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"ABSTRAKTotal Hip Replacement THR merupakan salah satu tindakan bedah rekonstruktif penggantian sendi panggul akibat gangguan anatomi, fungsi tubuh yang mengganggu dan berpengaruh terhadap status fungsional. Tujuan penelitian teridentifikasinya faktor-faktor yang berhubungan dengan status fungsional pasien paska operasi THR. Penelitian ini menggunakan desain case control. Penetapan jumlah sampel menggunakan nonprobability sampling dengan metoda consecutive sampling. Hasil penelitian didapatkan distribusi frekuensi status fungsional dengan menggunakan Hip Haris Score HHS proporsi responden yang mengalami gangguan status fungsional mencapai 24,4 kelompok kasus dimana diantara variabel yang mempunyai hubungan yaitu usia, program rehabilitasi dan lama rawat dengan status fungsional pasien paska operasi THR. Pada kelompok kasus usia merupakan faktor paling besar mempengaruhi status fungsional setelah dikontrol oleh program rehabilitasi dan lama rawat dengan nilai odd ratio OR usia 31,30 p value =0,031, program rehabilitasi OR 28,21, p value=0,056 dan lama rawat OR 12,99 dengan p value=0,093. Pada kelompok case penelitian ini merekomendasikan melakukan latihan meningkatkan status fungsional terintegrasi dengan memperhatikan kemampuan dan kelompok usia.

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ABSTRACTAbstractTotal Hip Replacement THR is one of the reconstructive surgery of hip joint replacements which is done due to anatomic disorder, disturbing body function and effect on functional status. The purpose of the study is to identify the factors associated with the functional status of patients post THR surgery. This research uses case control design. Nonprobability sampling with consecutive sampling method is used to determine a number of samples. The result of this research shows that the functional status of frequency distribution using Hip Haris Score HHS proportion of respondents who have functional status disorder reached 24,4 case group where among variables possess age relationship, rehabilitation program and length of stay with functional status of patient after THR surgery. In the age group, it was the greatest factor affected functional status after controlled by rehabilitation program and length of stay with the value of odd ratio OR age 31,30 p value 0,031, rehabilitation program OR 28,21, p value 0,056 and length of treatment OR 12,99, p value 0,018. Based on the result, this case study group recommends for further research to do exercise enhancing functional status integrated with attention to ability and age group."

"ABSTRAKPendahuluan: Total Hip Replacement THR disebut sebagai operasi abad ini karena menunjukan hasil yang memuaskan walaupun memiliki harga yang relatif mahal. THR telah dilakukan lebih dari 1 juta kali/tahun secara global dan diperkirakan akan meningkat dua kali pada dekade depan. Pada institusi kami, permintaan THR meningkat 313 dari tahun 2011 -2016. Kini telah banyak hadir berbagai jenis desain implant terutama tipe bearing surface dengan kelebihan dan kekurangan masing-masing. Namun pemilihannya masih menjadi kontroversial. Metode: Kami melaporkan penelitian potong lintang terhadap tiga tipe bearing surface yang sering digunakan di institusi kami; ceramic on polyethylene CoP , metal on polyethylene MoP dan ceramic on ceramic CoC . Enam puluh tiga pasien berhasil dilakukan review dengan usia rata-rata 45 tahun dan follow up rata-rata 2,5 tahun. Kami menilai luaran fungsional dengan Harris Hip Score HHS dan radiologis. Hasil dan Pembahasan: Pada follow up terakhir, rata-rata HHS pascaoperasi yaitu 87,1 10,2 p=0,79 yang menunjukan tidak ada perbedaan antar kelompok. Rata-rata perbedaan HHS pascaoperasi ndash; praoperasi yaitu 46,48 14,1 p=0,005 yang menunjukan adanya perbedaan signifikan di dalam kelompok oleh analisis one-way ANOVA. Analisa post hoc menunjukan rata-rata perbedaan HHS pascaoperasi ndash; praoperasi secara statistik lebih tinggi pada kelompok CoC 56,82 12,7 dibandingkan dengan CoP 44,29 14,1, p = 0,007 dan MoP 42,05 11,9, p = 0,015 . Tidak ada perbedaan antara kelompok MoP dan CoP p = 1,000 . Tidak ditemukan perbedaan luaran radiologis pada ketiga kelompok. dimungkinkan karena follow up yang relatif pendek sehingga dibutuhkan studi dengan follow up yang lebih lama.

