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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 103 Documents
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Functional Outcome of Mesenchymal Stem Cells Vs. Hyaluronic Acid in Knee Osteoarthritis Kellgren-Lawrence Grade I-III At 6-and 12-Months Follow-Up: A Meta-Analysis I Gusti Ngurah Wien Aryana; Febyan; Shianita Limena
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 2 (2023): October 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i2.2023.66-76

Abstract

Background: Osteoarthritis (OA) is a degenerative synovial joint disease with progressive pain and deformity. Stem cell therapy, especially mesenchymal stem cells (MSCs), has revolutionized the treatment of knee OA. However, clinical evidence for MSCs in the treatment of knee OA is insufficient. The primary objective of this research is to offer substantiation and recommendations for advancing and utilizing MSC therapy in clinical settings, in contrast to the use of hyaluronic acid (HA) as the standard control group.Methods: This study was a meta-analysis conducted through a search for relevant scientific reports in PubMed, Embase, and Google Scholar, using some keywords such as "mesenchymal stem cell," "hyaluronic acid," and "osteoarthritis." Results: Mesenchymal stem cells showed promising results on a clinical basis. Among five included studies of 139 patients with knee osteoarthritis consisting of 70 patients treated with MSC and 69 patients treated with HA, mesenchymal stem cells provide significant short-term pain relief at 6- (I2=34%; SMD=-0.58 95% CI, -1.09 to -0.07; p=0.02) and 12-months follow-up (I2=28%; SMD=-0.79 95% CI, -1.22 to -0.37; p=0.0003), with relative clinical improvement. The highly differentiated MSC aids in tissue repair, regulation of immune response, and anti-inflammatory effect on knee osteoarthritis, including the chondrogenesis mechanism.Conclusion: Mesenchymal stem cell therapy has shown effectiveness compared to hyaluronic acid injection for knee osteoarthritis, providing pain relief and improved functional outcomes on short-term intervals up to 12 months follow-up. Mesenchymal stem cells display some chondroprotective effects requiring further research and development.
Triple Local Recurrence of Synovial Sarcoma: A Case Report Mouli Edward; Kukuh Ali Akbar
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 2 (2023): October 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i2.2023.83-87

Abstract

Background: Synovial Sarcoma (SS) hardly appears on non-extremity sites (20% of cases). Even rarer is a local recurrence, which occurs between 10-30% of cases. Here, we present a rare case of hip Synovial Sarcoma, which recurs three times.Case Report: A 33-year-old male came to our outpatient clinic with chief complaints of a sudden ingrowing mass on his left hip. The lump is the size of a chicken egg and doesn't get bigger over time. There was palpable tenderness felt whenever he touched the lump. The patient was diagnosed with SS of the left hip with IIB stage from additional radiographic and histopathologic examination. Surgical-wide resection had been done three years before the visit, and chemotherapy six times. The lump reappeared one year before the visit, and the patient underwent a second surgery. The mass re-surfaced within the same region on the current visit for the third time, and he underwent the same surgical treatment afterward. Two years after the third surgery and adjuvant chemotherapy, the patient had no complaint about a lump and planned a radiograph evaluation.Discussion: Detailed examination from history taking, physical examination, histopathologic, and radiological results is important to determine appropriate staging. With proper staging, physicians can better understand disease prognosis and risk of recurrence or metastases.Conclusions: The third recurrence may still happen on SS. Its unique location might contribute to this unique occurrence, and the size of the tumor makes the recurrence rate higher.
Medial Plantar Artery Flap for Soft Tissue Coverage of Heel Defect: A Case Report Ramadhani Hengki Wijaya; Achmad Fachrizal
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.41-46

