Luthfi Hidayat
Department Of Orthopaedics And Traumatology, Dr. Sardjito General Hospital/Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Department Of Orthopaedics And Traumatology, Universitas Gadjah Mada Academic Hospital, Universitas G

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Comparison of diagnostic accuracy between clinical examination and magnetic resonance imaging (MRI) in diagnosing anterior cruciate ligament (ACL) rupture on Indonesian population Luthfi Hidayat; Aditya Fuad Robby Triangga; Muhamad Afrizal Farkhan; Bernadeta Fuad Paramita Rahayu; Rahadyan Magetsari
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (872.563 KB) | DOI: 10.19106/JMedSci005302202107

Abstract

Anterior cruciate ligament (ACL) injury is the most common knee ligament injured. Anterior drawer and Lachman tests are the most common physical examinations for helping diagnose ACL injuries, while magnetic resonance imaging (MRI) is the first choice of supporting examination for evaluating any internal abnormality of the knee. However, studies concerning the accuracy of those examinations in the Indonesian population are limited. This study aimed to compare the accuracy between the anterior drawer test, Lachman test, and MRI in diagnosing ACL injury in Javanese patients. This retrospective study used medical records data of patients who underwent knee arthroscopy in the Department of Orthopaedics and Traumatology, Dr. Sardjito General Hospital, Yogyakarta in 2018. The MRI and the clinical examination results were compared to the arthroscopy results as the gold standard. The study showed the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for the anterior drawer test were 86.67% (95%CI: 69.28-96.24%), 80% (CI: 44.39-97.48%), 92.86% (CI: 78.88-97.84), 66.67% (CI: 43.28-83.98%), and 85% (CI: 70.16-94.29%), respectively. Lachman test had 96.67% (CI: 82.78-99.92%) sensitivity, 90% (CI: 55.50-99.75%) specificity, 96.67% (CI: 81.86-99.47%) PPV, 90% (CI: 56.44-98.43%) NPV, and 95% (CI: 83.08-99.39%) accuracy. The diagnostic parameters of MRI were 83.33% (CI: 65.28-94.36%) for sensitivity, 60% (CI: 26.24-87.84%) for specificity, 86.21% (CI: 74.21-93.14%) for PPV, 54.55% (CI: 31.77-75.57%) for NPV, and 77.50% (CI: 61.55-89.16%) for accuracy. In conclusion, the Lachman test has better accuracy than the anterior drawer test. Both the anterior drawer and Lachman tests had higher accuracy compared to the MRI.
Correlation between the effect of increasing body weight with plantar pressure and ankle-knee radiographic angle parameters changes Dimas Triaryo; Luthfi Hidayat; Rahadyan Magetsari
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 10, No 1, (2019)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol10.Iss1.art5

Abstract

Background: Understanding the biomechanical structure of the body is important to preventing and treating the musculoskeletal system problems. The increase in body mass index contributes to the elevated peak plantar pressure and decreased longitudinal arch of the foot. This condition, consequently, may cause mal-alignment of the lower extremity, leading to promote cartilage breakdown, osteophyte formation, subchondral bone hypertrophy, lead to progression of knee joint destruction and functional deficits. Objective: The aim of the study was to examine the correlation between body weight, plantar pressures, ankle and knee angle measurement parameters.Methods: The research study sample included 30 female who met inclusion and exclusion criteria. In order to evaluate the structural characteristic of plantar foot, we used the blueprint method on bare-foot and also when carrying 15 and 25 kilogram of load. Furthermore, to measure knee-angle parameters, we also performed a bilateral standing radiograph approach of lower extremity. Results: This study showed a significant correlation between BMI/Body mass index and HW/heel width (p = 0,00) with low positive correlation for both sides. Furthermore, BMI and PAW/plantar arch width (p = 0,00) showed a moderate positive correlation for both sides. In contrast to that, BMI and MFA/mid-foot area (p = 0,00) showed a moderate positive correlation for the right side but low positive correlation for the left side. Another measurement such as BMI and AI/arch index (p = 0,00) had a strong positive correlation on the right side and moderate positive correlation on the left side. Moreover, BMI and AAL/Ankle angle alignment (p = 0,00) revealed a strong positive correlation for both sides, BMI and XCTP/trans-condylar tibial plateau angle (p < 0,05) had a low positive correlation for both sides, meanwhile BMI and AA/ankle angle (p = 0,00) showed a low positive correlation for both sides. Conclusion: Increasing axial load was statistically significant correlated with increasing plantar pressure and ankle-knee radiographic angle parameter. The results also revealed that increasing axial load was found to have strong correlation to the arch index (AI) and ankle angle alignment (AAL). It was a compensatory phenomenon, which can cause structural disturbances and function of the lower limb.
Correlation of Anthropometric Features with Peroneus Longus and Hamstring Tendons Graft Size for ACL reconstruction Aditya Fuad Robby; Luthfi Hidayat; Rahadyan Magetsari
The Hip and Knee Journal Vol 2, No 1 (2021): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1305.412 KB) | DOI: 10.46355/hipknee.v2i1.52