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ABSTRACTIntroduction Total Hip Replacement THR is considered to be the operation of the century with a high level of satisfactory result even though it has relatively high cost. It has been performed more than 1 million times year worldwide and its demand is estimated to double within decade. In our institution, its demand already increased by 313 from 2011 2016. Nowadays, we are faced with various implant design especially bearing surface with its benefits and weaknesses. But the ideal preference of bearing surface in THR remains a controversy. Methods We report a cross sectional study of three type of THR bearing surface which are ceramic on polyethylene CoP , metal on polyethylene MoP and ceramic on ceramic CoC , that was frequently used in our institution. Total patient of 63 were available for review with mean age of 45 years old and mean follow up of 2,5 years. We assessed their functional outcome with Harris Hip Score HHS and radiological outcome. Results and Discussion At the final follow up, mean post operative HHS was 87,1 10,2 p 0,79 that showed there were no difference between groups. Mean post operative ndash pre operative HHS differences was 46,48 14,1 p 0,005 that showed there were statically significant difference between groups as determined by one way ANOVA. A post hoc analysis revealed that postoperative ndash preoperative HHS differences were statistically significantly higher in CoC group 56,82 12,7 compared to CoP group 44,29 14,1, p 0,007 and MoP group 42,05 11,9, p 0,015 . There was no statistically significant difference between the CoP and MoP p 1,000 . Radiological outcomes reveal no loosening in all groups. This is predicted due to relatively short follow up time, thus longer follow up is needed. "

"Osteoartritis adalah penyakit degenerasi pada sendi yang melibatkan kartilago, lapisan sendi, ligamen, dan tulang karena proses inflamasi kronis pada sendi dan tulang disekitar sendi, sehingga dapat menyebabkan fraktur dengan angka kejadian yang meningkat ketika disertai dengan obesitas. Obesitas terjadi karena gaya hidup yang kurang baik, seperti menurunnya minat dalam berolah raga. Individu dengan osteoartritis pada sendi panggul dan disertai obesitas mudah mengalami fraktur collum femur sehingga ketika sudah terjadi fraktur maka diperlukan tindakan operasi THR Total Hip Replacement . Pada post operasi Total Hip Replacement harus segera dilakukan mobilisasi dengan latihan kekuatan otot seperti ankle pump, pengesetan quadtriseps, gluteal, hip and knee flexion, short arc quad, bed mobility exercise dan latihan penggunaan alat walker. Hasil yang didapatkan, klien mendapatkan tingkat ambulasi yang diharapkan, tidak terjadi komplikasi pada berbagai sistem tubuh serta tidak memperpanjang masa rawat.

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Osteoarthritis is a degenerative disease of the joint involving the cartilage, lining of the joints, ligaments, and bones due to chronic inflammatory processes in the joints and bones around the joint, thus causing fractures with increased incidence rates when accompanied by obesity. Obesity occurs due to poor lifestyle, such as decreased interest in exercise. Individuals with osteoarthritis of the hip joint and with obesity are susceptible to fracture of the femur collum so that when a fracture occurs it is necessary to perform THR Total Hip Replacement surgery. In post operation Total Hip Replacement should be mobilized with muscle strength training such as ankle pump, quadtriseps setup, gluteal, hip and knee flexion, short arc quad, bed mobility exercise and walker tool usage exercise. The results obtained, the client gets the expected level of ambulation, no complications occur on various body systems and does not extend the length of stay."

"Fraktur merupakan salah satu masalah perkotaan akibat cedera fisik. Penatalaksanaan fraktur patologis cukup kompleks dan mengakibatkan imobilisasi yang lama. Tingkat kemampuan mobilisasi pasien pasca total hip replacement dapat ditingkatkan melalui therapeutic exercise yang meliputi latihan range of motion, angkle pump, quads statis dan gluteal statis, serta latihan ambulasi menggunakan alat bantu yang telah diajarkan selama masa rawat. Hasil latihan menunjukkan meningkatnya kemampuan mobilisasi secara bertahap dan aman. Therapeutic exercise merupakan latihan efektif untuk meningkatkan mobilisasi dan mendukung ambulasi. Perawat perlu meningkatkan pengetahuan dan kemampuan melakukan therapeutic exercise untuk meningkatkan mobilisasi dan dibarengi peningkatan status kesehatan dengan perbaikan masalah kesehatan pasca THR.