Abstract

Background: Numerous flap options exist for providing soft tissue coverage for defects on the heel region. This study presents a case where a bone-exposed wound on the left heel region was successfully reconstructed using a medial plantar artery flap. Case Report: A 16-year-old girl presented with a necrotic wound on the left heel region with calcaneus, malleolus, and talus fractures following trans-ankle external fixation on her left leg. After debridement and necrotomy, the wound revealed exposed calcaneus and implant. A medial plantar artery flap was dissected, preserving its vascularization. The flap was then carefully transferred to the wounded area and sutured appropriately. A skin graft harvested from the ipsilateral femoral region was used to cover the donor site. Discussion: This case demonstrates the efficacy of the medial plantar artery flap as a local flap option for heel defect coverage. It is a relatively easy-to-perform procedure that provides a strong and thin skin flap. Moreover, it offers a favorable cosmetic outcome for the patient, as the surgical scar can be be relatively easy to hide with footwear. However, limitations of the medial plantar artery flap include its size and depth constraints, as well as loss of vascularization from a medial plantar artery on the plantar region. Conclusion: The medial plantar artery flap is a feasible option as a local flap for the heel region. It is relatively easy to perform, provides a strong thin skin flap, and can results in a preferable cosmetic outcome.
Clinical Characteristic of Patients Underwent Bone Mineral Density Examination in Prof. Dr. R. Soeharso Orthopaedic Hospital in 2022-2023: A Cross-Sectional Study R. Andhi Prijosedjati; Pamudji Utomo; Leli Sabariyah; Ahmad Fauzi
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.1-11

Abstract

Background: In Indonesia, osteoporosis affects roughly 23% of men and women aged 50-70 and a staggering 53% of those over 70. Understanding the characteristics of patients undergoing bone mineral density (BMD) examinations is crucial for developing better strategies for prevention, diagnosis, and treatment. This study investigates the characteristics of patients who had BMD examinations at the Prof. Dr. R. Soeharso Orthopaedic Hospital. Methods: A cross-sectional study was conducted at Prof. Dr. R. Soeharso Orthopaedic Hospital from April 2022 to April 2023, using a total sampling approach and data extracted from digital medical records. The variables included age, gender, body mass index (BMI), BMD T-score from the lumbar spine, hip, and forearm, frequency and location of fragility fracture (FF), osteoporosis frequency, and fracture risk assessment (FRAX) score for major osteoporotic fracture (MOF) and hip fracture. Patients with incomplete data were excluded. Results: This study involved 168 patients, mainly women (83%) and men (17%). Most (81.5%) were aged 50-74, with osteoporosis affecting 29.2% and severe osteoporosis affecting 60.7%. The spine was the most common site of FF (88.2%). Osteoporosis severity correlated with higher BMI (p<0.05). FRAX scores for MOF and hip fractures were mostly in the low-risk category. Conclusions: A high prevalence of osteoporosis and severe osteoporosis among women, particularly those in the age of 50 to 74 years, and higher BMI was correlated with greater severity of osteoporosis. FF was found more common among women with the spine as the most frequently affected site.
Bioanthropological and Biomechanical Perspectives on Skeletal Senescence Variation Alaydrus, Sayf Muhammad; Jauhari, Muhamad Andri
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.24-34

Abstract

Background: Senescence is the deterioration of the body's biological and physiological function throughout later life. Senescent populations are more prone to diseases. However, aside from osteoporosis, skeletal senescence is a less discussed topic in Indonesia. A global and national increase in the aging population indicates they will be a major group in society, raising the urgency of reviewing this matter. This study aims to comprehend the physiological and biomechanical mechanisms of skeletal senescence, as well as senescent variations in certain sex and population affinities. Literature Review: Age-related skeletal cellular death and imbalance contributes to bone damage in elders. Senescence also affects skeletal biomechanics, expressed in increased bone porosity and brittleness. Stresses in aged bone risks straining above its elastic limit and causing fractures due to its inability to tolerate such stresses. The loss of sex hormones is related to skeletal senescence, especially in females, while the effects of testosterone on skeletal senescence are under-researched. Dietary change, estrogen replacement therapy, and calcitonin consumption are effective measures in reducing the effects of osteoporosis. Variations were found in the bone aging process in different populations, especially regarding bone mineral density loss in white, African-American, Asian, and Hispanic populations. Conclusion: Specific population-based healthcare services in geriatrics and gerontology are highly suggested to ensure inclusive healthcare for every aged individual. Due to the minimal data about bone aging in Indonesia (other than osteoporosis), the authors encourage data procurement from the local populations to create more suitable medical guidelines for elders in Indonesia.
Thumb Arthrodesis in The Arthritis Cases: A Scoping Review Ghifar Akbar; Viskasari Pintoko Kalanjati; Teddy Heri Wardhana
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.35-40