Abstract

Background: Reconstruction of the anterior cruciate ligament (ACL) is a commonly performed surgical procedure in recent years. Surgeons have to consider several factors including patient’s anthropometric variables to harvest the best graft. The hamstring tendon has its’ limitation, such as the tendon graft size deemed unfit especially for people of small statures. The peroneus longus tendon is a relatively new choice compared to hamstring. This study was conducted to know the correlation between anthropometric features with graft parameters or graft size in patients who underwent ACL reconstruction using peroneus longus and hamstring tendons.Materials and Methods: This cross-sectional study was performed in patients who underwent ACL reconstruction using peroneus longus or hamstring tendon autografts. We evaluated their anthropometric variables (age, gender, body mass index (BMI), height and weight) and correlated them with the graft diameter obtained during surgery. Post-operative results were assessed with Karlsson and Peterson Scoring System which represent the ankle function.Results: Twenty-three non-athletic patients underwent ACL reconstruction surgery. Patients with hamstring graft have the average height of 170 cm and 163.6 cm for the peroneal graft group. The average body weight of the hamstring graft group was 72.917 kg and the peroneal graft group was 68.82 kg. The measured BMI of the hamstring graft group was 25.2 kg/m2 and 7.833 mm of graft diameter in average, with 25.5 kg/m2 and 7.636 mm respectively for the peroneus graft group. There were strong positive correlations between weight and BMI with hamstring tendon graft diameter, but negative weak correlations with peroneus tendon graft diameter.Conclusion: We found that body weight and BMI correlate with the diameter of both peroneus and hamstring tendon grafts. Both autografts showed equally good functional results.
AO Reconstruction Plate as Buttressing for Greater Trochanter in Hemiarthroplasty Procedure Luthfi Hidayat; Aditya Fuad Robby Triangga; Rahadyan Magetsari
The Hip and Knee Journal Vol 3, No 1 (2022): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (534.326 KB) | DOI: 10.46355/hipknee.v3i1.53

Abstract

INTRODUCTIONThe trend of intertrochanter fractures has gradually increased leading to a high frequency of difficulties and damage as the result of the increased age and risk factors. Accordingly, the aim of stable fixation in these fractures is designed with appropriate surgical procedures and patient care. The contribution of a stable fixation is due to several considerations including fracture shape and assurance, bone quality, comminution pattern, implant choice, and surgical technique. This study aimed to assess the functional outcomes of the patients with an intertrochanteric fracture who underwent hemiarthroplasty with AO recon as buttressing.MATERIALS AND METHODSThis was a case series study conducted in Gadjah Mada University Academic Hospital in Yogyakarta from July 2017 to August 2018. Patients with Evans unstable intertrochanteric femoral fractures who underwent simultaneous bipolar hemiarthroplasty and fixation with AO reconstruction plate and SS wire as buttressing were evaluated. Pre and postoperative radiographs, postoperative Visual Analog Scale (VAS) score, walking ability using Harris Hip Score (HHS), and Lower Extremity Functional Score (LEFS) were the outcome parameters.RESULTSA total of 6 patients, 4 of whom were male with an average age of 81 years old were included in this study. All the mechanisms of injury were low-energy trauma. The mean VAS score was decreased, from 7 pre-operatively to 1.5 post-operatively at final follow-up (p-value 0.05). The patients had a mean HHS of 82.5 and a LEFS mean of 56.7.CONCLUSIONButtress plate fixation using an AO reconstruction plate for trochanteric fracture following bipolar hemiarthroplasty resulted in a good functional outcome.