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Sample translations submitted: 1
English to Indonesian: Acetabular cup migration after primary cementless total hip arthroplasty in rheumatoid arthritis and its influencing factors: a comparative study with osteoarthritic hip General field: Medical Detailed field: Medical (general)
Source text - English Acetabular cup migration after primary cementless total hip arthroplasty in rheumatoid arthritis and its influencing factors: a comparative study with osteoarthritic hip
Abstract
Purpose To compare the radiographic migration profiles of primary cementless total hip arthroplasty (THA) between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA).
Methods A total of 197 patients (215 hips) who underwent cementless THA for RA or OA between January 2001 and January 2013 and followed up for a minimum of 5.5 years were included. Ninety-four RA patients (109 hips) were compared with 103 OA patients (106 hips). Radiological evaluation was performed for acetabular cup loosening, and cup migration was measured using Einzel-Bild-Röntgen-Analyse (EBRA) software. Multiple variables were assessed to identify influencing factors for cup migration. Results Early cup migration was observed in 13 hips (11.9%) in the RA group and four hips (3.8%) in the OA group, showing a significant difference (p = 0.041). Acetabular cup loosening occurred in three cups (2.8%) in the RA group and in one cup (0.9%) in the OA group, showing no significant difference (p = 0.321). Total cup migration was higher in the RA group (2.62 mm) than in the OA group (1.44 mm, p = 0.005). Total cup migration was significantly higher in patients aged < 50 years than in those aged > 50 years (p = 0.005). Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibody influenced total cup migration. Patients with seropositive RA showed significantly higher total cup migration and early cup migration incidence than those with seronegative RA (p = 0.005, p = 0.038, respectively).
Conclusions Acetabular cups in primary cementless THAs of RA patients were less stable in terms of cup migration compared with that of OA patients.
Rheumatoid arthritis (RA) is characterized by peripheral and systematic polyarthritis and erosion of cartilage and bone, resulting in joint destruction and deformity [1]. RA patients have poor bone stock and compromised musculoskeletal structure, with their bone metabolism being influenced by various factors, such as anti-RA medication, circulating cytokines, and reduced physical activity [2]. Therefore, a higher risk of shorter prosthesis durability may be expected in these patients due to their poor bone quality.
Relatively higher failure rates of cups have been reported previously in RA patients undergoing primary total hip arthroplasty (THA) than in osteoarthritis (OA) patients [3]. The functional results of RA patients were reportedly inferior to those of patients who underwent cemented THAs for other diagnoses [4]. However, recent comparative studies have not found a significant difference in the survival rate of THAs between RA and OA patients [5]. Overall survival of primary THAs in RA patients was reportedly similar to that of OA patients [5, 6]. These results might be explained by a lower level of physical activity in RA patients.
Previous studies comparing cup migration after primary THAs between RA and OA patients are rare [7]. The RA group reportedly showed more prominent proximal migration of the acetabular components than the OA group [7]. However, the study was limited by its small sample size, short-term follow-up duration, and the fact that it is only applicable to the earlier cemented implant design. Given that the previous studies showed that the failure rate of cemented cups differs from cementless cups due to compromised bonecement interface by inflammatory joint disease [8], the degree of migration in cemented and cementless cups after THA of RA patients is likely to be different. Therefore, documenting the long-term outcomes of a larger size cohort and comparing migration of cementless cups between RA and OA patients are required.
Einzel-Bild-Röntgen-Analyse (EBRA) software has been used to measure acetabular component migration [9, 10]. EBRA is a highly accurate method with 1-mm and 0.8-mm confidence limits for longitudinal and transverse migrations, respectively [9]. Recently, EBRAwas reported to be an accurate diagnostic tool for predicting aseptic loosening of cementless acetabular components [11]. We aimed to compare the radiographic migration profiles of cementless cups using the EBRA software between RA and OA patients and to identify the influencing factors associated with cup migration in RA patients.
Patients and methods
Patients who underwent primary THA for OA or RA were evaluated for inclusion. This retrospective comparative study included 94 patients (109 hips) with RA who underwent primary THA at our institution between January 2001 and December 2010 and followed up for a minimum of 5.5 years. RA diagnosis was based on the 1987 American College of Rheumatology criteria [12] or 2010 ACR/European League Against Rheumatism (EULAR) criteria [13]. The RA group was compared with 103 patients (106 hips) who underwent primary THA for OA, and who were considered as the control group and matched for age, sex, body mass index (BMI), bone mineral density (BMD), history of smoking and diabetes, disease duration, and implant design. Demographic data of both groups are summarized in Table 1.
Surgery was performed through a lateral approach with a trochanteric osteotomy by a single senior surgeon. To reattach the greater trochanter, stainless steel wires were inserted crosswise through the proximal femur, then passed through the holes in the greater trochanter. The wires were tightened and tied twice with square knots using Kirschner wire bows. ABG II cups (Stryker Orthopaedics, Mahwah, NJ) were used in all cases with ABG II femoral stems (Stryker Orthopaedics). We also utilized Biolox Forte ceramic inserts (Stryker Orthopaedics) with a metal backed socket. The ceramic V40™ femoral head (Stryker Orthopaedics) was used in all hips. Postoperative rehabilitation programs were equally applied to both groups. Active range of motion exercise of hips was encouraged. Patients were allowed to walk using a walker after 5 days with partial weight-bearing, and full-weight bearing was allowed six weeks post-operatively.