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The most frequent problem of urban health is fractures due to physical injuries. The management of pathological fracture is complex and leads to prolong immobilization. Patients ability level after total hip replacement surgery can be enhanced by therapeutic exercise that includes range of motion, ankle pump, quads and gluteal static exercise, and ambulatory exercises using walker in rehabilitation phase while hospital stays.

The results of exercise show patients ability had increased gradually and secure to perform mobilizations. Therapeutic exercise is an effective exercise to improve mobilization and support ambulation. Nurses need to improve their knowledge and ability to perform therapeutic exercise as treatment of mobilization and be accompanied by improved patient health status from potential health problems after total hip replacement."

"Pendahuluan: Total Hip Replacement (THR) merupakan prosedur pembedahan tersering pada ekstremitas bawah. Kemajuan teknik operasi dan semakin canggihnya instrumen bedah meluaskan indikasi THR primer pada pasien yang sebelumnya tidak mungkin dilakukan dan memiliki angka komplikasi tinggi pasca operasi. Prosedur ini disebut THR primer sulit yang dilakukan pada kelompok pasien dengan kelainan panggul kompleks seperti defek tulang panggul, fusi panggul atau kontraktur jaringan lunak. Metode: 81 prosedur THR primer yang dikerjakan di RSUPN Dr. Cipto Mangunkusumo antara Januari 2012-Juni 2017. Kelompok THR primer sulit terdiri dari 29 pasien dan 52 pasien lainnya merupakan kelompok sederhana. Parameter intraoperatif seperti jumlah perdarahan, durasi operasi, ketepatan penempatan komponen, tingkat komplikasi dan luaran fungsional pasca operasi (Harris Hip Score) pada akhir follow up dicatat dan dilakukan analisis dengan membandingkan kedua kelompok tersebut.Hasil: Kelompok sulit memiliki jumlah perdarahan (p=<0.001), durasi operasi (p=<0.001) tingkat komplikasi (p=<0.012) lebih besar dibanding kelompok sederhana. Luaran radiologis berupa ketepatan penempatan orientasi komponen pada zona aman tidak memiliki perbedaan antar kedua kelompok (p=0.333). Luaran fungsional pada follow up akhir kelompok sulit (88.67) tidak memiliki perbedaan bermakna (p=0.080) dibandingkan kelompok sederhana (91.50). Pembahasan: Prosedur THR primer sulit yang dikerjakan di RSUPN Dr. Cipto Mangunkusumo walau memiliki parameter kesulitan dan tingkat komplikasi lebih besar tidak memiliki perbedaan luaran radiologis maupun fungsional dibandingkan THR primer sederhana. Perlu dilakukan identifikasi setiap prosedur THR primer apakah ada, jenis dan tingkat penyulit yang akan dihadapi saat intraoperasi untuk dilakukan perencanaan operasi yang baik sehingga didapatkan hasil luaran yang maksimal.

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Introduction: Total hip replacement (THR) is the most common surgery in lower extremities. Improvement in surgical technique and advancement of surgical instrumentation extended the indications for primary THR in previously impossible to treat. This procedure is known as primary difficult THR which performed in patients with complex hip disorders including hip bone defect, hip fusion, or soft tissue contracture. Methods: 81 primary THR procedures were performed in Cipto Mangunkusumo National Hospital from January 2012 until June 2017. Primary difficult THR group consisted of 29 patients and 52 patients in simple group. Intraoperative parameters including bleeding volume, operation time, complication rate, radiological outcome and functional outcome (Harris Hip Score) were recorded at the end of follow up and analyzed.Result: Difficult group had bleeding volume (p=<0.001), operation time (p=<0.001), complication rate (p=<0.012), higher than simple group. Radiological outcome is measured by accuracy of component orientation placement in the safe zone resulted no significant difference between two groups (p=0,333). Functional outcome at the end of follow up in difficult group (88.67) did not have significant difference (p=0.080) with simple group (91.50). Discussion: Primary difficult THR procedure performed in Cipto Mangunkusumo National Hospital although have higher difficulty parameters and complication rates, didn't have significant difference in radiologic and functional outcome compared to simple group. It was necessary to identify each primary THR procedures whether there were any, types and levels of difficulties that would be faced intraoperatively in order to improve preoperative planning so the outcome would be optimal."

