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Lukas Widhiyanto, dr., SpOT(K)
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INDONESIA
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 121 Documents
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Hypertonic Dextrose Prolotherapy Injection Improves Clinical Outcomes in Shoulder Impingement Syndrome with Diabetes Mellitus: A Quasi-Experimental Study Pane, Rita Vivera; Al Hajiri, Aufar Zimamuz Zaman
(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.v14i2.2025.99-104

Abstract

Background: Shoulder impingement syndrome (SIS) is the most common cause of shoulder pain. Current conservative management approaches often require years for patients to achieve pain relief. This study aimed to identify the effects of hypertonic dextrose prolotherapy (HDP) injections on pain levels and shoulder functionality in SIS patients with diabetes mellitus. Methods: A quasi-experimental study was conducted recruiting SIS patients at Hajj Regional Hospital, Surabaya, Indonesia, from January 2022 to December 2023. The study group was divided into two: the HDP group, which received a 5 mL injection of HDP at a concentration of 20%, and the control group, which received pharmacotherapy and regular rehabilitation therapy. While the control group received regular pharmacotherapy and rehabilitation therapy only. The study outcomes assessed were the Numeric Rating Scale (NRS) and shoulder Active Range of Motion (AROM). The evaluation was conducted three times: before the intervention, immediately after the intervention, and two weeks after the intervention. Results: A total of 20 study participants were divided into two groups: 10 in the HDP group and 10 in the control group. Inter- and intragroup analyses showed significant differences in NRS mean values between the HDP and control groups (p < 0.05). Similarly, AROM analysis showed significant differences in mean values between the HDP and control groups, both inter- and intra-group (p < 0.05). Conclusions: HDP injection reduces pain intensity and improves shoulder AROM within two weeks after injection.
Biological Reconstruction with Liquid Nitrogen for Osteosarcoma of the Distal Tibia: A Case Report Idulhaq, Mujaddid; Gardjito, Fajar Baskoro; Wiranegara, Tanri Hadinata
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.75-81

Abstract

Background: Osteosarcoma, a primary malignant bone tumor, typically requires limb salvage surgery to maintain function while ensuring complete tumor resection. This case report presents a rare instance of distal tibial osteosarcoma treated through biological reconstruction utilizing liquid nitrogen.Case Report: This report describes a 17-year-old female patient who was initially diagnosed with low-grade osteosarcoma via biopsy, but was later confirmed to have high-grade osteosarcoma after undergoing wide excision and reconstruction using a liquid nitrogen-treated autograft. After the extensive removal of the tumor, the resected bone was devitalized using liquid nitrogen, followed by treatment with liquid nitrogen, reimplantation, and stabilization using double-plate fixation.Discussion: This method significantly diminished the likelihood of local recurrence while restoring both the structural integrity and biological function of the bone defect. This case highlights the benefits of biological reconstruction, specifically the use of recycled autografts with liquid nitrogen, as a cost-effective and sustainable approach for limb preservation in osteosarcoma patients. Conclusion: In this instance, biological reconstruction utilizing liquid nitrogen demonstrated efficacy as a limb salvage method. Liquid nitrogen freezing and inactivation provide a precise and effective method for devitalizing tumor bone while maintaining structural integrity and biological potential.
Posterior Ganglion Cyst of the Knee Treated by Ultrasound-Guided Aspiration with Adjunctive Saline Injection: A Case Report Butarbutar, John Christian Parsaoran; Hananto, Joshua Edward; Siahaan, Henoch Gugun Parulian; Yong, Yee Wen
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.82-86

