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Lukas Widhiyanto, dr., SpOT(K)
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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 111 Documents
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Correlative Analysis of Radiological Measurements and 1-year SRS-22r in Early and Middle Adolescents with Adolescent Idiopathic Scoliosis: A Retrospective Study Ermawan, Rieva; Jiwandono, Bayu Sakti; Yudistiro, Ibnu; Abdulhamid, Muhammad; Corrigan, Hubertus; Renata, Felicia
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 1 (2025): April 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i1.2025.26-36

Abstract

Background: Patient-reported outcomes are increasingly valuable for assessing the effectiveness of clinical interventions from the patient's perspective. This study aims to investigate the differences in the correlation between radiological measurements and 1-year postoperative SRS-22r domain scores in early (EA) and middle adolescence (MA) patients with adolescent idiopathic scoliosis (AIS), as well as analyze the correlation of these outcomes across different Lenke curve types. Methods: We reviewed records of 87 female AIS patients who underwent scoliosis corrective surgery, collecting data on age, body mass index, preoperative and postoperative radiographic measurements, and 1-year postoperative quality of life assessments, including function, pain, self-image, and satisfaction scores from the SRS-22r questionnaire. Patients were categorized into subgroups based on age and the number of curves. The Spearman correlation test evaluated correlations between radiographic measures and SRS-22r domain scores across these subgroups. Results: Significant correlations were found between self-image and preoperative main apical vertebral translation (AVT), Cobb angle, and trunk shift, with stronger associations in EA than MA. Pain had a weak inverse correlation with the postoperative main Cobb angle, notably in the one-curve group and more strongly in EA. Satisfaction scores decreased with age and were lower in the two-curve group and EA. Conclusions: Cobb angle correction in AIS patients strongly correlates to postoperative self-image, particularly in Lenke type 2, 3, and 6. In Lenke type 1 and type 5, greater correction of the Cobb angle is associated with increased postoperative pain.
Therapeutic Modality of Mesenchymal Stem Cells for Moderate to Severe Knee Osteoarthtritis: A Systematic Review Fathani, Irfan Jaen; Hanif Al Asad Budiyanto, Muhammad; Jannatin, Nurin
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 1 (2025): April 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i1.2025.46-55

Abstract

Background: Osteoarthritis (OA) is a chronic degenerative joint disease that commonly affects weight-bearing joints, such as the knee. A potential treatment is the intra-articular injection of mesenchymal stem cells (MSCs), which may stimulate joint tissue regeneration, cartilage formation, and angiogenesis. This systematic review aimed to evaluate the efficacy and safety of MSC therapy in moderate-to-severe knee OA.Methods: Literature searches were conducted using PubMed, Science Direct, Taylor and Francis, Google Scholar, Springer Link, Wiley, and the Garuda Portal. From the 644 identified articles, only seven randomized controlled trials published within the last 10 years met the inclusion criteria.Results: Five of the seven studies demonstrated significant reductions in pain based on Visual Analog Scale (VAS) scores following MSC injections. Four studies reported significant improvements in WOMAC scores, whereas one study showed no notable change. Adverse effects noted after injections included joint swelling, contusions, postprocedural hematomas, mild effusion, and injection site pain.Conclusions: Intra-articular MSC therapy shows potential for reducing pain and improving joint function in moderate-to-severe knee OA. Improvements in VAS and WOMAC scores suggest clinical benefits that can last up to 12–48 months post-treatment. MSC injections may be considered as a causal therapy in addition to symptomatic treatments, such as analgesics, to enhance patient quality of life.
Type III Osteogenesis Imperfecta with Severe Limb Deformities: A Report with Review of The Literature Zacharia, Balaji; Kambagi, Kashinath Yamanappa; Kumar, R. Manoj
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 1 (2025): April 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i1.2025.56-63

