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Lukas Widhiyanto, dr., SpOT(K)
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joints@fk.unair.ac.id
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(+6231) 5501481
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joints@fk.unair.ac.id
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Jl. Prof. Dr. Moestopo 6-8, Surabaya
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Journal Orthopaedi and Traumatology Surabaya (JOINTS)
Published by Universitas Airlangga
ISSN : 2722712X     EISSN : 24608742     DOI : 10.20473/joints.v10i2.2021.39-45
Core Subject : Health,
Health Professions Medicine & Pharmacology
The JOINTS research topics are relating to education and training in the field of orthopedics and traumatology, including research reports, case reports, and literature reviews.
Arjuna Subject : Kedokteran - Ortopedi dan Kedokteran Kesehatan
Articles 5 Documents
 1 
Search results for , issue "Vol. 9 No. 2 (2020): October 2020" : 5 Documents clear
ADOLESCENCE TIBIAL TUBERCLE AVULSION FRACTURE: OPTION OF SURGICAL TREATMENT IN WORSENING CONDITION OF PRE-EXISTING OSGOOD-SCHLATTER DISEASE (OSD) Fira Soraya; Ritzky Pratomo Affan; Bagus Danu Hariyanto
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i2.2020.55-62

Abstract

Background: Osgood-Schlatter disease (OSD) is the most frequent cause of chronic knee pain in adolescents. Tibial tubercle avulsion fractures are an infrequent injury, approximately between 0.4-2.7% of all epiphyseal injury. Even though the relation between OSD and tibial tubercle avulsion fracture is still controversial, there are cases previously reported with this presentation.Case Report: A 16-years-old boy complained of pain on his left knee, significantly below the patella with ambulation limitation. He had a two-months history of knee pain in the same location and prominence on the area below the patella that was getting more significant over time. The patient was actively involved in volleyball in his school. The radiographic findings show fragmented tubercle fractures on the left tibial, soft tissue swelling in the tubercle's anterior side, and increased density of the infrapatellar fat pad. The patient underwent ORIF with screws. After a one-month post-surgery, the patient felt minimal pain when bending his left knee.Discussion: Male adolescents (12-15 years) and repetitive sprinting and jumping sports are the risk factors for OSD. About 90% of cases show a complete resolution, but some conditions make the OSD worse, such as low compliance at exercise avoidance. Surgery is rarely indicated for OSD, but in the condition of, even though very uncommon, tibial tubercle avulsion fracture, surgery gives a better outcome and resolution.Conclusion: All Osgood-Schlatter disease' patients should temporarily restrict sports activities to prevent tibial tubercle avulsion fractures.
Influence of Medication on Flare Up and Infection After Elective Orthopedic Surgery in Rheumatoid Arthritis Patient – A Narrative Review Rosadi, Yaldi; Marinta, Yustin; Afifah, Muthiah Nur
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i2.2020.77-89

Abstract

Background: Orthopedic Surgery in Rheumatoid Arthritis (RA) patients is still controversial between orthopedic surgeons and rheumatologists, mainly due to infection and disease flares. The incidence of postoperative infections may be high due to the immunosuppressive effect of RA medication. Conversely, discontinuance of antirheumatic agents increases the possibility of a disease flare. The objective of our review is to assess the influence of drugs on both incidences.Literature Review: There were 13 studies included in this review. Methotrexate (MTX) is the most common csDMARD option among the included studies. One retrospective study that the incidence of flares tends to be higher among the group of patients who received MTX therapy and stopped more than one week before surgery than the group who did not stop. The use of MTX doses of 5 to 10 mg/week did not show an association with infection or flare incidence. On the use of bDMARD, 37.0% of patients had higher surgical site infection (SSI). Specifically, Tumor Necrosis Factor-alpha (TNF-α) inhibitors significantly (OR: 9.5, 95% CI: 1.0-88.8) increase the incidence of postoperative infections in standard-dose and high-dose, but not significantly in the rate of flares.Summary: csDMARD is recommended for continuous therapy, whereas for bDMARD, although it is recommended for withholding in the perioperative period, the results of the study did not show significant differences. The ideal dosage of medication is by the basic properties of the drug. In comparison, the incidence of flares and infections was significantly higher in biologic than csDMARD.
UNSTABLE LUMBAR FRACTURE-DISLOCATION TREATED BY LONG SEGMENT POSTERIOR PEDICLE SCREW INSTRUMENTATION Ferdiansyah Danang; Primadenny Ariesa Airlangga
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i2.2020.71-76

