Journal Orthopaedi and Traumatology Surabaya

Therapeutic Modality of Mesenchymal Stem Cells for Moderate to Severe Knee Osteoarthtritis: A Systematic Review

2025-03-12T09:18:02+07:00

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

2025-03-12T09:42:20+07:00

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.

Characteristics of Patients with Thoracolumbar Fractures at Dr. M. Djamil Padang Central General Hospital in 2018-2022

2025-02-04T08:36:56+07:00

Background: Vertebral fracture is one of the traumas that results in the highest rates of disability and death. Vertebral fractures can occur in various regions, but more than 50% of cases occur in the thoracolumbar region T10-L2. This can be caused by several factors, such as age, gender, and BMI. More than 30% of patients have symptoms of chronic back pain accompanied by neurological deficits. This study discussed the characteristics of patients with thoracolumbar fractures at Dr. M. Djamil Padang Central General Hospital.

Methods: This research is an observational descriptive study with a cross-sectional design. Research data were obtained from patient medical records, and the total inclusion sample is 139 patients with thoracolumbar fracture at Dr. M. Djamil Padang Central General Hospital in the 2018-2022 period. The data were processed and displayed as frequency distributions.

Results: This research showed that the incidence of thoracolumbar fractures is found in 72 patients, with 72 being women. Mainly occurred between 15-64 years of age (73.4%), with 61.2% of cases caused by low energy trauma. As many as 62.6% of the patients received conservative management accompanied by surgery.

Conclusion: This study concluded that thoracolumbar fractures often occur in women of reproductive age. The most common etiology is a fall from a height of less than three meters.

Functional Outcome of Post Anterior Cruciate Ligament Reconstruction Patients in Dr. M. Djamil Central General Hospital Padang 2020-2022

2024-12-06T10:55:01+07:00

Background: The anterior cruciate ligament (ACL) is the main stabilizer of the knee joint. The incidence of ACL injuries is quite high, especially in individuals who participate in sports. ACL injuries result in knee instability, hindering daily activities and sports participation. This study aimed to determine the functional outcomes of patients who have undergone ACL reconstruction.

Methods: This study was descriptive, with a cross-sectional approach, and used medical record data from Dr. M. Djamil Central General Hospital Padang. The total sampling technique was used from patients after ACL reconstruction in 2020-2022. Patients with bilateral knee injuries, multiple ligament injuries, or revision reconstruction were excluded from the study. The samples were contacted to determine their functional outcome by filling out the Lysholm Knee Score.

Results: This study analyzed 27 patients, with 77.8% in the 19-44 age group, and no patients were over 60 years old. This study identified 85.2% of male patients with sports-related injuries being the most common (70.4%). The non-dominant knee was injured more frequently (51.9%). Functional outcomes, as assessed by the Lysholm Knee Score, showed excellent, good, and moderate results in 37 %, 29.6%, and 33.3% of patients, respectively.

Conclusions: ACL reconstruction was most frequently performed in the adult population aged 19–44 years, predominantly in males. Sports-related injuries were the primary cause, with the majority of reconstructions involving the non-dominant knee. The average patient achieved good functional outcomes after ACL reconstruction.

Bone Mineral Density Values Using Radiofrequency Echographic Multi-Spectrometry in Premenopausal Breast Cancer Patients Receiving Tamoxifen Therapy

2024-11-25T15:32:44+07:00

Background: Breast cancer (BC) is the most prevalent malignancy in women. Tamoxifen produces varying effects on the bone according to menopausal status. This study was performed at Adam Malik Hospital to analyze the risk factors for osteoporosis, focusing on bone mineral density (BMD) and length of tamoxifen therapy in premenopausal breast cancer patients. This research also used radiofrequency echographic multi-spectrometry (REMS) to evaluate BMD as a potential alternative to dual x-ray absorptiometry (DXA) in the diagnosis of osteoporosis patients.

Methods: This case-control study analyzed and interviewed 20 premenopausal breast cancer patients who received at least one year of tamoxifen therapy. The stadium of cancer, type of tamoxifen therapy, and BMD of each patient were determined using REMS.

Results: The study of 20 breast cancer patients showed a mean age of 50.4 ± 5.61 years. The average length of tamoxifen therapy was 2.65 years, with a standard deviation of 1.13 years. Most patients presented with osteopenia status, namely 16 patients (80%), whereas three patients (15%) of the total sample presented with osteoporosis. REMS showed excellent accuracy in distinguishing between various tissue types, providing detailed information on tissue composition and structure.

Conclusions: Based on the conducted research, it was determined that the use of tamoxifen for more than four years in premenopausal breast cancer patients influenced the incidence of osteoporosis. REMS shows potential as an alternative to DXA for the diagnosis of osteoporosis.

Correlative Analysis of Radiological Measurements and 1-year SRS-22r in Early and Middle Adolescents with Adolescent Idiopathic Scoliosis: A Retrospective Study

2025-01-08T09:12:45+07:00

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.

The Profile of Road Traffic Injury-Related Fracture Patient in the Emergency Department of H. Damanhuri Barabai General Hospital

2024-12-12T10:27:46+07:00

Background: Road traffic injuries (RTIs) are a major cause of fractures, posing significant challenges for healthcare systems especially in rural areas. Based on data from to Traffic Corps of the Indonesian National Police published by the Ministry of Transportation, the number of traffic accidents in Indonesia reached 103,645 cases in 2021. Understanding the profile of RTI-related fracture patients is crucial to improve emergency care and guide preventive strategies. This study aims to identify the profile of the RTI-related fracture patient in the emergency department of H. Damanhuri Barabai General Hospital.

Methods: This study was retrospective observational. We analysed the medical records of RTI-related fracture patients in Emergency Department of H. Damanhuri Barabai General Hospital during March – July 2023. We observed gender, age, mode of injury, type of fracture and bone involved.

Results: There were 91 RTI-related fracture patients from 146 orthopaedic patients recorded. Male had a higher incidence (74%). The highest incidence was observed in 41 – 60 ages group (32%) and 21 - 40 ages group (31%). The most common mode of injury was double traffic injuries (65%) involving motorcycle vs motorcycle (41%). The primary type of fracture was identified as closed fracture (63%). The bone most involved was tibia (27%).

Conclusions: Fractures are common among males during their productive years as a result of traffic injuries. This study provides insights that advance understanding to the prevalence of RTI-related fractures. Additional research is required to develop further overview of RTI-related fractures.