Abstract

Background: Type III osteogenesis imperfecta (OI) is very rare. In this article, we describe the clinical features and management of a case of type III osteogenesis imperfecta with a review of the literature.Case Report: A 5 – year - old girl presented with deformities of the bilateral lower and upper limbs. Posterior bowing of both humerus, cubitus varus deformity of both elbows, shepherd crook deformities of the femur, and anterolateral bowing of both legs were observed. She was unable to walk. Her face was triangular, and she had a kyphoscoliotic deformity of the spine. Radiographs showed osteopenia and multiple fractures at different stages of healing. The clinical and radiological findings were consistent with those of type III OI. She was treated by deformity correction of the right femur and tibia using the Sofield technique.Discussion: OI is a disorder caused by a mutation in type 1 collagen. It is characterized by increased bone fragility, dentigerous imperfecta, and generalized ligamentous laxity. There are 18 types of OI. We describe a case of type 3 OI in which the child developed deformity of the spine and limb at a later age without involvement of the sclera. Lower limb deformities were corrected using the Sofield technique of multiple osteotomies and intramedullary nailing. The implants were removed once the osteotomies were united. After implant removal, anterolateral bowing of the tibiae recurred.Conclusions: Long bone deformities can be managed using the Sofield technique. Long-term follow-up is essential for the early detection and correction of recurrence.
Comparison of Oxford Knee Score in Knee Osteoarthritis Patients Before and After Total Knee Replacement at Dr. Mohamad Soewandhie Hospital Santosa, Sharlene Joy; Sasono, Bimo; Sekarputri, Cempaka Harsa; Rambung , Etha
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.64-71

Abstract

Background: One of the most common degenerative joint diseases is knee osteoarthritis. This condition leads to pain and reduces functionality of the knee joints, which can negatively impact a patient’s quality of life. Total knee replacement (TKR) has become the standard procedure to treat end-stage osteoarthritis. Evaluating the success of TKR procedures is very important. One instrument that can be used for this purpose is the Oxford Knee Score (OKS). Methods: This observational analytic comparative study involved 40 patients. The data were collected by interviewing patients who had undergone TKR at Dr. Mohamad Soewandhie General Hospital between 2019 and 2024. The data were analyzed using Wilcoxon signed-ranks test, independent samples t-test, and Kruskal-Wallis test.  Results: The majority of the sample in this study was aged over 60 years (62.5%), female (87.5%), and had an overweight BMI (47.5%). The analysis showed a significant increase in the OKS after surgery, with a p-value of <0.05. The independent samples t-test showed a significant difference in the improvement of the OKS between males and females. Meanwhile, the Kruskal-Wallis test showed no significant difference in OKS improvement across BMI categories. Conclusions: There is a significant difference in the OKS before and after TKR surgery, which indicates an improvement in knee functionality and quality of life after surgery. Differences in patient gender may affect the outcome of the surgery, including post-surgery recovery rate and knee functionality. Meanwhile, BMI showed no significant difference in the outcome of TKR surgery.
Solitary Neurofibroma Mimicking Giant Cell Tumor of The Upper Cervical Spine: A Case Report Ermawan, Rieva; Renata, Felicia; Muzakkiyafi, Mohammad; Corrigan, Hubertus
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.105-111

Abstract

Background: Spinal neurofibromas are benign peripheral nerve sheath tumors typically occurring in the thoracic region. Involvement of the C2 vertebra is particularly rare. Atypical presentations of solitary neurofibromas can pose diagnostic challenges when their radiological features resemble other neoplastic entities. Case Report: A 35-year-old male presented with a 3-month history of neck pain and no history of trauma. Physical examination revealed mild bulging and localized tenderness in the posterior neck, with restricted neck extension to 30 degrees. Plain radiography showed a round, expansile lytic lesion with well-defined, nonsclerotic borders on the C2 spinous process, while MRI confirmed enhancing solid components and extensive bone involvement, indicative of a giant cell tumor. The histopathology from the core needle biopsy was inconclusive, showing few inflammatory cells and no evidence of malignancy. The lesion was marginally resected from a posterior approach, achieving only subtotal resection to preserve the vertebral artery. Histopathological analysis from the open biopsy confirmed the diagnosis of neurofibroma. At the 3-month follow-up, postoperative imaging showed the residual tumor. Despite this, the patient reported significant neck pain relief.Discussion: Radiography is insufficient for differentiating spinal tumors; therefore, histopathological biopsy is necessary for an accurate diagnosis. Open biopsy offers higher diagnostic accuracy than core needle biopsy.Conclusion: Neurofibroma should be considered in differential diagnosis for patients initially suspected of giant cell tumors based on radiological findings.
Functional Outcomes After Total Knee Replacement in Kupang: A Retrospective Cohort Study Rante, Su Dji To; Kareri, Dyah Rambu; Manafe, Derri RT
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.72-76

