Lukas Widhiyanto
Department Of Orthopaedic And Traumatology, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Hospital, Surabaya

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Collagen Type I and Type II Expression Evaluation on Cartilage Defect Regeneration Treated with Dwikora–Ferdiansyah–Lesmono–Purwati (DFLP) Scaffold Supplemented with Adipose–Derived Stem Cells (ASCs) or Secretome: An In-Vivo Study Adrianto Prasetyo Perbowo; Dwikora Novembri Utomo; Lukas Widhiyanto; Primadenny Ariesa Airlangga; Purwati Purwati
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 2 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v4i2.4377

Abstract

Abstract Cell-based therapies such as Scaffold, stem cells, and secretome, are one of the alternatives to enhance the regeneration of hyaline-like cartilage in cases of cartilage defects. This study is an in-vivo experiment using animal models, in which we apply a composite of DFLP (Dwikora-Ferdiansyah-Lesmono-Purwati) Scaffold and Adipose-Derived Stem Cells (ASCs) or Secretome to an injury model on the distal femoral trochlea of New Zealand White Rabbits. The animals were divided into four groups: (1) control (K); (2) Scaffold only (S); (3) Scaffold + ASCs (SA); (4) Scaffold + Secretome (SS). Animals were terminated in the 12th week, and an immunohistochemistry (IHC) evaluation for Collagen type I and II were done. Statistical analysis shows that collagen type I IHC between groups shows no significant difference (p = 0.546). Collagen type II IHC shows significant difference between groups (p = 0,016). The findings in this study showed that Scaffold + ASCs group and Scaffold + Secretome have better collagen type II expression compared to the control group. DFLP Scaffold composite with ASCs or Secretome shows potential for cartilage regeneration therapy by increasing type II collagen expression as in hyaline-like cartilage which may be used for regenerative therapy for cartilage defects. Keywords             : DFLP Scaffold; Adipose-Derived Stem Cells (ASCs); Secretome; Collagen Type I; Collagen Type IICorrespondence    : ianperbowo@me.com
Triple Curve Scoliosis Presented with Developmental Dysplasia of the Left Hip in Marfan Syndrome Lukas Widhiyanto; Tri Wahyu Martanto; Febrian Brahmana
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 2, No 2 (2018)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v2i2.975

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Introduction: Marfan syndrome is an autosomal dominant disorder of connective tissue, and skeletal system involvements are the cardinal features.  Triple rigid large major curve in conjunction with developmental dysplasia of the hip in Marfan syndrome is rare then sagittal and coronal imbalance correction on this case is challengingCase Presentation: We reported a case of 12 years old female with Marfan syndrome presented triple rigid large Major curve scoliosis on left cervico-thoracal, right main  thoracal and left thorakolumbal, also developmental dysplasia of the left hip has been done correction surgery consist of open reduction following cast immobilization of the left hip, multiple ponte osteotomy and asymetrical pedicle substraction osteotomy to correct sagittal and coronal imbalance.Discussion: the treatment of scoliosis in patients with Marfan syndrome parallels that in patients with idiopathic scoliosis and spinal fusion and instrumentation should be considered for curves greater than 45 to 50 degrees. Posterior technique, Ponte osteotomy correct 10 to 20 degrees and pedicle substraction osteotomy correct 30 to 40 degrees at each segment are effective for managing sagittal and coronal imbalance in scoliosis. Open reduction developmental dysplasia of the hip to overcome complicated coronal balance correction.Conclusion : Detailed planning scoliosis surgery is needed to correct a rare the sagittal and coronal imbalance due to scoliosis complicated with developmental dysplasia of the hip in Marfan syndrome.
Studi Epidemiologi Fraktur Vertebra di RSUD Dr.Soetomo Surabaya Pada Tahun 2013-2017 Lukas Widhiyanto; I Ketut Martiana; Primadenny Ariesa Airlangga; Donny Permana
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 3, No 1 (2019)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (391.446 KB) | DOI: 10.30651/jqm.v3i1.2191