Abstract

Background: Ganglion cysts around the knee, particularly those originating from the gastrocnemius muscle, are uncommon and may cause significant posterior knee discomfort. Although surgical excision remains the gold standard, it carries risks such as postoperative complications, recurrence, and prolonged recovery.Case Report: A 41-year-old male presented with a 10-year history of posterior knee pain, aggravated during squatting and the Jalsa position during Islamic prayer. Physical examination revealed tenderness in the popliteal fossa without ligamentous instability. Ultrasound (US)-guided aspiration was performed, yielding approximately 4 mL of yellow, viscous fluid, followed by the injection of 10 mL of normal saline to facilitate cyst wall rupture and collapse, without corticosteroid use. This minimally invasive modification may reduce recurrence while avoiding potential steroid-related adverse effects. Immediate improvement in knee mobility was observed. At the 4-month follow-up, complete symptom resolution was reported, and all daily activities, including Islamic prayer, were performed without restriction. Follow-up US imaging confirmed a reduction in cyst size.Discussion: Ganglion cysts can be effectively managed with minimally invasive approaches such as ultrasound-guided aspiration, which offers precise localization and reduced complication risk compared to surgery. In this case, adjunctive saline injection facilitated cyst collapse and resulted in excellent functional recovery, although recurrence remains a possibility.Conclusion: US-guided aspiration with adjunctive saline injection is a promising alternative to surgical excision; however, further studies are needed to confirm its long-term efficacy.
Current and Future Global Research Trends in Osteosarcoma: A Bibliometric Analysis of Surgical Strategies and Recurrence Dalimunthe, Ridha Aswina; Saputra, Rhyan Darma; Ermawan, Rieva
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.56-67

Abstract

Background: Osteosarcoma is the most common primary malignant bone tumor, yet comprehensive mapping of its evolving research landscape remains limited. This bibliometric analysis aims to characterize global research trends, identify thematic hotspots, and delineate emerging directions in osteosarcoma research, with a particular focus on publications related to local control, recurrence, and wide surgical margins.Methods: Publications from January 2021 to April 2025 were retrieved from the Dimensions database using the terms “osteosarcoma,” “local control,” “recurrence,” and "wide margins." After screening, 498 eligible records were analyzed using Bibliometrix/Biblioshiny in RStudio and Microsoft Excel.Results: Publication output increased from 2021 to 2023, with China, the United States, and Japan as the leading contributors. Chinese institutions represented 23% of the top 50 productive organizations, whereas Canada, Austria, and Greece showed the highest international collaboration rates. Thematic mapping identified motor themes related to tumor classification, treatment, prognosis, and local recurrence; niche themes such as en bloc sacrectomy and 3D-printed reconstruction; and emerging themes including artificial intelligence-based risk prediction and early metastasis detection.Conclusions: This bibliometric analysis identifies a trend in osteosarcoma research toward technology -driven and precision-oriented surgical strategies, including AI-assisted risk stratification, 3D-printed reconstruction, and immunomodulatory perioperative approaches. These bibliometric trends suggest growing research interest in optimizing local control and minimizing recurrence, although their clinical impact remains to be validated through prospective studies. The findings provide a descriptive overview of current research directions and may inform future research prioritization.
Hypoxic Culture (1% O2) Preserves Stemness and Reduces Spontaneous Osteogenic Differentiation In Early and Late Passage Bone Marrow-Derived Mesenchymal Stem Cells Rahadiansyah, Erreza; Mubarok, Muhammad Iqbal; Karsari, Deya
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.1-9

Abstract

Background: Bone marrow–derived mesenchymal stem cells (BMMSCs) are widely investigated for regenerative medicine applications. During in vitro expansion, BMMSCs may undergo loss of stemness and spontaneous lineage commitment. Hypoxic culture conditions better mimic the physiological bone marrow niche; however, their effects across early and late passages remain incompletely understood. This study aimed to evaluate the effect of hypoxic culture (1% O₂) on stemness-associated features, BMMSC identity, and spontaneous osteogenic mineralization at early and late passages.Methods: BMMSCs were isolated from a New Zealand White rabbit and cultured under normoxic (21% O₂) or hypoxic (1% O₂) conditions. Cells at passages 4 and 8 were analyzed for OCT4, SOX2, and CD105 expression using immunofluorescence and immunocytochemistry. Osteogenic differentiation was assessed by Alizarin Red S staining. Statistical analysis used independent t-tests and Mann–Whitney U tests (p < 0.05).Results: SOX2 and CD105 expression significantly decreased at late passages compared to early passages under both conditions (p < 0.05), whereas OCT4 expression remained stable under hypoxia (p > 0.05). BMMSCs cultured under hypoxia exhibited significantly higher expression of OCT4, SOX2, and CD105 than normoxic cultures at both passages (p < 0.05). Spontaneous calcium deposition was significantly lower under hypoxia (p < 0.05), with no significant difference between early and late passages.Conclusion: Hypoxic culture conditions better preserve stemness-associated features and MSC identity in BMMSCs and suppress spontaneous osteogenic mineralization. Prolonged hypoxic culture supports the maintenance of stem-like characteristics during in vitro expansion, highlighting its relevance for optimizing BMMSC culture strategies.
Functional Outcome of Patients with Proximal Humerus Bone Tumors after Tikhoff–Linberg Procedure and Reconstruction Using Hemiarthroplasty in a National Orthopaedic Hospital (2020–2023) Khrisna Purwa Satyaksa; Mujaddid Idulhaq
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.10-16

