Highlights Glomus tumor is a rare small benign perivascular tumor, which develops from the glomus body located in the reticular dermis. The pain caused by glomus tumor could be easily mistaken to lower extremity pain whether it is radiating, sciatic, or just a localized one. A localized thermoregulator subcutaneous tumor could generate paroxysmal pain and sensitivity to pressure which is feigned as chronic radiating pain. A thorough examination is the key to a proper diagnosis of uncommon locations of the tumor.

Background: Cuttlefish bone Xenograft, calcium phosphate (CaP)-based biomaterial graft, offers an alternative and has been accepted for osteoconductive and probable osteo-inductive attributes. This study aims to compare the bone healing potential between the bovine-derived (BHA) and cuttlefish bone-derived (CHA).Materials and Methods: The study compared osteoblast cell proliferation of 27 New Zealand rabbits in 2.5 mm bone defect made in the femoral bone. The samples were divided into three groups, which were control, BHA and CHA group. The chemical and physical characteristics of BHA and CHA were determined for the content of hydroxyapatite by FourierTransform Infrared Spectroscopy (FTIR) and X-Ray Diffraction (XRD), then tested by Scanning Electron Microscopy (SEM) to evaluate the porosity. In the end of the second week, histopathologic and immunohistochemistry examinations were performed to evaluate the amount of osteoblast and osteocalcin expression.Results: The FTIR, XRD and SEM analysis showed both BHA and CHA samples were hydroxyapatite according to Joint Committee on Powder Diffraction Standards (JCPDS). The CHA was significantly higher (297.22±19.772) compared to BHA (258.22±30.926) and control (131.67±34.213). Osteocalcin expression in CHA (7.82±2.230) compared to BHA (6.09±3.724) and control (4.07±3.606), was not significant (p>0.05). Conclusion: CHA group has the highest osteoblast cell proliferation and osteocalcin expression, meaning has a good potential as future source of bone graft.Keywords: cuttlefish bone, bovine, bone graft, osteoblast cell

Introduction. Without appropriate treatment, nerve injuries may result in permanent loss of function. Platelet-rich plasma (PRP) injection is found to help in nerve regeneration. PRP is a concentrated platelet derived from autologous blood with the potential to release various growth factors (GF) to promote nerve regeneration. This study aims to know the best time for PRP injection to promote nerve regeneration. Methods. This is an experimental in vivo research using male New Zealand white rabbits in the randomized control group posttest only design. Samples were divided into 5 groups (1 control group and 4 treatment groups). The control group without PRP injection and treated groups injected immediately after nerve injury, 3 days, 7 days, and 14 days afterward. Nerve regeneration was evaluated by the histology specimen sacrificed on day 21. Inflammation cells and endoneurium vacuoles were counted as mean percentage of five nerve fragments in each injured nerve sample specimen. Result. Inflammation cells and vacuole cells increased significantly when PRP was administered 3 days after injury (group 2) (respectively, 14 ± 6.7 and 56.6 ± 11.6) compared to all treatment groups ( p < 0.005 ) (control group, respectively, 6 ± 2.6 and 15.7 ± 9.5). On the other hand, significantly lower endoneurium vacuoles and inflammation cells were found on “the day 14” sample group (respectively, 5 ± 1.3 and 5.2 ± 1.6) compared to all other groups ( p < 0.005 ). Conclusion. This study found that the best time for injecting PRP for nerve regeneration is 14 days after injury.

Introduction: The only treatment for grade IV knee osteoarthritis is total knee arthroplasty (TKA) irrespective of the age of the patient. Most of the grade IV OA patient are elderly and most likely to have some comorbidities. Age and comorbidities are the major reasons for patient’s reluctance to undergo TKA. A clinical pathway with standard length of stay (LOS) could justify the patient’s hesitation for TKA. The aim of this study was to determine the factors, including age and comorbidity, that affect the LOS of patients treated with TKA. Materials and Methods: This is a retrospective study of TKA patients in Surabaya Orthopedics and Traumatology Hospital from January 2011 to July 2017. Preoperative comorbidities were scored using Charlson Comorbidity Index (CCI) and physical status by ASA (American Society of Anesthesiologist), classification for age, sex, BMI, blood loss, operation time, method of anaesthesia and postoperative day of rehabilitation were recorded as factors potentially affecting LOS. The discharge criteria for the patients were ability to ambulate to the bathroom and clean operative wound with no complications. The data obtained were analysed statistically.Results: The average LOS was 5.58 days, ranging from three to eight days. There were no demographic factors that affected the patients’ LOS. BMI, ASA, CCI, and blood loss did not significantly affect LOS. Operation time was between 90-140 minutes, and spinal anaesthesia showed significant longer LOS, but within the average.Conclusion: Age and comorbidity did not affect length of stay in TKA patients.

Introduction: Percutaneous vertebroplasty (PV) is one of the available treatments for vertebral compression fracture (VCF). Polymethylmethacrylate (PMMA) is the most common bone substitute used in the procedure, but it has several disadvantages. Bioceramic material, such as hydroxyapatite (HA), has better biological activity compared to PMMA. The aim of this study was to find an optimal biomaterial compound which offers the best mechanical and biological properties to be used in PV.Materials and Methods: This was an experimental study with goat (Capra aegagrus hircus) as an animal model. The animals’ vertebral columns were injected with PMMA-HA compound. Animal samples were divided into four groups, and each group received a different proportion of PMMA:HA compound. The mechanical and biological effects of the compound on the bone were then analysed. The mechanical effect was assessed by measuring the vertebral body’s compressive strength. Meanwhile, the biological effect was assessed by analysing the callus formation in the vertebral body.Results: The optimal callus formation and compressive strength was observed in the group receiving PMMA:HA with a 1:2 ratio.Conclusion: A mixture of PMMA and HA increases the quality of callus formation and the material’s compressive strength. The optimum ratio of PMMA:HA in the compound is 1:2.