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Maltracking Patella, Pseudo Patella Baja, dan Patellar Tilt sebagai faktor risiko terjadinya nyeri patellofemoral pasca total knee arthroplasty tanpa mengganti komponen patella di RSUP Sanglah, Bali, Indonesia Gusti Ngurah Putra Stanu; Putu Astawa; I Wayan Suryanto Dusak; Elysanti Dwi Martadiani; I Gede Eka Wiratnaya; I Gusti Ngurah Wien Aryana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Total Knee Artrhoplasty (TKA) is the final therapeutic choice for osteoarthritis (OA) if conservative therapy fails. However, some studies show that about 50% of patients undergoing TKA complain on anterior knee pain postoperatively. One of the most common causes of knee pain comes from the patellofemoral components. Some interesting potential risk factors needing investigations include patellar maltracking, pseudo patella baja, and patellar tilt. By knowing the relationship between these potential risk factors and patellofemoral pain after TKA, it is hoped that further modifications can be made intraoperatively to maximalize the functional outcomes of these patients.Methods: This is a Case Control study to investigate the factors affecting patellofemoral pain after TKA without patellar resurfacing, including patellar maltracking, pseudopatella baja, and patellar tilt, compared to those who don’t experience patellofemoral pain. The study was conducted at Sanglah Hospital, Denpasar, Bali in September-December 2019. Clinical and radiographic data were obtained secondarily from patient medical records.Results: Chi Square Test for Maltracking patella test showed a value of P = 0,000 (P <0.05), indicating a significant difference between the group with patellofemoral pain and those without. Chi Square Test for Pseudopatella Baja showed a value of P = 1,000 (P> 0.05), indicating no significant difference. While the Chi Square Test for Patellar Tilt showed a value of P = 0.045 (P <0.05), indicating a significant difference.Conclusion: Patellar maltracking and patellar tilt are proven to be risk factors for higher NRS values compared to those without, in post-TKA patients patellar resurfacing. Whereas Pseudopatella Baja was not proven to be a risk factor for higher NRS values. Latar Belakang: Total Knee Artrhoplasty (TKA) merupakan pilihan terapi tahap akhir dari osteoartritis (OA) lutut bila manajemen konservatif gagal. Walaupun demikian, beberapa studi menunjukan bahwa pasca operasi TKA, sekitar 50% pasien justru mengeluhkan nyeri pada bagian depan lutut. Salah satu penyebab tersering nyeri lutut pada pasien-pasien OA pasca TKA berasal dari komponen patellofemoral. Beberapa faktor risiko yang menarik untuk diteliti sebagai peyebab nyeri patellofemoral pasca TKA antara lain maltracking patella, pseudo patella baja, dan patellar tilt. Dengan mengetahui keterkaitan antara faktor-faktor risiko potensial tersebut dengan nyeri patellofemoral pasca TKA, diharapkan lebih lanjut dapat dilakukan modifikasi saat operasi guna mengurangi insiden nyeri patellofemoral pada pasien-pasien pasca TKA, sehingga dapat meningkatkan keluaran fungsional pasien-pasien tersebut.Metode: Penelitian ini merupakan penelitian Case Control untuk mengetahui faktor risiko terjadinya nyeri patellofemoral pasca TKA tanpa mengganti komponen patella pasien-pasien dengan OA lutut, terkait dengan yang memiliki faktor maltracking patella, pseudopatella baja, dan patellar tilt, dibandingkan dengan yang tidak memiliki faktor tersebut. Penelitian dilakukan di RSUP Sanglah, Denpasar, Bali selama bulan September-Desember 2019. Data klinis dan radiografis didapat dari data sekunder dari rekam medis penderita.Hasil: Uji Chi Square Maltracking patella menunjukkan nilai P = 0,000 ( P < 0,05), menandakan perbedaan yang signifikan antara kelompok yang nyeri dan tidak nyeri. Uji Chi Square Pseudopatella Baja menunjukkan nilai P = 1,000 ( P > 0,05), menandakan tidak adanya perbedaan yang signifikan. Sedangkan Uji Chi-square Patellar Tilt menunjukkan nilai P = 0,045 ( P < 0,05), menandakan perbedaan yang signifikan.Simpulan: Maltracking patella dan patellar tilt merupakan faktor risiko terhadap nilai NRS yang lebih tinggi dibandingkan tanpa maltracking patella pada pasien-pasien pasca-TKA tanpa mengganti komponen patella. Sedangkan Pseudopatella Baja tidak terbukti sebagai faktor risiko terhadap nilai NRS yang lebih tinggi dibandingkan tanpa pseudopatella Baja pada pasien-pasien pasca-TKA tanpa mengganti komponen patella.

