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All Journal The Hip and Knee Journal Physical Therapy Journal of Indonesia
Yushan, Rafael Marvin
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Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Current Treatment Update for Anterior Cruciate Ligament Tears in Adolescence: A Narrative Review Yushan, Rafael Marvin; Winaga, Handriadi; Singjie, Leonard Christianto
The Hip and Knee Journal Vol 5, No 2 (2024): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46355/hipknee.v5i2.158

Abstract

To follow up regarding orthopedic updates in respect of the treatment of ACL tears in adolescence. The methods we performed a comprehensive literature search from four databases to synthesize a narrative review of available evidence on the recent update of ACL treatment in adolescence. The results is conservative treatment remains preferred for partial ACL tears in adolescence. Some surgeons have favored non-operative or delayed surgical treatment until skeletal maturity has reached or after a failed trial of non-operative management. However, adolescent patients who delayed ACLR for more than 12 weeks had increased risk of meniscal pathology and irreparable meniscal tears by a 4.3 and 3.2 times, respectively. Various ACL reconstruction techniques for adolescents have developed to respect growing physes, these are physeal sparing (extraphyseal and all-epiphyseal), partial transphyseal, and transphyseal. The conclusions is early operative treatment of ACL injury is preferred compared to non-operative or delayed treatment. The reconstruction techniques were adjusted to each patient's potential for growth, the facilities' capabilities, and the surgeons' skills. High-growth potential patients should still undergo surgery using a technique with the slightest manipulation of growth cartilage.
Methicillin-Resistant Staphylococcus Aureus in orthopedic surgery: Current evidence from diagnosis until rehabilitative management Handoko, Yosia; Johan, Muhammad P.; Usman, Muhammad A.; Sakti, Muhammad; Arifin, Jainal; Sjahril, Rizalinda; Sultan, Andi Rofian; Pertiwi, Yunialthy Dwia; Yushan, Rafael Marvin; Kusuma, Samuel Andi
Physical Therapy Journal of Indonesia Vol. 7 No. 1 (2026): Inpress January-June 2026
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v7i1.342

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant threat in orthopaedic surgery. This study aimed to evaluate the current evidence from diagnosis to rehabilitative management of MRSA in orthopedic surgery Methods: This narrative overview synthesized current evidence across the care pathway in orthopaedics, epidemiology and pathogenesis (including key resistance/virulence determinants), diagnostic approaches (sampling strategies and rapid molecular tests), therapeutic strategies (surgery plus tailored antimicrobials and local delivery), rehabilitation considerations, prevention and stewardship programs, and emerging modalities (new antibiotics, bacteriophages, and nanotechnology-enabled delivery). Results: MRSA resistance is primarily mediated by mecA (PBP2a) and augmented by additional virulence factors (e.g., panton-valentine leukocidin). Biofilm on orthopaedic implants protects bacteria from host defences and antibiotics, underpinning recurrent infection. Diagnostic yield improves with deep tissue or implant-associated sampling, while polymerase chain reaction expedites detection of resistance genes to guide early management. Optimal treatment typically combines surgical debridement with implant retention or exchange where appropriate and prolonged, targeted antimicrobials; adjuncts include local antibiotic carriers and negative-pressure wound strategies. Innovative options—novel agents, bacteriophage therapy, and nanotechnology-based delivery—show promise in early studies. Conclusion: Integrated programs, preoperative screening/decolonization, risk-adapted prophylaxis, and antimicrobial stewardship have helped lower MRSA infection rates, yet biofilm biology and rising resistance sustain a substantial burden. Emerging options include linezolid/tedizolid or minocycline plus rifampicin, with efficacy superior to vancomycin, bacteriophage therapy as an adjunct in refractory prosthetic joint infections, and nanotechnology-enabled implant coatings to deter biofilm formation.
Co-Authors Arifin, Jainal Handoko, Yosia Johan, Muhammad P. Kusuma, Samuel Andi Pertiwi, Yunialthy Dwia Riza Linda Sakti, Muhammad Singjie, Leonard Christianto Sultan, Andi Rofian Usman, Muhammad A. Winaga, Handriadi