AbstractIntroduction: The direct anterior approach (DAA) for total hip arthroplasty (THA) is a very sophisticated and complicated surgery typically performed using a specialized operating room table and instruments. In our clinic, this procedure was performed with a modified incision to avoid dependence on a special operating room table and we could use ordinary THA instruments. There is an obvious absence of literature regarding this subject.Methods: A total of 31 patients (31 hips) were recruited for primary THAs from January 1, 2020 to December 31, 2021 who underwent THAs using the DAA in the supine position with modified incision. The technical feasibility and early results were evaluated.Results: The orientation of the acetabular component average cup inclination was 41.57o ±6.7o, (23o-57o) and the mean cup anteversion was 17.36o ± 5o, (11o-38o). The incidence of neutral coronal femoral stem alignment were 30 hips (97%), varus was 1 (3%), neutral sagittal alignment were 30 hips (97%), and flexion was 1 (3%). The preoperative Harris Hip Score (HHS) was 57.89 points (range: 17-68 points), whereas the postoperative HHS was 89.97 points (range: 82-100 points). There were no postoperative problems such as proximal femur fracture, hematoma, superficial wound complications, deep vein thrombosis, lateral femoral cutaneous nerve damage, heterotopic ossification, loosening of the acetabular component, loosening of the stem, dislocation, infection, or postoperative periprosthetic fracture.Conclusion: The DAA supine for THA with modified incision may be a valuable alternative in the absence of a special operating room table or special instruments for DAA. This technique also seems to provide satisfactory clinical and radiographic outcomes with acceptable complications in our early follow-up.
Abstract Introduction This study aimed to assess the efficacy of adipose-derived mesenchymal stem cell exosomes (ASCs exosome) and platelet-rich fibrin (PRF) in treating critical long bone defects in Sprague-Dawley rats. Critical long bone defects, defined as exceeding 2 cm or 50% of the bone diameter, often pose a healing challenge. While autologous bone grafts have been considered, they have shown unreliable results and donor-site complications, necessitating alternative treatments. Methods The research followed a quasi-experimental post-test only control group design involving 30 male Sprague-Dawley rats. The rats were divided into five groups and subjected to femur bone defect creation, internally fixed with a 1.4 mm K-wire, and treated with various combinations of hydroxyapatite (HA), bone graft (BG), ASCs exosome, and PRF. Histomorphometry and BMP-2 gene expression analysis were performed to evaluate bone healing. Results and Discussion The results indicated that the group treated with HA + BG + ASCs exosome (group IV) exhibited the highest BMP-2 gene expression, while group III (HA + BG + ASCs exosome + PRF) had the highest chordin level. Overall, groups receiving ASCs exosome or PRF intervention showed elevated BMP-2 expression compared to the control group. The use of ASCs exosome and PRF showed comparable outcomes compared to bone graft administration in terms of histomorphometry analysis. Conclusion The administration of adipose tissue derived mesenchymal stem cells and PRF has a comparable outcome with the use of bone graft in terms of osseus area and expression of BMP-2 in critical bone defect.
Latar Belakang : Hepatitis B merupakan penyakit infeksi
menular berbahaya yang disebabkan virus hepatitis B
(VHB). Infeksi VHB merupakan permasalahan kesehatan
global. Waria adalah populasi beresiko terinfeksi VHB
melalui kontak seksual. Infeksi hepatitis B tersamar
dikarakteristikkan sebagai infeksi VHB tanpa
terdeteksinya antigen permukaan hepatitis B (HBsAg),
yang dapat menyamarkan terjadinya risiko transmisi
infeksi VHB. Infeksi hepatitis B tersamar dihubungkan
dengan fibrosis jaringan hati dan karsinoma
hepatoseluler. Pada populasi beresiko dibutuhkan suatu
prediktor infeksi hepatitis B tersamar yang dapat
dideteksi dengan cepat agar kejadian infeksi hepatitis
B tersamar bisa dikendalikan. Gamma Glutamyl Transferase
(GGT) adalah enzim mikrosomal yang kenaikannya dapat
digunakan untuk memprediksi kejadian fibrosis dan
kerusakan jaringan hati. Hubungan GGT dengan infeksi
Hepatitis B tersamar belum jelas dan perlu diteliti.
Tujuan : Mengetahui hubungan GGT dengan kejadian infeksi
Hepatitis B tersamar pada waria di Yogyakarta.
Metode : Penelitian ini menggunakan desain potong
lintang dengan menggunakan sampel darah subjek.
Diagnosis infeksi hepatitis B tersamar pada subjek
ditentukan dengan metode passive hemaglutination
didapatkan HBsAg dan anti-VHC negatif, dan pemeriksaan
PCR didapatkan DNA VHB positif. Kadar GGT diukur dengan
metode absorbansi spektrofotometer. Kemudian akan
dilakukan analisis statistik terkait hubungan kadar GGT
dengan kejadian infeksi hepatitis B tersamar.
