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All Journal Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan Jurnal Sehat Indonesia (JUSINDO) The Hip and Knee Journal
Ludwig A. Pontoh
Department Of Orthopaedic And Traumatology, Faculty Of Medicine, Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Measurements of Patellofemoral Morphology Characteristics in Indonesian Population: an MRI Based Study Ludwig Andre Pontoh; Ismail Hadisoebroto Dilogo; Achmad Fauzi Kamal; Wahyu Widodo; Sholahuddin Rhatomy; Jessica Fiolin
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 15 No 2 (2021): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v15i2.3043

Abstract

Patellar malalignment is the imbalance relationship between patella and trochlea, in which clinical findings most of the time are obscured; hence diagnosis is often challenging. Magnetic resonance imaging (MRI) is the most sensitive tool to detect subtle patellar malalignment features, so diagnosis can be made early. However, there has been no clear consensus on the normal value of patella morphology until today. This study aims to determine patellofemoral morphology values in Indonesian using MRI. This was a retrospective study of 202 patients aged 18-40 years old with knee problems without patellar instability. Patellar morphology parameters including Insal Savati ratio (IS ratio), patellar tilt angle (PTA), sulcus angle (SA) and tibial tubercle-trochlear groove distance    (TT-TG) were evaluated and recorded for statistical analysis. There was no significant correlation between anthropometric values and patellar morphology values. There were significantly higher PTA, SA and TT-TG values in females compared to males. The mean value of the IS ratio in the Asian population using MRI was 0.99 ± 0.14, PTA was 9.09 ± 6.88, SA was 139.20 ± 6.38, and TT-TG distance was 8.00 ± 5.25. Further studies with larger samples and multi-center results are required.
Isolation and Characterization of Adipose-Derived Mesenchymal Stem Cell Exosomes: an In-Vitro Study Jessica Fiolin; Ismail Hadisoebroto Dilogo; Radiana Dhewayani Antarianto; Ludwig Andre Pontoh
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 16 No 2 (2022): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v16i2.4867

Abstract

Exosomes from Mesenchymal Stem Cells (MSC) is currently one of the highlighted research due to its more specific action on the target tissue. Exosome is one of the MSC Extracellular Vesicle (EVs) that acts as a mediator in the cellular communication. However, not so many literatures have succeed in elaborating its isolation and characterization process. This study aimed to explain the method used in exosomes isolation from Adipose-Derived MSC (ASC) and elaborate its characteristics. This is an in-vitro study performed in the Stem Cell and Tissue Engineering (SCTE) Indonesia Medical Education and Research Institute (IMERI) laboratory. Ultracentrifugation method was performed to isolate exosome from ASC. The exosome were characterized based on its particle size, morphology, and CD63 and CD81 expression for its purity. We were able to isolate sterile exosome from ASC by performing differential ultracentrifugation. The mean size of exosome was 88.7 nm ± 40 nm SD and showed expression of CD63 and CD81. Exosome was successfully isolated from ASC using ultracentrifugation method and characterization following the MISEV standard should be implemented in order to meet the therapeutic efficacy and safety issues as a regenerative agent.
Prosthetic Joint Infection Microorganism Pattern and Risk Factor Profile: A Single Center Study Fahreza Hilmy; Yoshi Pratama Djaja; Anggaditya Putra; Jamot Silitonga; Ludwig Andribert Pontoh
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 (805.612 KB) | DOI: 10.46355/hipknee.v1i1.24