Abstract

 AbstractThe incidence of spinal trauma in the world is 0.019-0.088% per year. However, the epidemiological data from each country varies according to the specificities of each country. Until now, there have been no reports of epidemiological research for vertebral trauma in Indonesia. This research is a descriptive analytic study. The sample of this study were all patients with vertebral fractures who entered the Dr. Soetomo Hospital in 2013-2017. The data were obtained through medical records and electronic data in hospital databases. The data are displayed in tables and graphs and comparative analysis of variables is carried out. Based on data from 2014-2017, there were a total of 442 patients with vertebral fractures, with male and female ratio of 3.3: 1. The mean age of patients was 43.6 year. The causes of vertebral fractures are due to fall from altitude (38%), traffic accidents (34%), and direct impact / hit burden (10%). Based on fracture level, most fractures were at the lumbar level (153 patients, 34,6%). At the lumbar level, the most fracture subtypes were type A with a percentage of 91.5% and the most mechanism of injury was due to falling from a height. Based on the fracture subtype, type A (compression or burst) fracture is the most common type of fracture. Lumbar vertebral fracture is the most fractured in vertebral fractures. The most common cause of fracture in the vertebrae is trauma with great energy due to falling from a height.Keywords: Epidemiology, vertebral fractures, spinal traumaCorrespondence to : dr.donnypermana@gmail.com Abstrak Insiden trauma spinal di dunia tercatat sebesar 0,019% hingga 0,088% per tahun, namun data epidemiologi dari masing-masing negara adalah berbeda-beda, sesuai dengan kekhususan dari masing-masing negara. Hingga saat ini, belum terdapat laporan penelitian epidemiologi untuk trauma vertebra di Indonesia. Penelitian ini merupakan penelitian deskriptif analitik. Sampel penelitian ini adalah seluruh pasien dengan fraktur vertebra yang masuk di RS Dr. Soetomo Surabaya pada tahun 2013-2017. Data penelitian ini didapatkan melalui data berkas rekam medis dan database elektronik rumah sakit. Data ditampilkan dalam bentuk tabel dan grafik serta dilakukan analisa komparasi dari variabel. Berdasarkan data tahun 2014-2017 didapatkan total 442 pasien dengan fraktur vertebra, dengan perbandingan laki-laki dan perempuan sebesar 3,3:1.  Rerata usia pasien adalah 43,6 tahun. Penyebab fraktur vertebra adalah akibat jatuh dari ketinggian (38%), kecelakaan lalu lintas (34%), dan benturan langsung/ tertimpa beban (10%). Berdasarkan level fraktur, fraktur terbanyak sejumlah 153 pasien (34,6%) pada level lumbal. Pada level lumbal didapatkan subtIpe fraktur terbanyak adalah tipe A dengan persentase 91,5% dan mechanism of injury terbanyak adalah akibat jatuh dari ketinggian. Berdasarkan subtipe frakturnya, fraktur tipe A (kompresi atau burst) merupakan jenis fraktur yang paling banyak terjadi. Fraktur vertebra lumbal adalah fraktur terbanyak pada kasus fraktur pada vertebra. Penyebab terbanyak fraktur pada vertebra adalah trauma dengan energi besar akibat jatuh dari ketinggian. Laki-laki 3 kali lebih banyak mengalami fraktur vertebra dibanding perempuan.Kata kunci: Epidemiologi, fraktur vertebra, trauma spinalKorespondensi  : dr.donnypermana@gmail.com
EVALUATION OF POLYMORPHONUCLEAR IMMUNE CELLS IN BIOCOMPATIBILITY TEST DFLP SPONGE CARTILAGE SCAFFOLD, ADIPOSE-DERIVED MSC AND SECRETOME WITH CARTILAGE INJECTION MODEL Brilliant Citra Wirashada; Dwikora Novemberi Utomo; Lukas Widhiyanto
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 1 (2020): April 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i1.2020.1-8

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Background: In recent years, Freeze-Dried Scaffold Bovine Cartilage has been widely used as an alternative therapy for joint cartilage defects. This study aims to determine the biocompatibility of scaffold without involving implantation which provides clinical reports as expected through the evaluation of post-implantation chondrocytes regeneration, biocompatibility markers of the scaffold, and biocompatibility of sponge cartilage scaffold involving cartilage defects New Zealand White Rabbit. Methods: This experimental in-vivo study was conducted for four weeks. Rabbits were divided into 4 treatment groups: microfracture defect group with DFLP sponge cartilage scaffold (P1) implantation; Microfracture defect group with DFLP sponge cartilage scaffold-secretome implantation (P2); Microfracture defect group with DFLP sponge cartilage scaffold-adipose derived Mesenchymal Stem Cells (ADMSCs) (P3); Microfracture defect group without implantation (control). The evaluations of basophil, eosinophil, neutrophil, and polymorphonuclear (PMN) cells were done in the first 24 hours, 3 days, and 1 week after the treatment. The collected data will be analyzed statistically. Results: Research observations performed three times in the first, third, and seventh days. The results showed a small number of average Neutrophil (Neutrophil granulated) and PMN (segmented Neutrophils) cells both in the P2 and P3 groups compared with the control and the P1 group. Conclusion: In general, biocompatibility is not included on the cytotoxic effects including inflammatory reactions and post-cartilage scaffold sponge implantation (DFLP) with or without the addition of ADMSC and secretome in the white rabbit New Zealand cartilage defect associated with differences seen in eosinophils, basophils, neutrophils, also total PMN cells in four groups.
CORRELATION BETWEEN KNEE OSTEOARTHRITIS (OA) GRADE AND BODY MASS INDEX (BMI) IN OUTPATIENTS OF ORTHOPAEDIC AND TRAUMATOLOGY DEPARTMENT RSUD DR. SOETOMO Lukas Widhiyanto; Andre Triadi Desnantyo; Lilik Djuari; Maynura Kharismansha
Journal Orthopaedi and Traumatology Surabaya Vol. 6 No. 2 (2017): October 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v6i2.2017.71-79