Abstract

Background: Among all the thoracolumbar fractures, 50-60% affects the thoracolumbar transitional zone, and 51% AO Type C Fractures has a neurological deficit. We experienced treating a case of unstable lumbar fracture-dislocation treated with long segment pedicle screw instrumentation.Case: A 26-year-old man came to the ER after his back hit by a canopy while working 2 hours before admission. The motoric function was diminished from the L2-S1 level and hypoesthesia at the T12 level. Plain X-Ray showed Fracture-Dislocation Lumbar Vertebral 1-2 Denis Classification Flexion Rotation (AO Type C) ASIA A. The patient underwent reduction, decompression, and long-segment posterior pedicle screw instrumentation.Discussion: The surgery’s primary purpose is to restore alignment and stability to improve the patient’s quality of life by enabling daily activity in a wheelchair without significant pain. Short segment or long segment pedicle screw instrumentation remains a debate. In this case report, we apply long segment pedicle screw instrumentation for lumbar vertebral fracture-dislocation.Conclusion: Thoracolumbar fracture and dislocation fixation aim to restore alignment and stability, to reduce kyphotic deformity, and to decompress the spinal canal. The long segment pedicle screw instrumentation can resist the deforming force of thoracolumbar fractures and dislocations that will inevitably collapse into further kyphosis, resulting in a better outcome.
DIFFERENCES OF BONE REGENERATION USING BOVINE HYDROXYAPATITE AND BOVINE HYDROXYAPATITE WITH FREEZE-DRIED PLATELET RICH PLASMA ALLOGRAFT IN BONE DEFECT OF FEMORAL WHITE RABBIT Mouli Edward; Henry Dominica; Ferdiansyah Mahyudin; Fedik Abdul Rantam
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i2.2020.34-54

Abstract

Background: Hydroxyapatite is a bone graft that has osteoconductive properties for bone defects treatment. Platelet-rich plasma (PRP) has a capability of providing many bioactive molecules in physiological proportions. Hydroxyapatite given freeze-dried PRP is expected to create a graft that can strengthen the matrix while promoting osteoinduction. This study compares the effects of regeneration on the bone between bovine hydroxyapatite (BHA) and bovine hydroxyapatite with freeze-dried platelet-rich plasma (FD-PRP) as a bone graft in bone defect of the femoral white rabbit.Methods: The 12 equal New Zealand white rabbits aged 6-9 months are divided into two groups. Bone defects were made in the lower femoral meta-diaphysis with a diameter of 2.5 mm. The defects were filled with BHA with FD-PRP allograft in the treatment group and BHA in the control group. Both groups will be sacrificed in the third and sixth weeks, then evaluated histologically for microvascular structure, osteoblasts, woven bone, type-I collagen, osteocalcin, alkaline phosphatase, and immunoglobulin G.Results: During the evaluation in week 3 and 6, microvascular structure, osteoblast, and type-I collagen decreased in both groups with insignificant differences (p>0.05). Woven bone, osteocalcin, and immunoglobulin G increased in the treatment group but was not significant (p>0.05). Alkaline phosphatase increased higher in the treatment group, with a considerable difference in the sixth week (p=0.008).Conclusion: The elevation in the production of woven bone, osteocalcin, and alkaline phosphatase at the third and sixth-week evaluations highlight the possibility that administering BHA given FD-PRP may have contributed to the healing of bone defects.
TUBERCULOUS ARTHRITIS OF THE ANKLE MIMICKING SYNOVITIS IN CHILD - A CASE REPORT Erick Yudistira Christanto; Sulis Bayusentono
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i2.2020.63-70

Abstract

Background: Extrapulmonary Tuberculosis is approximately 10% of all tuberculosis (TB) cases, and the musculoskeletal system’s involvement was only 2-4. The incidence of ankle TB was found to be less than 2% of all musculoskeletal TB. The rare occurrence, uncommon site, non-specific symptoms, lack of awareness frequently causes diagnosis difficulties.Case Report: A 2,5-year-old child came to the hospital with the main complaints of swelling and pain on the left ankle since one year ago. She was diagnosed with the ankle’s synovitis from the previous hospital and was given analgesics and a warm compress on the left ankle. However, the swelling of her left ankle increased during the last seven months, causing limitation of the left ankle movement, then she was admitted to the hospital for further examination.Discussion: Radiologic examination revealed peripheral osseous erosions, reduced bone mineral content, and soft tissue swelling. A Mantoux test was positive with 15 mm induration and 25 mm erythema. Anti-tuberculous drugs (ATD) therapy was given with isoniazid 50 mg, rifampicin 75 mg, pyrazinamide 150 mg, and ethambutol 230 mg for two months, as an intensive phase therapy following rifampicin 75 mg and isoniazid 50 mg for ten months.Conclusion: Tuberculous arthritis of the ankle poses a diagnostic-difficulties, it should be considered especially in the endemic area. It is often misdiagnosed with other musculoskeletal conditions, which can delay the initiation of appropriate treatment. TB must be confirmed by histological pathology. A combination of ATD and surgery can lead to clinical improvement.

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