Abstract

Introduction: Prosthetic joint infection (PJI) is a serious complication especially following arthroplasty surgeries. The outcome of these cases is affected by the pattern of infection, causative microorganism, and antibiotic resistance. This study was aimed to evaluate the prevalence of PJI, distribution of causative microorganism, antibiotic resistance, and risk factor profiling.Methods: A retrospective review was performed by arthroplasty registry evaluation from 2008-2018, followed by a medical record review and patient interview. Distribution of causative microorganisms, antibiotic resistance patterns, and the onset of infection was extracted. Risk factor evaluation was performed by assessing preoperative (age, body mass index (BMI), frailty index) and perioperative parameters (duration of surgery, number of previous surgeries, the interval between those surgeries). Results: Seventeen patients were diagnosed with PJI (13 hip and 4 knees), with a prevalence of 1.56% and 1.77% respectively. The most common causative organism was Staphylococcus aureus and Escherichia coli with multiple antibiotic resistance patterns. These infections mostly occurred in patients with the age of 40-60 years, BMI 30kg/m2, and pre-operative frailty index of 4. The perioperative risk factor was the duration of surgery for more than 3 hours, have undergone more than 3 surgeries with an average surgical interval of 2 months.Conclusions: The prevalence of PJI in this series was 1.56% in hip and 1.77% in the knee. The risk factor profile showed that most cases have high BMI, prolonged duration of surgery, and a high number of previous surgeries within a short interval. 
Adhesive Plastic Drapes Did Not Prove to Prevent Surgical Site Infection in Total Knee Arthroplasty: A Randomized Controlled Trial Pontoh, Ludwig Andretia Powantia; Dilogo, Ismail Hadisoebroto; Putra, Anggaditya; Widodo, Wahyu; Oesman, Ihsan; Fiolin, Jessica; Herdiman, Joshua Alward
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.v5i2.159

Abstract

Surgical site infection (SSI) prevention is crucial in total knee arthroplasty (TKA) procedures. One controllable factor is preventing foreign substances from contaminating the surgical field, for which adhesive draping over surgical drapes is commonly used. To determine whether using adhesive transparent film dressing has any effect on the occurrence of SSI in TKA. We conducted a study comparing 100 TKA, divided into two groups (each with 50 participants). The first group received adhesive plastic draping during TKA, while the second group was the control. Bacterial aerobic culture swabs were taken before applying the plastic draping and after surgery following skin closure. Follow-up evaluations were conducted within one month to detect signs of SSI. The results none of the 100 TKAs included in the study yielded positive bacterial culture results. One-month post-operative evaluations revealed no signs of SSI in any of the groups.The conclusion use of adhesive plastic drapes does not provide any benefit in preventing SSI in TKA. Skin preparation, prophylaxis, and surgeon preparation protocols are more crucial for SSI prevention than adhesive plastic drapes.
Clinical Outcomes and Complications of Simultaneous Bilateral Total Knee Arthroplasty Compared with Staged Total Knee Arthroplasty in Patients with Severe Knee Osteoarthritis Othdeh Samuel Halomoan Siahaan; Ludwig Andribert Powantia Pontoh; Ismail Hadisoebroto Dilogo; Endro Tomo Sumargono
Jurnal Sehat Indonesia (JUSINDO) Vol. 8 No. 2 (2026): Jurnal Sehat Indonesia (JUSINDO)
Publisher : CV. Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/-.v8i2.538

Abstract

Osteoarthritis (OA), the most common degenerative joint disease and a leading cause of disability, primarily affects the knee joint. In severe knee OA, total knee arthroplasty (TKA) is an effective treatment option; bilateral cases may be managed through simultaneous bilateral total knee arthroplasty (simBTKA) or staged total knee arthroplasty (staTKA), depending on patient characteristics and risk profiles. simBTKA may reduce overall treatment duration and healthcare costs but is associated with a higher risk of short-term mortality, venous thromboembolism, increased transfusion requirements, and more complex rehabilitation. Evidence remains limited regarding which patients derive the greatest benefit, medium- to long-term outcomes (patient-reported outcome measures [PROMs], including the Oxford Knee Score [OKS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], and range of motion [ROM]), and total treatment costs. This study aimed to compare the clinical outcomes and complications of simBTKA and staTKA in patients with severe knee OA using a retrospective cohort design based on medical records of patients with severe bilateral OA who underwent either simBTKA or staTKA at RSCM, Fatmawati Central General Hospital, and St. Carolus Hospital between January 2021 and September 2024, according to predefined eligibility criteria. The assessed outcomes included OKS, WOMAC, ROM, length of stay (LOS), and complication incidence, which were analyzed using SPSS version 25 for Windows. Before adjustment, WOMAC scores were higher in the simBTKA group than in the staTKA group (median 28 vs. 14; p = 0.012), with no significant differences observed in OKS or ROM. Following ANCOVA adjustment, WOMAC scores were lower in the simBTKA group than in the staTKA group (adjusted mean 22.31 vs. 28.72; p = 0.04), and ROM was superior in the simBTKA group (adjusted mean 119.42 vs. 112.80; p = 0.03). Blood loss was greater in the staTKA group than in the simBTKA group (median 650 vs. 200 cc; p < 0.001). Overall, after adjustment, WOMAC scores and ROM outcomes were better in the simBTKA group than in the staTKA group, whereas blood loss was greater in the staTKA group.
Comparison of Anterior Half Peroneus Longus Autograft versus Hamstring, Quadriceps and Bone–Patellar Tendon–Bone Grafts in ACL Reconstruction Ludwig Andre Pontoh
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 20 No 1 (2026): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan (In Press)
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v20i1.13869