Abstract

Background: The proximal humerus is a common site for primary and metastatic bone tumors. Limb-salvage surgery aims to achieve oncologic clearance while preserving function. The Tikhoff–Linberg procedure combined with hemiarthroplasty is one reconstructive option; however, functional outcomes remain variable. This study aimed to evaluate functional outcomes following this procedure at a tertiary orthopaedic center.Methods: A retrospective observational study was conducted on patients who underwent Type I Tikhoff –Linberg resection with hemiarthroplasty for proximal humerus tumors at Prof. Dr. R. Soeharso National Orthopaedic Hospital between January 2020 and December 2023. Functional outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) and Musculoskeletal Tumor Society (MSTS) scores at a minimum follow-up of 6 months.Results: Eleven patients met the inclusion criteria (6 males, 5 females; mean age 51.2 years). Four patients (36%) had benign tumors and seven (64%) had malignant tumors. The mean DASH score was 42.3, and the mean MSTS score was 15.4. Patients with benign tumors demonstrated better functional outcomes (DASH 39.4; MSTS 17.6) compared to those with malignant tumors (DASH 46.9; MSTS 13.2). Shoulder range of motion was limited, particularly in flexion and abduction, although distal upper limb function was preserved.Conclusion: Tikhoff–Linberg resection with hemiarthroplasty provides acceptable functional outcomes, particularly in terms of hand and elbow function. However, shoulder mobility remains limited. Careful patient selection is required based on functional demand and prognosis.
Demographic and Clinical Profile of Juvenile Idiopathic Arthritis Patients in a Tertiary Referral Hospital in Indonesia (2021–2023) Satwika, Callista Nadhifa Parama; Putera, Azwin Mengindra; Fetarayani, Deasy; Hidayat, Taufiq
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.17-27

Abstract

Background: Juvenile Idiopathic Arthritis (JIA) is the most common chronic rheumatic disease in children, characterized by joint inflammation lasting ≥6 weeks in individuals aged <16 years without a clear etiology. Despite advances in research on genetic, immunological, and environmental factors, its pathogenesis remains incompletely understood. In Indonesia, epidemiological data and clinical characteristics of JIA are still limited. This study aimed to describe the demographic profile and clinical characteristics of JIA patients at the pediatrics outpatient clinic of a tertiary referral hospital in Indonesia from 2021 to 2023.Methods: A descriptive retrospective study was conducted to evaluate medical records of patients who met the diagnostic criteria for JIA based on the International League of Associations for Rheumatology (ILAR) classification.Results: Of the 73 JIA patients, most were male (60.3%) and belonged to the age group >132–216 months (32.9%). Most patients were domiciled in Surabaya (35.6%). The most common chief complaint was joint pain (71.2%), and 58.9% had joint involvement involving <5 joints, suggesting an oligoarthritis subtype. Most patients’ vital signs were within normal limits, while anemia (58.9%) and elevated erythrocyte sedimentation rate (ESR) (80.8%) were the dominant laboratory findings.Conclusion: The majority of JIA patients were late-adolescent boys (132–216 months) presenting with pain and an oligoarthritis subtype. These findings highlight the importance of early detection and appropriate referral to prevent long-term complications.
Stability Exercise Reduces Pain and Improves Function in Postpartum Lumbo-Pelvic Pain: A Systematic Review Setia Ningrum, Fuja; Kalanjati, Viskasari Pintoko
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.68-74