"Sendi pinggul adalah sendi yang menghubungkan tulang paha (femur) dengan tulang pinggul (pelvis). Persendian ini rentan mengalami kerusakan akibat infeksi, kecelakaan, robeknya kartilago, osteoarthritis, keausan, dan degenerasi tulang. Untuk mengatasi masalah tersebut dapat dilakukan operasi penggantian sendi atau Total Hip Arthroplasty (THA), yakni implan untuk menggantikan sendi pinggul yang rusak menjadi sendi buatan. Hal ini dilakukan untuk mengembalikan fungsi sendi pinggul. Akan tetapi masa penggunaan implan THA terbatas, yakni setelah 10-20 tahun harus dilakukan pelapisan ulang. Sehingga terdapat ruang yang cukup luas untuk pengembangan desain implan yang akan bertahan lebih lama. Komponen utama dalam implan THA adalah acetabular cup, femoral head, dan femoral stem. Penelitian ini akan melibatkan beberapa model design femoral stem berbeda seperti lingkaran, elips, oval, dan trapesium untuk mengevaluasi tingkat kinerja dari setiap model yang dikembangkan dalam implan THA menggunakan finite element analysis (FEA). Pengujian dilakukan dengan dua variasi material berbeda untuk menentukan material yang paling kuat, yakni Co-Cr-Mo dan Ti-6Al-7Nb. Selain itu, pembebanan juga menggunakan dua variasi beban berbeda untuk memastikan implan kuat saat diberi pembebanan dari tubuh. Variasi pembebanan yang digunakan adalah 2300 N dan 3900 N. Pembuatan geometri dilakukan pada perangkat lunak Autodesk Fusion 360 serta pengujian finite element analysis (FEA) dilakukan pada ANSYS. Dari hasil penelitian, diperoleh bahwa bentuk trapesium menunjukkan performa terbaik karena deformasi dan tegangan yang paling rendah. Selain itu, CoCr Alloy lebih unggul dari pada Ti-6Al-7Nb karena nilai deformasi yang lebih rendah.

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The hip joint is a joint that connects the thigh bone (femur) with the hip bone (pelvis). These joints are susceptible to damage due to infection, accidents, torn cartilage, osteoarthritis, wear and tear, and bone degeneration. To overcome this problem, joint replacement surgery or Total Hip Arthroplasty (THA) can be performed, namely an implant to replace the damaged hip joint with an artificial joint. This is done to restore function of the hip joint. However, the period of use of THA implants is limited, namely after 10-20 years they must be resurfaced. So there is ample room for developing implant designs that will last longer. The main components in a THA implant are the acetabular cup, femoral head, and femoral stem. This research will involve several different femoral stem design models such as circular, elliptical, oval and trapezoidal to evaluate the performance level of each model developed in THA implants using finite element analysis (FEA). Tests were carried out with two different material variations to determine the strongest material, namely Co-Cr-Mo and Ti-6Al-7Nb. Apart from that, loading also uses two different load variations to ensure the implant is strong when subjected to load from the body. The load variations used were 2300 N and 3900 N. Geometry creation was carried out in Autodesk Fusion 360 software and finite element analysis (FEA) testing was carried out in ANSYS. From the research results, it was found that the trapezoidal shape showed the best performance because of the lowest deformation and stress. In addition, CoCr Alloy is superior to Ti-6Al-7Nb because of its lower deformation value."

"Total hip arthroplasty, the most commonly performed orthopedic procedure, is used to replace or reconstruct the hip with an artificial joint. Perspectives in Total Hip Arthroplasty outlines developments in technologies and biomaterials used for this procedure, with a focus on the tribological interactions of the materials used.Part one outlines the history of total hip arthroplasty and goes on to explore advances in techniques and biomaterials. Part two focuses on the tribology of materials used to perform this procedure, explaining the impact of wear on the load-bearing surface, a major cause of failure in hip prostheses. Chapters review a range of materials, including modern biomaterials, hybrid materials, metal, ceramic, and polyethylene. The book also discusses the tribological interactions of these materials when used in total hip arthroplasty."

