Rizki Rahmadian
Konsultan Rekonstruksi Sendi Panggul dan Sendi Lutut
Bagian Bedah FK Unand/ RS. Dr. M. Djamil Padang
Sendi Lutut
Tulang
• Patella
• Tibia
• Fibula
Sendi Lutut
Ligament
• Anterior Cruciate Ligament
(ACL)
• Posterior Cruciate Ligament
(PCL)
• Medial Collateral Ligament
(MCL)
• Lateral Collateral Ligament
(LCL)
• Popliteal Ligament
Sendi Lutut
Meniskus
• Crescent shape
• Fibrocartilaginous
• Medial : C shape
• Lateral : sirkuler
Anamnesis dan Pemeriksaan
Fisik
Mekanisme Injuri
• Posisi sendi lutut saat terjadi cedera
– Weight supporting
– Varus atau valgus
– Cedera kontak atau non kontak
• Lesi osteokonral
• Robekan meniskus
• Ruptur Cruciate Ligament
• Ruptur collateral ligament
Knee injuries
LESI OSTEOKONRAL
Hunter 1743
“From Hippocrates to present age,
it is universally allowed that
ulcerated cartilage is a trouble some thing &
that once destroyed, is not repaired”
Penyebab Kerusakan Rawan Sendi
• Cedera olah raga
• Trauma
• Keadaan patologis
– OCD
ICRS Arthroscopic Classification
Lesion Thickness
• Grade 0: Normal
• Grade I: Superficial
fissures
• Lesi < 1 cm
• Dokumentasi
• Monitoring ketat
• Menghasilkan fibrocartilage
• Bertahan sampai 10 th
• Indications:
– Non degenerative
– 1.5 to 4 cm2
– Isolated
• Absolute contraindications:
– Age > 50
– Size > 4-8 cm2
– Depth > 10 cm.
• Menghasilkan
kartilago hyalin
RUPTUR MENISKUS
ANATOMI
• Perimeniscal capillary
plexus (PCP) :
vaskularisasi menuskus
dari perifer
Mekanisme Injuri
• Rotasi akut pada sendi
lutut yang menerima
beban tubuh
• Robekan degeneratif
terjadi akibat cedera
berulang
Tipe Robekan
Pemeriksaan Fisik
• Nyeri saat menerima berat badan
tubuh dan rotasi sendi lutut
• McMurray test
• Apley test
• etc
IMAGING (MRI)
Penetalaksanaan
• Konservatif
• Operatif:
– Open technique
– Inside-out
– Outside-in
– All inside
• Meniscus transplantation
• Partial meniscus replacement
SURGICAL TECHNIQUES
• Open techniques
• An inside-out technique
using vertical sutures
• An outside-in technique
using horizontal sutures
• A 10mm meniscal
fixation device
(Biostinger)
Knee injury