Abstract

Background: Total knee replacement (TKR) is effective for advanced knee osteoarthritis, but its access can be limited by implant and perioperative costs. Our tertiary center in Kupang, Indonesia, adopted a single implant system to support service delivery. This study quantified early functional change using the Oxford Knee Score (OKS) three months after TKR.Methods: We conducted a retrospective single-centre cohort at Siloam Hospital in Kupang, from December 2022 to May 2024. Consecutive adults with Kellgren–Lawrence grade IV knee osteoarthritis who underwent primary TKR with one implant system (Fixamet) were included. The OKS (0–48; higher scores indicate better function) was collected preoperatively and at three months in Bahasa Indonesia using a standardized protocol. Pre–post change was analyzed as paired data.Results: Forty-seven patients were analyzed (mean age 65.77 ± 7.44 years; 80.9% women). The mean OKS improved from 12.53 ± 3.69 preoperatively to 41.02 ± 2.17 at three months, a mean change of 28.48 points (95% CI 27.24–29.70; p < 0.001). One early complication was documented (arthrofibrosis, 2.1%).Conclusions: In this single-centre cohort, TKR was associated with large early improvements in patient-reported knee function at three months. These findings describe early recovery within our service and do not establish comparative effectiveness versus other implant systems. Future studies should follow patients for a longer period, directly compare Fixamet with other implant systems, and include cost-effectiveness analyses to assess both clinical and economic value.
Complicated Calcaneal Fracture with Displacement Following Osteosynthesis and Successful Reoperation: A Case Report Skov, Tobias Bak
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.112-118

Abstract

Background: Calcaneal fractures are relatively uncommon but account for a significant proportion of tarsal injuries. Often resulting from high-energy trauma, they carry a high risk of complications and remain a clinical challenge. Although open reduction and internal fixation (ORIF) is often successful, certain risk factors may predispose to failure and unexpected complications. Case Presentation: A 49-year-old female sustained a closed, displaced tongue-type calcaneal fracture after a fall from height and underwent acute screw fixation. At four weeks, radiographs revealed fracture recurrence and hardware failure, necessitating urgent reoperation with realignment and re-fixation, followed by a restrictive postoperative regimen. At 14 weeks post-reoperation, radiographs confirmed fracture healing. Upon completion of the treatment course, the patient was referred for continued physiotherapy to support ongoing functional recovery. Despite slight residual limitations, the patient reported minimal discomfort and regained mobility, reflected in an American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score of 81.Discussion: Calcaneal fractures are complex injuries with a high complication rate. Initial fixation of tongue-type calcaneal fractures may fail due to factors such as obesity, age, gender, surgical technique, or inadequate aftercare. A good functional outcome was ultimately achieved through timely reoperation, strict rehabilitation protocols, and close follow-up.Conclusion: This case underscores the importance of early surgical intervention, mitigating risk factors, and structured rehabilitation in managing complex calcaneal fractures. Risk factors should guide both surgical planning and aftercare. Early recognition of fixation failure and reoperation within four to six weeks can still result in favourable outcomes, even in high-risk patients.
Early Application of Neuromuscular Electrical Stimulation Prevents Excessive Muscle Wasting in Critically Ill Patients in the Intensive Care Unit Utama Hutapea, Johannes Diandra Indra; Subadi, Imam; Arfianti, Lydia; Semedi, Bambang Pujo; Melaniani, Soenarnatalina
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.77-83