"During the 2011 EFORT Congress in Copenhagen, many interesting topics relating to tribology in total hip arthroplasty were discussed during a special day devoted entirely to the subject. EFORT decided that, given the wide interest in these discussions, publication of the presentations would be warmly welcomed by all fellow professionals who were unable to attend. This book is the result. It provides detailed information on currently used articulating materials and their wear performance. Clinical outcomes are discussed, and important new frontiers are carefully considered. "

"ABSTRAKLatar Belakang: masalah yang sering terjadi setelah pembedahan sendi panggul yaitu defisit kekuatan otot, gangguan fisik, dan gangguan kemampuan berjalan kondisi ini dapat mengakibatkan ketidakmampuan pasien dalam menyelesaikan tugas fungsionalnya secara mandiri. Oleh karena itu, diperlukan intervensi yang berkelanjutan untuk dapat mengembalikan status fungsional pasien. Intervensi berupa program activehip exercise dengan melibatkan keluarga dilakukan untuk meningkatkan kemampuan fungsional. Tujuan: mengetahui pengaruh activehip exercise dan keterlibatan keluarga terhadap kemampuan fungsional pasien pasca pembedahan sendi pinggul. Desain penelitian: penelitian kuantitatif dengan menggunakan quasi experiment pre and post test without control group design dengan jumlah sampel 23 pasien pasca pembedahan panggul. Analisis data menggunakan uji Paired t-Test, Independet t-Tes dan Pearson Correlation. Hasil: analisis menunjukkan terdapat pengaruh activehip exercise dan keterlibatan keluarga dilihat dari adanya perbedaan rerata nilai status fungsional sebelum dan sesudah intervensi (p=0,0001). Hasil analisis bivariat menunjukkan adanya hubungan yang signifikan antara usia (0,001) dan nyeri (0,001) terhadap status fungsional. Kesimpulan: adanya pengaruh activehip exercise dengan keterlibatan keluarga terhadap status fungsional pasien paca pembedahan panggul.

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ABSTRACTBackground: Problems that usually happen after hip joint surgery are deficits in muscle strength, physical disorders, and impaired difficulties to walk or impaired mobility. These conditions can causes patient inablity to to fullfill their functional tasks independently. Therefore, a intervention is required to return functional status optimally. This intervention which is Activehip exercise which is modified with the family involvement was conducted to improve functional abilities. Objective: to identifiy the effect of Activehip exercise and family involvement on the functional abilities of patients after hip joint surgery. Design study: Quantitative research using quasi pre and posttest experiments without control group design with 23 patients after hip joint surgery as a sample. Data analysis used Paired t-Test, Independent t-Test and Pearson Correlation. Results: the result showed that there was an effect of Activehip exercise and family involvement as seen from the difference in mean functional status values before and after the intervention (p = 0.0001). The results of the bivariate analysis showed a significant relationship between age (0.001) and pain (0.001) to status functional. Conclusion: There was an effect of Activehip exercise and family involvement on the functional status of hip joint surgery's patients."

"Rasio lingkar pinggang panggul (RLPP) adalah salah satu metode untuk mendeteksi obesitas sentral. Skripsi ini bertujuan untuk mengetahui hubungan antara karakteristik individu, asupan makan, gaya hidup, dan indeks massa tubuh (IMT) dengan obesitas sentral berdasarkan RLPP pada kelompok usia dewasa di wilayah urban dan rural terpilih. Data yang digunakan dalam penelitian ini adalah data sekunder, dengan jumlah 195 sampel. Desain penelitian yang digunakan adalah desain studi kuantitatif observasional cross-sectional. Prevalensi obesitas sentral berdasarkan RLPP pada penelitian ini adalah 57,9%. Variabel yang memiliki hubungan bermakna dengan obesitas sentral berdasarkan RLPP adalah jenis kelamin dan IMT.

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Waist-hip ratio (WHR) is a method to measure the risk of central obesity. This study is focus on finding the association between individual characteristics, dietary intake, lifestyle, and body mass index (BMI) with central obesity based on WHR among adults in selected urban and rural area. Secondary data was used in this study, with total 195 samples. The design of this study is quantitative observational cross-sectional. The prevalence of central obesity based on WHR in this study is 57,9%. Variables which are significantly related to central obesity are sex and BMI."