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Osteoarthritis (OA) is the number eight disease causes Years of Disability in developing countries. OA worsen life quality, from movement limitation until inability to perform normal daily routines. Obesity is one of the risk factor of OA. The doubles increasing trend of obesity from 1980, might possibly causes the escalation of OA case. However, there is still no study that explains the correlation between OA grade, especially knee OA, with Body Mass Index (BMI). The purpose of this study was to determine whether there is correlation between knee osteoarthritis (OA) grade with Body Mass Index (BMI) in outpatients of Orthopaedic and Traumatology department RSUD Dr. Soetomo. This study was cross-sectional study with analitical observational design and survey was the method to determine whether there is correlation between knee OA grade and BMI. Height and weight measurement and also knee x-ray reading were performed to determine the BMI and knee OA grade. The BMI categories that were used were based on standard from Health Department of Republic of Indonesia, while the grading system that were used were based on Kellgren-Lawrence’s grading system. Populations in this study were taken from the outpatients of Orthopaedic and Traumatology Department RSUD Dr. Soetomo during August until November 2015. After statistic test using Spearman correlation test was done, the result was p=0,822. It can be concluded that there was no significant correlation between knee OA grade and BMI. Furthermore, knee OA grade was not affected by BMI only, but also other risk factors as well.
TRAUMATIC CERVICAL SPINAL CORD INJURY. IS URGENT INTERVENTION SUPERIOR TO DELAYED INTERVENTION? A META-ANALYSIS EVALUATION I Ketut Martiana; Donny Permana; Lukas Widhiyanto
Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 1 (2019): April 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v8i1.2019.12-18

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Introduction: Cervical spine is the most mobile part of the human spine, thus making it the most vulnerable compared to all the other vertebral structures. Surgical procedures are usually performed within the first 24 hours, or 4-6 weeks after trauma in order to prevent any secondary trauma. The research was conducted to evaluate the amount of time of the surgical procedure towards the effectivity and improvement of the neurological status in the cervical injury or acute spinal cord injury (ASCI).Methods: A meta-analysis research which evaluate the effectivity of surgical procedure on cervical trauma/ASCI, with the database procured from PubMed, Embase, and Cochrane. The main parameter is the decompression procedure and the clinical outcome which were categorized. The time of surgery or decompression are categorized into “<24 hours” and “>24 hours”, the neurological outcome is categorized into “improvement” and “no improvement”. The data was presented in odd ratio (OR) and confidence interval (CI) and were further analyzed by forest plot.Results: From PubMed, there were 353 articles, Embase 2 articles, and Cochrane 594 articles, but only 3 articles which fulfilled the inclusion criteria. The comparison between the surgical procedure in the cervical <24 hours with the surgical procedure >24 hours was identified for this research. Statistically, there was a significant difference on the neurological status (OR=1,85; 95%CI=1,21-2,84; p<0,01).Conclusion: With meta-analysis background, early decompressive procedure <24 hours for cervical trauma patients produced a significantly better result in improving the neurological status compared to the late decompressive procedure >24 hours.
Clinical Outcome Evaluation in Anterior Cruciate Ligament Reconstruction using Transportal Technique Augmented with Platelet Rich Plasma (PRP) Injection Steesy Benedicta; Mouli Edward; Lukas Widhiyanto; Dwikora Novembri Utomo; Kukuh Dwiputra Hernugrahanto
The Hip and Knee Journal Vol 1, No 1 (2020): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1108.929 KB) | DOI: 10.46355/hipknee.v1i1.21