Laminoplasty provides better functional outcomes than laminectomy in the management of cervical stenosis myelopathy: a systematic review Putu Kermawan; I Ketut Siki Kawiyana; I Gusti Ngurah Wien Aryana; I Gusti Lanang Ngurah Agung Artha Wiguna; I Gede Eka Wiratnaya; I Ketut Suyasa
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Increasing the life expectancy of an individual will be accompanied by the emergence of various degenerative diseases such as cervical stenosis myelopathy (CSM). CSM is characterized by the presence of signs and symptoms of spinal cord compression associated with narrowing the spinal canal dimensions. Decompression can be achieved by conventional methods such as laminectomy or a lamina reshaping procedure known as a laminoplasty. This study reports recent evidence regarding laminectomy and laminoplasty procedures in managing CSM in terms of functional outcomes.Methods: A systematic search was conducted on the PUBMED database to identify and find studies comparing laminoplasty and laminectomy procedures. Inclusion criteria included patients older than 65 years diagnosed with cervical myelopathy, including CSM and/or ossified posterior longitudinal ligament (OPLL). Randomized controlled studies and prospective and retrospective cohorts were included in this study, while case series and case reports were excluded. The comparison of effectiveness is based on the results of measuring functional outcomes using the Japanese Orthopedic Association (JOA) score, neck disability index (NDI), and the visual analogue scale (VAS) for pain assessment.Results: A thorough search through the PUBMED database yielded 156 citations. Scanning titles and abstracts from studies that met the inclusion and exclusion criteria resulted in 14 articles. All articles have a retrospective cohort design. In total, there were 187 patients in the laminoplasty group and 161 patients in the laminectomy group. There was no significant difference between laminoplasty and laminectomy when viewed from the JOA score in weighted mean difference (WMD) (WMD 0.28; 95% Confidence Interval [CI]:-0.34-0.91) and VAS score (WMD 0.06; 95% CI: -1.13-1.02). However, laminoplasty was shown to have a better NDI score (WMD 3.32; 95% CI: -6.50-0.14).Conclusion: Laminoplasty is superior to laminectomy for managing cervical myelopathic stenosis in terms of NDI score.

Sel Punca sebagai Terapi Regenerasi Potensial Kasus Ortopedi I Gusti Ngurah Wien Aryana; Febyan
Cermin Dunia Kedokteran Vol 50 No 2 (2023): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i2.531

Cedera muskuloskeletal merupakan masalah kesehatan global; namun, metode pengobatan yang paling efektif masih kontroversial. Terapi sel punca telah menjadi populer di bidang ortopedi, terutama untuk kasus cedera muskuloskeletal yang melibatkan tendon, ligamen, tulang, meniskus, dan tulang rawan. Beberapa studi praklinis telah menggunakan terapi sel punca. Penelitian lebih lanjut diperlukan untuk mengevaluasi keamanan dan efektivitas sel punca pada kasus - kasus ortopedi. Musculoskeletal injuries are a global health problem, however, its most effective management are still controversial. Stem cell therapy has been popular in the field of orthopaedics, especially for cases of musculoskeletal injuries involving tendons, ligaments, bones, meniscus, and cartilage. Several preclinical studies have been conducted. Further research should be done to evaluate its safety and effectiveness, especially in orthopaedics cases.

Correlation between Body Mass Index and Cartilage Oligomeric Matrix Protein Levels in Woman with Postmenopausal Symptomatic Osteoarthritis IGN Wien Aryana
Journal of Global Pharma Technology Volume 11 Issue 04.
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Measurement of serum cartilage oligomeric matrix protein (sCOMP) concentration is expected to be new approach for osteoarthritis early detection. Osteoarthritis has been linked to obesity as its risk factor. This study aimed to determine relationship between BMI and sCOMP in woman with symptomatic osteoarthritis. Methods: : A cross-sectional study was done using consecutive sampling. The study population comprised of female patients age 50-70 y.o who had menopause since last 1 year and symptomatic knee arthritis. Osteoarthiris were comfirmed by genu imaging. sCOMP concentration were determined in Clinical Phatology Laboratorium of Sanglah Hospital using ELISA technique. The body mass index was calculated using the standarized formula. Correlation test was used to determine the correlation between body mass indexes with sCOMP level. Results: From total of 68 participants, the mean age was 73.66 (SD 9.356), the mean BMI was 21.97 (SD 4.66), and the mean sCOMP concentration was 7.935 (SD 10.11). Significant correlations (p <0.01) occured for this sample. However, Spearman’s rho was quite low (r = -0.382), indicating only weak correlations. A higher BMI was associated with lower sCOMP concentration. Conclusion: The results prove the relationship between BMI and sCOMP concentration. Further research is needed to reveal causality between both variables.Keywords: Osteoarthitis, Women, BMI, sCOMP concentration.

Sel Punca sebagai Terapi Regenerasi Potensial Kasus Ortopedi I Gusti Ngurah Wien Aryana; Febyan
Cermin Dunia Kedokteran Vol 50 No 2 (2023): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i2.531

Cedera muskuloskeletal merupakan masalah kesehatan global; namun, metode pengobatan yang paling efektif masih kontroversial. Terapi sel punca telah menjadi populer di bidang ortopedi, terutama untuk kasus cedera muskuloskeletal yang melibatkan tendon, ligamen, tulang, meniskus, dan tulang rawan. Beberapa studi praklinis telah menggunakan terapi sel punca. Penelitian lebih lanjut diperlukan untuk mengevaluasi keamanan dan efektivitas sel punca pada kasus - kasus ortopedi. Musculoskeletal injuries are a global health problem, however, its most effective management are still controversial. Stem cell therapy has been popular in the field of orthopaedics, especially for cases of musculoskeletal injuries involving tendons, ligaments, bones, meniscus, and cartilage. Several preclinical studies have been conducted. Further research should be done to evaluate its safety and effectiveness, especially in orthopaedics cases.

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