Hasil : Dari 42 sampel, 17 sampel didiagnosis sebagai
infeksi hepatitis B tersamar (40,5%). Satu dari 17 sampel
didapatkan kenaikan kadar GGT (5,9%). Dari analisa
statistik didapatkan P>0,05 yang menandakan tidak ada
hubungan bermakna antara GGT dan infeksi hepatitis B
tersamar.
Kesimpulan : GGT tidak memiliki hubungan bermakna dengan
kejadian infeksi hepatitis B tersamar dan belum bisa
dijadikan prediktor terjadinya infeksi hepatitis B
tersamar.
Backgrounds : Hepatitis B is an infectious disease caused
by hepatitis B virus (HBV). HBV infection is global
health problem. Transvetites are population at risk of
HBV infection through sexual contact. Occult Hepatitis
B infection (OBI) is characterized by presence of HBV
infection without detectable hepatitis B surface antigen
(HBsAg), which can disguise the risk of transmission of
HBV infection. OBI is associated with progression of
liver fibrosis and hepatocellular carcinoma. At-risk
populations need a predictor of OBI which can be detected
quickly so that the incidence of OBI can be controlled.
Gamma Glutamyl Transferase (GGT) is a microsomal enzyme
which increase can be used to predict the incidence of
liver fibrosis and tissue damage. GGT relationship with
OBI is unclear and need to be investigated.
Objectives : To determine the relationship GGT with OBI
incidence on transvetites in Yogyakarta.
Methods : This study used a cross-sectional design using
a blood sample of the subject. OBI diagnosis on the
subject is determined by the method of passive
hemaglutination obtained negative HBsAg and anti-HCV,
and by PCR, obtained positif HBV DNA. GGT level were
measured by a spectrophotometer absorbance method. Then
the statistical analysis were conducted regarding the
relationship GGT level with the incidence of OBI.
Results : From the 42 samples, 17 samples diagnosed as
OBI (40,5%). Increased level of GGT were found in 1 of
the 17 samples (5,9%). From the statistical analysis, we
obtained P>0,05 indicating no significant association
between GGT and OBI.
Conclusions : GGT does not have a significant
relationship with OBI and can not be used as predictor
of OBI occurence.
Paravertebral abscess is a common complication of spondylitis tuberculosis which has high prevalence in Indonesia. Surgical intervention such as open surgery or endoscopic debridement is needed to remove and drainage the abscess in addition to chemotherapy. However, this surgeries have several complications such as soft tissue damage and abscess contamination to the healthy tissue. We reported closed system strategy to evacuate the paravertebral abscess on spinal infection.The technique is performed by orthopaedic team under guidance of the C-Arm and ultrasound sonography (USG) in March-June 202. The needle which connected to 20 cc syringe is inserted into the lesion to aspirate the abscess. After evacuation of the abscess, 2-g broad spectrum antibiotic is injected through the needle to eradicate the bacteria locally.We performed the closed system paravertebral abscess evacuation in three patients, a 30-year-old male, 43-year-old male, and 22-year-old female. All the patients had back pain and limitation spine movement due to pain and were diagnosed with spondylitis and paravertebral abscess based on the plain radiography and magnetic resonance imaging (MRI). It reported that up to 2000 cc abscess can be evacuated with this micro invasive technique.The closed system is a micro-invasive procedure result in minimal soft tissue injury and faster recovery. It succesfully remove paravertebral abscess followed by direct antibiotic eradication on spinal infection.
Surgical techniques developed for distal radius fracture fixation have become increasingly advanced, including minimally invasive plate osteosynthesis (MIPO). This study aimed to introduce and evaluate the functional outcome of a novel MIPO technique that differs from previous reports. This study included 42 patients with distal radius fractures who underwent minimally invasive surgical plating of the distal radius. All patients were treated with closed reduction, fixation using K-wire, and subsequent insertion of a volar anatomical stable angle short plate on the distal radius. An arthroscopy-assisted evaluation and repair procedure were performed to correct intra-articular involvement, triangular fibrocartilage complex tears, and scapholunate injuries. Functional outcomes were assessed using a visual analog scale score; quick disabilities of the arm, shoulder, and hand score; and postoperative range of motion of flexion, extension, supination, and pronation at the 3-month follow-up, showing significant improvement in all parameters (all ≤ 0.05). This study provides a simpler yet reliable method with reproducible and consistent results to treat distal radius fractures using minimally invasive plating with closed reduction and plate insertion, resulting in satisfactory clinical outcomes in all patients.