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Background: Anterior cruciate ligament (ACL) injury is a common injury in the athlete with an incidence of 30-78 cases per year. PRP injection can be applied to enhance graft healing and help patient return to sports faster. Transportal placement is a newer technique and believed can handle this problem. No perspective surveillance system has been made to monitoring the outcome of ACL surgery using the transportal technique and PRP injection in our hospital.Materials and Methods: A total data of 157 patients using medical records in our hospital between 1 January 2014 and 31 December 2018 were evaluated. All patients underwent ACL reconstruction surgery using the transportal technique and additional platelet rich plasma (PRP) intraarticular, with the exclusion of multiple ligament and meniscal injuries. The values evaluated in this study were clinical examination, SF-12 Daily Living Score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Oxford knee Score (OKS), Tegner Lysholm score and Cincinnati score. Patients were followed up from a minimum of 6 months to 4 years after surgery.Results: We found male-dominant (82.8%) patients with the mean age is 25.59 ± 7.61 years old. MOI mostly sports-related activity (78,9%). Anterior drawer and Lachman test post-surgery showed significant improvement. SF-12 showed increasing post-op with mean 80.94. Mean Tegner Lysholm and Cincinnati post-operative was 87.30 and 378.57. OKS pre and post-op mean was 23.56 and 43.82. No significant difference in KOOS score with p0.0001.Conclusions: The ACL reconstruction augmentation with PRP injection with the transportal technique showed significant satisfaction and function restored to normal.
Profiles of Patients with Low Back Pain Caused by Disc Herniation in the Neurology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya during the Period of 2021 Agindra, Bani; Hidayati, Hanik Badriyah; Widhiyanto, Lukas; Herawati, Lilik
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.52778

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Highlight: The degenerative process plays a dual role, both protecting from and causing disc herniation. Men have a quicker degeneration rate at a younger age, while women have a quicker rate at an older age. Occupational factors such as physical workload, repetition, bending, and sitting periods all contribute to disc herniation.   ABSTRACT Introduction: Low back pain (LBP) refers to a sensation of pain or discomfort occurring in the region between the lowest costal and gluteal crease, with or without leg pain. Damage to the annulus fibrosus causes disc herniation, allowing the nucleus pulposus to herniate into the spinal canal. In less than 5% of cases, LBP is caused by disc herniation. Objective: This study examined the profiles of individuals with herniated LBP discs and related factors at Dr. Soetomo General Academic Hospital Surabaya. Methods: The study was conducted at Dr. Soetomo General Academic Hospital Surabaya using secondary data from medical records, which was then analyzed using descriptive statistics. Results: Fifty-eight LBP patients with herniated discs were enrolled in this study. The patient sample ranged from 23 to 74 years old, with a mean of 47,98±14,92. The majority of patients (29.3%) were 31–40 years old. Male and female prevalence rates were the same. Employees have the highest percentage of any occupation group, with 56.9%. Conclusion: Some of the findings clarify previous studies. Age, gender, and occupation were all linked to the occurrence of either LBP or disc herniation. However, our data cannot indicate whether or not these factors contribute to the occurrence of LBP and disc herniation. Therefore, more research is required to understand these factors and their relation to disc herniation and LBP.  
The Impact of COVID-19 Pandemic on the Epidemiology of Hip and Knee Arthroplasty: A Two-Year Look into the Pandemic from A Single Tertiary Referral General Hospital in Indonesia Hanif, Hanan; Wardhani, Indrayuni Lukitra; Widhiyanto, Lukas; Chilmi, Mohammad Zaim
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 15 No. 1 (2024): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V15I12024.44-50

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Highlights: Arthroplasty surgeries were reduced significantly during the COVID-19 pandemic. The number of operations gradually increased between the first and second year of the pandemic. Patients' median age and hospital stays were reduced during the pandemic.   Abstract Introduction: The COVID-19 pandemic has had significant effects on arthroplasty surgeries worldwide. Various studies have described decreased arthroplasty procedures among the most common orthopedic surgeries. This study aimed to analyze the effects of the pandemic on the epidemiology and demography of hip and knee arthroplasty in a tertiary referral general hospital in Indonesia. Methods: This was a retrospective study of medical records data conducted on hip and knee arthroplasty cases from the pre-pandemic (April 2019–March 2020), first-year pandemic (April 2020–March 2021), and second-year pandemic (April 2021–March 2022) periods. Each period was compared for epidemiology and demography data, which included the annual number of arthroplasties, female-to-male ratio, age, duration of hospitalization, and in-hospital post-operative rehabilitation participation. All statistical data calculations were performed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26. Results: This study observed a statistically significant decrease of 232.00% for hip and 371.43% for knee arthroplasty performed during the first-year pandemic and an increase of 41.86% for hip and 74.07% for knee arthroplasty in the second-year pandemic. A decrease in median age and fluctuation of the female-to-male ratio were observed. The median duration of hospitalization was 80.00% shorter between the pre-pandemic and first-year pandemics and 11.11% shorter between the first and second-year pandemics. Participation in rehabilitation fluctuated during each period. There were four positive cases of COVID-19 and two cases of mortality during the first- and second-year pandemics. Conclusion: The COVID-19 pandemic caused a significant reduction in arthroplasties performed during the first year and a slight increase during the second year. Several changes to the demographics of the patients were also observed between the pre-pandemic and the pandemic periods.