Abstract

Background: Graft selection is a key determinant of outcomes after anterior cruciate ligament reconstruction (ACLR). The anterior half peroneus longus tendon (PL) has emerged as an alternative autograft that may preserve hamstring–quadriceps balance while providing adequate graft size and strength, but its role relative to established grafts remains unclear. Methods: A narrative review of biomechanical studies, randomized controlled trials, cohort studies, and systematic reviews was conducted to compare ACLR using PL, hamstring tendon (HT), quadriceps tendon (QT), and bone–patellar tendon–bone (BPTB) autografts. Outcomes included graft mechanical properties, muscle strength balance, knee stability, clinical scores, donor-site morbidity, rehabilitation considerations, and harvesting techniques. Results: The anterior half PL autograft provides sufficient tensile strength and consistent graft diameter (≥8 mm), with knee stability and functional outcomes comparable to HT grafts. PL grafts demonstrate advantages in harvest time, graft size, and donor-site morbidity, while preserving hamstring strength and hamstring–quadriceps balance. Ankle function is largely maintained with appropriate tenodesis. QT grafts show greater early quadriceps weakness, and BPTB grafts are associated with higher anterior knee pain. Conclusion: The anterior half peroneus longus autograft is a viable alternative for ACL reconstruction.
Patellofemoral Tracking After Total Knee Arthroplasty: Etiology, Diagnosis, Management, and the Emerging Role of Robotic-Assisted Alignment Ludwig Andre Pontoh
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 19 No 2 (2025): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan (In Press)
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v19i2.14095

Abstract

Patellofemoral maltracking remains a major cause of pain, instability, poor function, and dissatisfaction after total knee arthroplasty (TKA). Despite advances in implant design and surgical technique, patellofemoral complications continue to contribute to revision surgery and inferior outcomes. This review summarizes the etiology, diagnosis, prevention, and management of patellofemoral tracking abnormalities after TKA, including a comparison between conventional and robotic-assisted techniques. The most common causes of maltracking include internal rotation of the femoral or tibial component, excessive valgus alignment, soft-tissue imbalance, patella baja, anterior overstuffing, and implant design mismatch. Internal femoral malrotation is consistently identified as the leading factor causing lateral patellar tilt, subluxation, and instability. Clinical evaluation includes anterior knee pain, crepitus, apprehension, and extensor lag, while radiographs and computed tomography are important for assessing patellar tilt, shift, and component rotation. Treatment depends on the underlying cause. Revision of malrotated components, lateral release, tibial tubercle transfer, medial patellofemoral ligament reconstruction, and secondary patellar resurfacing may be required. Robotic-assisted TKA improves component alignment and intra-operative assessment, but current evidence has not shown superior functional outcomes compared with conventional TKA.
Co-Authors Achmad Fauzi Kamal Andri M.T. Lubis Anggaditya Putra Edu Tehupeory Endro Tomo Sumargono Fahreza Hilmy Fiolin, Jessica Harahap, Alida R. Herdiman, Joshua Alward Hori Hariyanto Ismail Hadisoebroto Dilogo Ismail Hadisoebroto Dilogo Jamot Silitonga Jessica Fiolin Jessica Fiolin John Butarbutar Mohammad Hidayat Oesman Ihsan Othdeh Samuel Halomoan Siahaan Pandelaki, Jacub Putra, Anggaditya Radiana Dhewayani Antarianto Saptawati Bardosono Sholahuddin Rhatomy Wahyu Widodo Wahyu Widodo Yeremia Tatang Yoshi Pratama Djaja