Abstract

Background: Postpartum lumbo-pelvic pain (LPP) is a common musculoskeletal problem that may persist for several months after childbirth and interfere with maternal function. Stability exercise, focusing on deep core muscles, has been suggested as a non-pharmacological approach; however, the evidence remains scattered.Methods: A systematic review was carried out following PRISMA 2020 guidelines. Electronic databases (PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar) were searched for studies published between March 2015 and December 2024. Eligible studies included postpartum women (≤ 6 months) with LPP, comparing stability/core-focused exercise with conventional care or other exercise modalities. Primary outcomes were pain intensity measured using the Visual Analogue Scale (VAS) and functional disability assessed by the Oswestry Disability Index (ODI). Quality assessment of included papers was performed using the JBI tools. Data were extracted independently and analyzed narratively. Results: Three randomized controlled trials enrolling a total of 130 postpartum women with lumbopelvic pain were included. Intervention protocols varied from 6 to 12 weeks, with 3–5 sessions per week. All studies consistently reported greater reductions in pain scores in the stability exercise groups compared with control groups. Two studies additionally found significant improvements in functional disability (ODI) following stability training.Conclusion: Stability exercise appears effective in alleviating pain and improving function in postpartum women with LPP. Its integration into postpartum rehabilitation programs may provide a safe, accessible, and beneficial alternative to conventional management strategies. Further large-scale trials are needed to confirm optimal protocols and long-term outcomes.
Short-Term Functional Outcome Following Primary Total Hip Replacement With and Without Acetabular Screw Fixation: A Prospective Indian Cohort Study Narayan Nanda, Saurav; Kaushik, Sumit; Jena, Sabyasachi; Adwani, Rahul
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.28-34

Abstract

Background: Supplemental acetabular screw fixation is commonly used in cementless total hip arthroplasty (THA) to enhance initial cup stability; however, its routine necessity remains debated, particularly in populations with distinct anatomical and bone quality characteristics.Methods: A prospective observational cohort study was conducted at a tertiary care center in India from January 2023 to July 2024 to evaluate the effects of supplemental screws in primary cementless THA. Based on intraoperative assessment of press-fit stability, 80 consecutive patients were allocated into two groups: Group A (with supplemental screws, n = 40) and Group B (without screws, n = 40). Primary outcomes included functional improvement (Harris Hip Score (HHS) and WOMAC) and radiographic cup stability at 12 months. Secondary outcomes included complications and operative parameters.Results: Baseline characteristics were comparable between groups. Both groups showed significant improvement in HHS and WOMAC scores at 12 months, with no statistically significant intergroup differences (p > 0.05). Mean acetabular cup migration was minimal (0.20 ± 0.21 mm with screws vs 0.21 ± 0.22 mm without screws; p = 0.86). No cup demonstrated migration greater than 1 mm. No screw-related complications or revisions were observed.Conclusion: In primary cementless THA with adequate intraoperative press-fit stability, supplemental acetabular screws did not provide additional short-term clinical or radiographic benefit in this cohort. These findings suggest that routine screw fixation may not be necessary and should be used selectively.
Novel Rabbit Model for Femoral Head Osteonecrosis Characterized by Osteoclast Activity and Number of Empty Lacunae Sihombing, Masri; Dewi, Fitriya Nur Anisa; Siregar, Nurjati Chairani; Utomo, Dwikora Novembri; Pawitan, Jeanne Adiwinata; Dilogo, Ismail Hadisoebroto; Kekalih, Aria
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 15 No. 1 (2026): April 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v15i1.2026.35-47

Abstract

Background: Osteonecrosis, or avascular necrosis (AVN) of the femoral head, is a progressive and irreversible bone pathological condition with an increasing amount of morbidity each year in Indonesia. Testing therapeutic strategies requires an ethical and reliable protocol for inducing femoral head AVN in animal models. This study evaluates a rabbit protocol's feasibility to support a larger investigation into secretome-based treatments.Methods: In this in vivo study, New Zealand white rabbits were divided into three test groups and one control group (n = 3 per group). Methylprednisolone was injected three times at 24-hour intervals, with lipopolysaccharide administered to the third test group on day four. Following a four-week observation period, effects were evaluated using histology, immunohistochemistry, lipid profiles, and radiology.Results: The results showed that both a dose of 20 mg/kgBW methylprednisolone plus 10 μg/kgBW lipopolysaccharide and 20 mg/kgBW methylprednisolone alone resulted in statistically significant femoral head AVN induction, characterized by an increase number of osteoclasts on caspase-3 staining and empty lacunae on hematoxylin–eosin staining. Conversely, the test group with a lower concentration did not show significant differences.Conclusion: These findings support the recommendation of a credible and promising animal model of femoral head osteonecrosis as a basis for the study of osteocytes, osteoblasts, and osteoclast regeneration, along with secretome therapy, which acts as a potential non-surgical treatment option. The absence of radiological confirmation limits a more established analysis, and further studies on this matter are needed.

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