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All Journal Medical Journal of Indonesia Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan The Hip and Knee Journal

Ludwig A. Pontoh

Department Of Orthopaedic And Traumatology, Faculty Of Medicine, Universitas Indonesia, Fatmawati Hospital, Jakarta

Author-ID : 953798

Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Medicine & Pharmacology Neuroscience

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Articles

Modified exorotation graft tension for tibial fixation in anterior cruciate ligament reconstruction: a randomized controlled trial Pontoh, Ludwig A.P.; Dilogo, Ismail H.; Bardosono, Saptawati; Lubis, Andri M.T.; Harahap, Alida R.; Pandelaki, Jacub; Hidayat, Mohammad
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Background: The inability of anterior cruciate ligament reconstruction (ACLR) surgery to reduce tibial internal rotation causes many problems. A large tibial internal rotation will result in a patellofemoral pain syndrome. This study aimed to introduce a new technique of modified exorotation graft tension at tibial fixation to minimize endorotation, reduce tibial internal rotation, and prevent patellofemoral pain syndrome.Methods: This study was a randomized double-blind controlled clinical trial. ACL rupture patients underwent ACLR surgery between December 2014 and Februrary 2015. They were randomized to standard endorotation group or modified exorotation group. Hamstring autograft was used and fixed with an EndoButton® and bioabsorbable interference screw. Tibial tubercle to trochlear grove (TTTG) was used to evaluate rotation, whereas cartilage oligomeric matrix protein (COMP) was employed to analyze cartilage breakdown. The functional outcome was measured using the Kujala score to assess patellofemoral joint function. Evaluations were conducted before the surgery and at 6 months postoperation.Results: A total of 29 subjects were recruited. Sixteen subjects were allocated into the standard endorotation group, and 13 were assigned to the modified exorotation group. The exorotation group demonstrated better results than the endorotation group in all three parameters: TTTG (p=0.028), COMP (p<0.001), and Kujala score (p=0.015).Conclusion: A new technique of modified exorotation direction of graft tension for ACL reconstructive surgery at tibial fixation showed a significant reduction in tibial internal rotation and cartilage breakdown. The proposed method could significantly improve the functional outcome of those with total ACL rupture.

Distance between parapatellar portal and intra-articular space for needle positioning in knee osteoarthritis Butarbutar, John; Tatang, Yeremia; Hariyanto, Hori; Tehupeory, Edu; Pontoh, Ludwig A.
Medical Journal of Indonesia Vol 22, No 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Background: Intra-articular injection is a common therapeutic procedure in osteoarthritis (OA) that need high accuracy. This study was aimed to measure the distance between parapatellar skin and intra-articular space as a guidance to choose the length of needle needed to perform intra-articular injection. Methods: Twenty one knees MRI were taken from 16 females with knee osteoarthritis. The length of the needle needed to reach intra-articular space was reconstructed by drawing straight line from skin to intra-articular fluid. Paired t-test was using to analyze the mean difference of measurement of left side compare with right side with significant indicator if p-value < 0.05. Results: The entry point on both medial and lateral parapatellar were more cranial than transverse mid-patellar line. On medial portal, the closest distance from skin to intra-articular space is 27.81 ± 7.58 mm. Mean point of entry is 4.46 ± 2.16 mm cranial to mid-patellar line, and 14.20 ± 4.45 mm posterior to the prominence of medial border of patella. On lateral portal, the closest distance from skin to intra-articular space is 16.84 ± 6.79 mm. Mean point of entry is 11.10 ± 5.94 mm cranial to mid-patellar line, and 8.91 ± 3.83 mm posterior to the prominence of lateral border of patella. Conclusion: MRI knee osteoarthritis study showed that the mean distance between skin and intra-articular joint space of medial portal is 27.81 ± 7.58 mm, and lateral portal is 16.84 ± 6.79 mm. The portals on both sides is cranial to midpoint of patella, lateral appears more proximal than medial. This should be put into consideration in choosing needle length and portal projection to increase intra-articular injection accuracy. (Med J Indones. 2013;22:83-7)Keywords: Needle length, osteoarthritis, parapatellar skin portal

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

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)

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.

Co-Authors Andri M.T. Lubis Anggaditya Putra Edu Tehupeory Fahreza Hilmy Harahap, Alida R. Hori Hariyanto Ismail Hadisoebroto Dilogo Jamot Silitonga Jessica Fiolin John Butarbutar Mohammad Hidayat Pandelaki, Jacub Radiana Dhewayani Antarianto Saptawati Bardosono Yeremia Tatang Yoshi Pratama Djaja

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