateral meniscectomy. During research 6 goats were deceased. Distraction arthroplasty was performed on 10 joints for 4 weeks, contralateral knees left untreated. Cartilage were anatomically and histopathologically examined. There was worsening on treated joints. The anatomical difference assessed using ICRS stage was significant (p<0,002) and the histopathological difference assessed using OARSI scoring was significant (p<0,002). Therefore distraction arthroplasty requires more animal research before human studies."
Fakultas Kedokteran Universitas Indonesia, 2012
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Heka Priyamurti
Perbandingan Induksi Osteoarthritis pada lutut kambing (Capra aegagrus hircus) menggunakan injeksi Papain 5% Intraartikular dan Menisektomi total Meniskus Lateral = Comparison between Papain 5% Intraarticular injection and total Meniscectomy of the Lateral Meniscus for Osteoarthritis induction to stiffle joint of goat (Capra aegagrus hircus) / Heka Priyamurti
"ABSTRAK
Penelitian osteoarthritis (OA) memerlukan model hewan karena progresifitas penyakit yang lambat. Tujuan penelitian ini adalah untuk membandingkan metode induksi injeksi papain 5% intraartikular dengan menisektomi pada lutut kambing kacang sebagai model OA. Sembilan kambing menjadi subjek, satu ekor sebagai kontrol, grup papain dan menisektomi masing-masing empat ekor. Evaluasi dengan penilaian radiologis, makroskopis dan histologis. Penilaian makroskopis menunjukkan hasil tidak bermakna secara statistik tetapi penilaian menisektomi menunjukkan kerusakan pada kartilago dengan derajat yang lebih tinggi baik makroskopis maupun histologis.
ABSTRACT
Researches on osteoarthritis need animal model because slow progression of the disease. The aim of this study is to compare induction methods of papain 5% intraarticular injection and meniscectomy in Javanesse goat’s stiffle joints as animal model. Nine goats were involved in this study, one goat as control, four goats in papain and meniscectomy group each. Evaluation using radiologic, macroscopic and histologic scoring. Macroscopic scoring showed unsignificant finding statistically, but meniscectomy showed higher score of cartilage damage clinically and statistically."
Fakultas Kedokteran Universitas Indonesia, 2012
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