Abstract

Backgrounds: Osteoarthritis in the thumb is a common condition affecting men and women, especially postmenopausal women, causing pain, swelling, and reduced hand function. Arthrodesis is a treatment option for thumb arthritis, increasingly accessible in medical practice, though coverage remains limited. This article aims to review recent case reports on thumb arthrodesis in older people over the last three years, depicting the method's use and outcomes. Methods: After filtering per PRISMA-Sc guidelines on PubMed and the Journal of Hand Surgery (2020-2023), with additional manual filtering, four articles were found and analyzed using the JBI Critical Appraisal Checklist for Case Reports before inclusion. Result: Four case reports related to pollex arthrodesis in the last three years were published in PubMed. These include rare cases of bilateral thumb psoriatic arthritis, a novel surgical approach for nonunion after arthrodesis, and successful fusion using a vascularized bone graft. The limited number of articles may be attributed to the research cycle, shifting focus, and alternative treatments. With increased healthcare access and osteoarthritis prevalence, more people will seek treatment, potentially leading to increased arthrodesis procedures. Opportunities for new research include evaluating surgical techniques, biomaterials, and growth factors to enhance bone healing. Long-term follow-up studies remain crucial for identifying risk factors and improving patient outcomes in thumb arthrodesis. Conclusion: Despite limited research published in the last three years, arthrodesis remains a relevant treatment option for pollex conditions, with rising demand due to increasing osteoarthritis prevalence and healthcare access. Further research on surgical innovations and long-term outcomes is crucial.
The Risk Factors of Patients with Cruris Fracture Nonunion in Dr. Mohamad Soewandhie Hospital in 2021-2022: A Case-Control Study Clarissa, Regina; Sasono, Bimo; Juliasih, Ni Njoman
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.12-16

Abstract

Background: The crural region is highly susceptible to injury in Indonesia, with fractures being a common occurrence. If not properly treated, these fractures can lead to complications such as nonunion. To investigate the risk factors for nonunion cruris fractures, this study was conducted at Dr. Mohamad Soewandhie Hospital, examining age, gender, working status, education, trauma mechanism, and previous treatment history.Methods: This case-control study analyzed patient records from 2021 - 2022 at Dr. Mohamad Soewandhie Hospital, comparing 12 nonunion and 24 union cruris fracture cases. Data on age, gender, work, education, trauma, and treatment history was collected between August and October 2023. Statistical analysis was performed using the Mcnemar and Wilcoxon tests, with a significance level of p < 0.05.Results: A study of 149 cruris fractures found 12 nonunions, primarily affecting males aged 26-45 or 46-65. Notably, the highest nonunion rate (41.7%) was in the 12-25 age group (p = 0.027). Males were more affected, with 7 nonunion cases (58.3%) (p = 0.041). Working class patients had the highest fracture and nonunion rates (83.3%) (p < 0.001). High school education was most common among nonunion cases (75%) (p = 0.374). High-energy trauma was reported in almost all nonunion cases (91.7%) (p < 0.001). All nonunion patients had a history of ORIF (p = 0.102).Conclusions: The study revealed that age, gender, work status, and trauma mechanism significantly influenced nonunion cruris fractures at Dr. Mohamad Soewandhie Hospital in 2021-2022. Patient education and past treatment history had no significant impact.
The Application of Posterior Plate in Tibial Plateau Fracture: A Case Report Muhammad Zaim Chilmi; Firas Febrian
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.47-51

Abstract

Backgrounds: Tibial plateau fracture is the most frequent type of fracture caused by motor-vehicle collision. This injury may or may not be associated with soft tissue injury, such as the knee's ligaments. Posterior tibial plateau fractures are a rare subtype that requires surgical intervention. This case report describes the outcome of posterior plating in treating a posterior tibial plateau fracture. Case report: A 41-year-old female patient came to the emergency room (ER) after being involved in a traffic collision. The patient underwent a thorough medical examination, which revealed the tibial eminence avulsion associated with the fracture of the head of the fibula. Surgical treatment was performed using a posterior approach through an inverted L-shaped incision. Discussion: Tibial plateau fractures are serious injuries that often require surgery. However, the decision to operate depends on several factors, including the morphology of the fracture, the patient's profile, the condition of the soft tissues, and the expected recovery of the articular surface and the axis of the limb. Conclusion: A surgical technique using a posterior approach through an inverted L-shaped incision with a small medial T-plate, lateral bone graft, and roof K-wire fixation demonstrates positive outcomes for treating closed posterior tibial plateau fractures and avulsion fractures of the tibial eminence.
Characteristics of Nonunion Fractures in Patients with Antebrachial Fractures at dr. Mohamad Soewandhie General Hospital Surabaya 2021-2022: A Retrospective Study Tasya Monica; Bimo Sasono; Cempaka Harsa Sekarputri
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 1 (2024): April 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i1.2024.17-23