Abstract

Background: Intensive Care Unit-Acquired Weakness (ICU-AW) is a common neuromuscular complication in critically ill patients, leading to muscle atrophy, prolonged mechanical ventilation and impaired functional recovery. Effective rehabilitation strategies play crucial role in maintaining muscle strength. Neuromuscular electrical stimulation (NMES) had shown potential in preserving quadriceps femoris muscle thickness. This study aimed to examine the effect of NMES to quadriceps femoris muscle thickness in patient with ICU-AW.Methods: Patients that stayed in ICU more than 48 hours and used mechanical ventilation for at least 24 hours enrolled in one-group pretest-posttest design. Neuromuscular electrical stimulation applied to bilateral quadriceps femoris for 30 minutes daily over five consecutive days. Bilateral quadriceps femoris muscle thickness were assessed with USG day before and after therapy.Results: Twenty ICU-AW patients were enrolled from December 2023 to June 2024, and 13 of them completed the study. There were no significant changes in the thickness of the right and left quadriceps femoris muscle before and after 5-days of NMES therapy (p = 0.910 and p = 0.519, respectively). However, we preserved less than 5% decreased of muscle thickness.Conclusions: Early 5-days of NMES therapy did not increase quadriceps femoris muscle thickness but effectively prevented further muscle degradation in ICU-AW patients. The potential benefits of rehabilitation therapy in ICU-AW patients should be further explored in future studies with controlled indicators and larger sample sizes.
Anticipatory Balance in Athletes Cerebral Palsy After 6-Month Intervention of Proprioceptive Neuromuscular Facilitation Stretching Techniques Martino, Nieko Caesar Agung; Subadi, Imam; Satyawati, Rwahita; Indriani, Diah
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.84-91

Abstract

Background: The effect of Proprioceptive Neuromuscular Facilitation (PNF) stretching, in addition to standard stretching, improves anticipatory balance in athletes with Cerebral Palsy (CP). We aimed to analyze the effects of PNF stretching to standard training over 4 weeks on anticipatory balance in Cerebral Palsy athletes at 6-month post-intervention evaluation. Methods: The subjects of this study are 24 athletes with Cerebral Palsy at the Indonesian National Paralympic Committee (NPC) training facility. Subjects divided into the treatment group (n = 12) received standard stretching exercises along with PNF stretching, and the control group (n = 12) performed only standard stretching exercises. Both groups received intervention 3 times per week for 4 weeks and evaluation 6 months post-intervention. Y balance tests (YBT) were measured in three directions: anterior (A), posterolateral (PL), and posteromedial (PM), pre- and post-intervention.Results: There was significant improvement of YBT in the treatment group after 4 weeks of intervention. For the right and left limbs, marked increases were observed in all directions (p < 0.05). No significant improvements in YBT were observed at 6 months post-intervention in all directions (p > 0.05).Conclusions: Significant improvements in the Y Balance Test were observed after 4 weeks, but no differences between the two groups at the 6-month evaluation. These findings suggest that while short-term gains in dynamic stability are achievable with PNF, sustained benefits require ongoing reinforcement to maintain neuromuscular adaptations over time.
Diagnostic Value of Magnetic Resonance Imaging Based Coracoid Morphology in Patients with Subscapularis Tears Acar, Barış; Altundal, Hüseyin Buğra; Karaer, Ekremcan; ŞENEL, Ahmet; Kalyenci, Ahmet Sinan; Çarkçi, Engin
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.92-98

Abstract

Background: This study investigates the association between subscapularis tendon tears and the anatomical characteristics of the coracoid process, as assessed by magnetic resonance imaging (MRI) and to determine the predictive cut-off values for significant measurements.Methods: Patients who underwent surgery for rotator cuff injury between 2020 and 2024 were retrospectively reviewed. Those with a subscapularis tear were classified as Group 1, while those with an intact subscapularis were classified as Group 2. MRI images were analyzed to measure axial and sagittal coracohumeral distance (axCHD, sagCHD), coracoid overlap (CO), and coracoid angle (CA). The diagnostic utility of these parameters was assessed using receiver operating characteristic (ROC) curve analysis.Results: A significant association was found between subscapularis tear and axCHD, sagCHD, and CO measurements. Among these, sagCHD demonstrated the strongest predictive power, with an optimal threshold of 9.5 mm, a sensitivity of 77.8% and a specificity of 80.4%.Conclusion: Our study demonstrated that decreased axCHD and sagCHD, and increased CO, are associated with subscapularis tears. The intracoracoid angle, however, does not appear to influence the incidence of subscapularis tears.

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