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All Journal Indonesian Journal of Medicine The Hip and Knee Journal
Iwan Budiwan Anwar
Rumah Sakit Ortopedi Soeharso Surakarta Jl. Jend. A.Yani pabelan Surakarta
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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High Energy Injury Ankle Fracture-Dislocation without Neurovascular Involvement Utomo, Pamudji; Arimuqti, Zarkasyi; Santoso, Asep; Sibarani, Tangkas SMHS; Anwar, Iwan Budiwan
Indonesian Journal of Medicine Vol. 5 No. 3 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (30.878 KB)

Abstract

Background: Open tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture without neurovascular damage are rarely reported.Case presentation: This study present a case of 55-year-old female with open tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture without neuro­vas­cu­lar injury treated with emergent debridement, open reduction, and internal fixation.Results: Six months follow-up showed com­plete bone and soft tissue healing with excellent functional outcome.Conclusion: Emergent debridement, open reduction, and internal fixation is needed to treat tibiotalar joint dislocation associated with medial malleolus and distal fibular fracture.Keywords: high energy injury, ankle joint, fracture dislocationCorrespondence: Asep Santoso. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: asep­santoso@gmail.com.Indonesian Journal of Medicine (2020), 05(03): 259-264https://doi.org/10.26911/theijmed.2020.05.03.12
Correlation Realignment Mechanical Tibiofemoral Angle With Clinical Outcome On Patients Knee Osteoarthritis Valgus Deformity Perforemed Total Knee Arthroplasty at prof. Dr. R. Soeharso Orthopaedic Hospital Surakarta Warman, Fanny Indra; Islami, Umar Kharisma; Utomo1, Pamudji; Anwar, Iwan Budiwan; Sibarani, Tangkas SMHS
The Hip and Knee Journal Vol 3, No 2 (2022): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (460.361 KB) | DOI: 10.46355/hipknee.v3i2.130

Abstract

Knee osteoarthritis (OA) are the most important because of the high prevalence of pain and disability in older adults. Angular deformities around the knee joint necessitate special consideration to restore normal alignment during TKA. In the region of 10–15% of patients requiring a primary TKA present with a valgus deformity (VD), the accurate correction of which still poses a challenge. In Ranawat grade-III the axis deviation is more than 20°. The aim of this research to savy correlation realignment mechanical tibiofemoral angle with clinical outcome on patients knee osteoarthritis valgus deformity performed TKA with non-constrained imlpant. This research is an analytics observational with cross sectional that group patients knee osteoarthritis valgus deformity underwent total knee arthroplasty and performed correlation realignment tibiofemoral angle as well as clinical outome with total sampling method on patients knee osteoarthritis valgus deformity Kellgren Lawrence grade III–IV, have radiological knee x-ray and  lower extremity scanogram underwent TKA one side by orthopaedic surgeon sub adult reconstruction. Evaluation has performed to pain scale used Visual Analog Scale (VAS) score, clinical outcome with Knee Society Score (KSS), realigment mechanical tibiofemoral angle before and after TKA. Data were analyzed using t-test and correlation test with SPSS version 16. The result with analyzed 28 (male 6, female 22) patients with a mean age 65,75 years, which divided into three group Ranawat grade I was 14 patients, grade II was 9 patients and III was 5 patients. They were evaluated for VAS score, KSS objective and functional, mechanical tibiofemoral angle have significant result (P 0,05). There was also significantly correlation between improvement mechanical tibiofemoral angle with KSS knee score based value (P 0,05). In this study we found that TKA with non-constrained implant on knee osteoarthrits valgus deformity provides significant result in reducing pain scale and increased clinical outome. 
Total knee arthroplasty in severe valgus deformity of knee osteoarthritis with non-constrained implant: A Case Report Limbong, Suyenci; Santoso, Asep; Anwar, Iwan Budiwan; Sibarani, Tangkas; Mariyanto, Ismail
The Hip and Knee Journal Vol 4, No 2 (2023): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46355/hipknee.v4i2.134

Abstract

Osteoarthritis (OA) is main cause of musculoskeletal disability all over the world. The incidence and prevalence of OA increase with aging . The treatment for grade four of knee osteoarthritis (OA) as classified by Kellgren and Lawrence classification is knee replacement, approximately 10% of patient need TKA have valgus deformity and 15% of it is severe deformity. type-III deformity (severe osseous deformity) with an incompetent medial soft-tissue sleeve, which is best managed with a constrained or hinged total-knee design, but it is not always available due to insurance limitation. In this case we choosed to manage the type III deformity using non constrained or hinged total knee design and achieve knee balancing by a soft tissue procedure (MCL tightening). Presetasion of case with Reporting female patient Mrs. S, a 61-year-old with painful and valgus deformity on the right  knee. Her range of motion preoperatively was 5-10° with 30° fixed valgus deformity on the right knee. We performed total knee arthroplasty used non-constraint implant with additional soft tissue procedure to gain ligament balance by shifted MCL origin with its bone (epicondyle ) superior and anteriorly. Intra operative we were able to correct valgus deformity and achieved 5-90 range of motion. Discussion in this study with total knee arthroplasty is a procedure that contains two main steps, bone cut and soft tissue balancing. In valgus knee tightness found at lateral site with loosening at medial site. In its severe condition medial collateral ligament may be found disfunctioned . Selective soft tissue release was effective to achieve good ROM and aligment without prosthetic constraint needed which was helped to manage patient when the constraint implant was not accessible. The conclusion after 3 month post operative we found patient was able to stand and walk without pain and device with 0-80° range of motion, stable and corrected valgus deformity.
Co-Authors Arimuqti, Zarkasyi Islami, Umar Kharisma Limbong, Suyenci Mariyanto, Ismail Santoso, Asep Sibarani, Tangkas Sibarani, Tangkas SMHS Utomo, Pamudji Utomo1, Pamudji Warman, Fanny Indra