Abstract

Background: Nonunion, a complication of fracture healing, can lead to patient morbidity. Contributing factors include age, gender, fracture type, multiple fractures, infection, prolonged nonsteroidal anti-inflammatory drug (NSAID) use, smoking, nutritional status, and history of chronic disease. This study aims to determine the prevalence and characteristics of nonunion antebrachial fractures at dr. Mohamad Soewandhie General Hospital Surabaya. Methods: This retrospective descriptive study involved 111 patients. Data was gathered from medical records treated at dr. Mohamad Soewandhie General Hospital Surabaya for antebrachial fracture during 2021-2022. The study protocol obtained approvals from two local ethical committees. Data included demographics, fracture characteristics, fracture type, multiple fractures, infection, NSAID use, hypertension and diabetes history, smoking habits, and nutritional status by BMI calculation. Results: This study found a 24.3% prevalence of antebrachial nonunion fractures at dr. Mohamad Soewandhie General Hospital Surabaya in 2021-2022, mostly in males (66.7%) aged 17-25 years (22.2%). Nonunion in antebrachial fractures is marked by high rates in closed (92.6%) and single fractures (92.6%). Notably, infections (22.2%), smoking (7.4%), and hypertension history (7.4%) are common contributors. Despite ideal BMI in many cases (44.4%), nonunion still occurred. Conclusions: The study conducted at Dr. Mohamad Soewandhie General Hospital in Surabaya revealed a high prevalence of antebrachial nonunion fractures at 24.3%, particularly among young males. It was found that closed, single fractures were the most common type, with infections, smoking, and a history of hypertension being significant contributing factors. Interestingly, even individuals with an ideal BMI were still at risk for nonunion.
The Potential Applications of Stem Cell Conditioned Medium Secretome in Knee Cartilage Regeneration: A Systematic Review Aryana, I Gusti Ngurah Wien; Febyan, Febyan; Ustriyana, Nyoman Gede Grenata Nanda
Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 2 (2024): October 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i2.2024.84-99

Abstract

Background: Articular cartilage injuries often result from trauma, genetic predisposition, and degeneration. These injuries lack inherent regeneration mechanisms due to the absence of blood vessels and limited progenitor cell entry. Osteoarthritis is characterized by gradual cartilage deterioration. Mesenchymal stem cells (MSCs), particularly their secretome including exosomes, hold promise as a regenerative therapy. This review explores the application of MSCs and their secretome to address cartilage defects.Methods: This review was conducted based on PRISMA guidelines. Animal model studies focusing on the use of stem cell secretomes for cartilage regeneration were explored. The search, encompassing PubMed, MEDLINE, the Cochrane Library, Scopus, Web of Science, and Science Direct from January 10, 2023, to July 27, 2023, was conducted utilizing Google Chrome as the search engine. Studies with outcomes based on OARSI or ICRS scores, as well as any additional outcomes related to MSC secretome utilization, cartilage regeneration, and proliferation, were included.Results: Our systematic review identified six studies using MSCs in vivo and in vitro. Synovial membrane-derived MSCs significantly enhanced cartilage regeneration by elevating chondrogenic capabilities. Hydrogel-based systems techniques and 3D-printed scaffolds have emerged for innovative delivery. Specific microRNAs, such as miR-92a-3p, have been recognized for enhancing cartilage regeneration. Strategies for the effective targeting of MSC exosomes to the precise cartilage damage site have been explored.Conclusions: The studies demonstrate the potential of MSC-derived secretomes and exosomes for knee cartilage regeneration in animal models. Further research and clinical trials are needed to refine these approaches for practical application.

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