The Banff Patellar Instability Instrument: validity and reliability of an Indonesian version

BACKGROUND

The Banff Patellar Instability Instrument (BPII) is a valuable scoring tool for assessing patellofemoral instability in patients suffering from patellofemoral pain syndrome (PFPS). The BPII 2.0 is a shortened version of the BPII. However, there is no Indonesian edition of BPII 2.0 that has been validated. This study aimed to determine the validity and reliability of the Indonesian version of the BPII 2.0.

MATERIALS AND METHODS

This was a cross-sectional study that used a forward-backward translation protocol to create an Indonesian version of the BPII 2.0. Thirty patients with PFPS were given the questionnaires. The questionnaire's validity was evaluated by analyzing the correlation between score of each subscale and the overall score to the Indonesian version of the Kujala score using Pearson correlation coefficient, while the reliability was evaluated by measuring the internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient).

RESULTS

The Indonesian version of BPII 2.0 and the Indonesian version of Kujala score had a strong Pearson correlation coefficient for construct validity. For all subscales, Cronbach α was 0.90-0.98, indicating adequate internal consistency. The test-retest reliability was high, with intraclass correlation coefficient ranging from 0.89 to 0.98 for all subscales. There was no difference in the Indonesian version of BPII 2.0 response between the first and second administration of the questionnaire which was taken 7 days afterward.

CONCLUSION

The Indonesian version of BPII 2.0 was determined to be valid and reliable and is therefore an objective instrument to evaluate patellofemoral instability in patients with PFPS in the Indonesian population.

Adductor Canal Block in the Outpatient Clinic for Pain Control Following Knee Surgery

Background

Effective postoperative pain control is an important factor for the success of rehabilitation programs. Adductor canal block (ACB) is a recently developed technique.

Objectives

This study aimed to evaluate the application of ACB in patients who underwent knee surgery.

Methods

We performed ACB guided with ultrasonography for patients who underwent knee surgery. ACB was performed 14 days after surgery in the outpatient clinic with a ropivacaine mixture. The pain was evaluated using the visual analogue scale (VAS) every two days.

Results

In this study, 115 patients were included. The mean score of VAS before ACB on the fifth, seventh, and ninth days was 7.4, 7.2, and 6.2, respectively. Mean VAS was significantly decreased after providing the intervention. However, the VAS score was increased gradually until the 23rd day and then flattened. Analgesic (etoricoxib) consumption was 102 mg, 98 mg, and 98 mg in postoperative days (POD), 5th, 7th, and 9th, respectively. Analgesic consumption was significantly decreased (16 mg) after ACB (POD 15th) and gradually increased in PODs 17th, 19th, and 21st. Only one patient complained of thigh hematoma after the ACB procedure.

Conclusions

Single-shot ACB, provided in outpatient clinics, is a safe intervention that could significantly decrease both pain and analgesic consumption. It may enhance the postoperative rehabilitation program.

Peroneus Longus Tendon Regeneration after Anterior Cruciate Ligament Reconstruction with Magnetic Resonance Imaging Evaluation

BACKGROUND: Peroneus longus graft can be recommended as a superior graft over hamstring in anterior cruciate ligament (ACL) reconstruction. There are many studies concerning hamstring tendon regeneration, but there are few studies on the regeneration of the peroneus longus tendon after ACL reconstruction. AIM: This study aimed to investigate whether regeneration of the peroneus longus tendon occurs after ACL reconstruction with magnetic resonance imaging. METHODS: Twenty-five patients underwent ACL reconstruction with donors from the peroneus longus tendon by the same operator and were followed 12 months later with bilateral crural magnetic resonance imaging (MRI) for comparison of the donor and healthy peroneus longus tendon areas. Regeneration was assessed at 5 cm, 10 cm, and 15 cm from the ankle joint. RESULTS: The average age 30.4 (18-38) years old. There were 17 right and 8 left knees involved in this study. The interval between surgery and MRI was 1 year. The average regeneration presentation was located in the distal part (5 cm from the ankle joint) 66.78%, medial part (10 cm from the joint) 63.2%, and proximal part (15 cm from the ankle joint) 67.53%. There was no significant difference in the presentation of proximal, medial, and distal areas while there was a significant difference between age and regeneration of the proximal area, p <0.05 (p = 0.047). Tissue regeneration was tendinous and it appeared smaller in the place where the tendons grew. CONCLUSION: Regeneration of the peroneus longus tendon occurred after ACL reconstruction at a 1-year follow-up according to MRI.

Changes in Orthopedic Services in Two Indonesian Tertiary-referral Hospitals during the Coronavirus-19 Pandemic

BACKGROUND: Many countries report decreasing on the number of hospital visit even on the emergency cases. AIM: This study aims to reveal the important data on how big the impact of coronavirus-19 pandemic on orthopedic services in two Government’s tertiary-referral hospitals. METHODS: This research is a comparison study to measure the trend of orthopedic services, the monthly orthopedic surgical load and outpatient visit were examined during the period of March to May 2020 (the early pandemic period) then compared to the same period in the 2019. RESULTS: The lowest number of outpatient visits occurred during May 2020 with 715 total number of outpatient visit. The lowest number of orthopedic surgery occurred during May 2020 with 167 total number of orthopedic surgery. Significant decrease of outpatient visits is recorded in 3 months of early pandemic period compared to the same period in 2019 (p < 0.005). Regarding the orthopedic surgical loads, the data show significant decrease in number of orthopedic surgeries in early pandemic period compared to those months in 2019 (p < 0.005). The largest declines were in visits for post-operative control patient (–179), spinal problem (–127,33), and osteoarthritis (–91,33). CONCLUSION: There was a significant difference in outpatient visit and orthopedic surgery number in the early pandemic period compared to the period before the pandemic occur. The largest drops in outpatient visit were in visits for post–operative control patient and spinal problem.

The direct anterior approach in total hip arthroplasty: Publication trends of Asian countries on PubMed

Background

Total hip replacement (THR) is one of the most successful surgical treatment for advanced hip osteoarthritis. Some surgical approaches for THR have been established, one of it is Direct Anterior Approach (DAA), which is a relatively new and less commonly used, especially in Asian countries. This review aims to consolidate information from PubMed on the direct anterior approach (DAA) for total hip replacement (THR) in Asian countries.

Purpose

To collect and consolidate information from PubMed on the total hip replacement (THR) using the direct anterior approach (DAA) in Asian countries.

Methods

A search on the PubMed was done for DAA for THR. There were 461 search results about the DAA for THR publications obtained in total, and 51 articles meet the criteria were analyzed for details. The details include top countries publishing the topics, number of publications per year, top 5 journal publishing the DAA for THR topics, top 5 first authors publishing the articles on this topic, and top 5 author on all position published this topic.

Results

The Journal of Arthroplasty was the leading publisher on this topic, with 10 articles published. Author Yasuhiro Homma, Tomonori Baba, and Kazuhiro Oinuma published the most number with 9 articles as one of the authors. Japan is the leading country for the publication on this topic with 34 published journals in total.

Conclusion

The number of published articles in Asian country per year is still inconsistent, with one year without any publication on this topic. Searching the data on the DAA for THR in PubMed bestow useful information about good sources of publication on this topic.

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Direct anterior approach.

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Total hip arthroplasty.

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Publication trends.

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Asian countries.