Two authors who did not participate in the surgery independently reviewed the radiographic assessments. All hip anteroposteriorradiographsobtainedatfollow-upwereevaluated foracetabularcuploosening,whichwasradiologicallydefinedas cup migration of 3 mm, >5° of change in cup inclination, or a thick radiolucent line >1 mm in all three zones [14]. Routine follow-up was performed on post-operative day one, week two, months three and six, and annually thereafter. Acetabular component migration was measured on hip anteroposterior radiographs using EBRA. Time points for migration analyses were those routinely used for clinical follow-up. Radiographs were converted to graphic files using the hospital picture archiving and communication system (PACS) (Agfa IMPAX; AGFA-
Gevert N.V., Mortesl, Belgium) and ultra-high-quality setting and were analysed using EBRA (Universität Innsbruck, Innsbruck, Austria). Total acetabular component migration was evaluated. The Pythagorean theory was applied to calculate the total migration. Early cup migration in EBRA analysis was defined as total migration >1 and >2 mm at two and four years, respectively [10].
Translation - Indonesian Migrasi acetabular cup setelah total hip tanpa semen primer artroplasti pada rheumatoid arthritis dan faktor-faktor yang mempengaruhinya: sebuah studi perbandingan dengan osteoarthritic pinggul
Abstrak
Tujuan Untuk membandingkan profil migrasi radiografi dari artroplasti pinggul total primer (THA) tanpa semen antara pasien dengan rheumatoid arthritis (RA) dan mereka dengan osteoarthritis (OA).
Metode Sebanyak 197 pasien (215 pinggul) yang menjalani THA tanpa semen untuk RA atau OA antara Januari 2001 dan Januari 2013 dan ditindaklanjuti selama minimal 5,5 tahun dimasukkan. Sembilan puluh empat pasien RA (109 pinggul) dibandingkan dengan 103 pasien OA (106 pinggul). Evaluasi radiologis dilakukan untuk loosening asetabular cup, dan migrasi cawan diukur menggunakan perangkat lunak Einzel-Bild-Röntgen-Analyze (EBRA). Beberapa variabel dinilai untuk mengidentifikasi faktor-faktor yang mempengaruhi migrasi cawan. Results Migrasi cup awal diamati pada 13 pinggul (11,9%) pada kelompok RA dan empat pinggul (3,8%) pada kelompok OA, menunjukkan perbedaan yang signifikan (p = 0,041). Loosening asetabular terjadi dalam tiga cup (2,8%) pada kelompok RA dan satu cup (0,9%) pada kelompok OA, tidak menunjukkan perbedaan yang signifikan (p = 0,321). Migrasi total cup lebih tinggi pada kelompok RA (2,62 mm) dibandingkan pada kelompok OA (1,44 mm, p = 0,005). Migrasi total cup secara signifikan lebih tinggi pada pasien berusia 50 tahun (p = 0,005). Antibodi faktor reumatoid (RF) dan anti-siklik citrullinated peptide (anti-CCP) mempengaruhi migrasi total cup. Pasien dengan RA seropositif menunjukkan migrasi total cup secara signifikan lebih tinggi dan insiden migrasi cup awal dibandingkan dengan RA seronegatif (p = 0,005, p = 0,038, masing-masing).
Kesimpulan Acetabular cup pada THA primer tanpa semen pada pasien RA kurang stabil dalam hal migrasi cup dibandingkan dengan pasien OA
Rheumatoid arthritis (RA) ditandai oleh polyarthritis perifer dan sistematis serta erosi tulang rawan dan tulang, yang mengakibatkan kerusakan sendi dan kelainan bentuk [1], Pasien RA memiliki stok tulang yang buruk dan struktur muskuloskeletal yang terganggu, dengan metabolisme tulang mereka dipengaruhi oleh berbagai faktor, seperti obat anti-RA, sitokin yang beredar, dan berkurangnya aktivitas fisik[2]. Karena itu, lebih tinggi risiko daya tahan prostesis yang lebih singkat dapat diduga pada pasien ini karena kualitas tulang mereka yang buruk.
Tingkat kegagalan yang relatif lebih tinggi pada cup telah dilaporkan sebelumnya pada pasien RA yang menjalani artroplasti panggul total primer (THA) daripada pada pasien osteoartritis (OA) [3]. Hasil fungsional pasien RA dilaporkan lebih rendah daripada pasien yang menjalani THA dengan semen untuk diagnosis lainnya [4]. Namun, studi perbandingan terbaru belum menemukan perbedaan yang signifikan dalam tingkat kelangsungan hidup THA antara pasien RA dan OA [5]. Kelangsungan hidup keseluruhan THA primer pada pasien RA dilaporkan serupa dengan pasien OA [5, 6]. Hasil ini mungkin dijelaskan oleh tingkat aktivitas fisik yang lebih rendah pada pasien RA.
Penelitian sebelumnya yang membandingkan migrasi cup setelah THA primer antara pasien RA dan OA jarang terjadi [7]. Kelompok RA dilaporkan menunjukkan migrasi proksimal yang lebih menonjol dari komponen asetabular daripada kelompok OA [7]. Namun, penelitian ini dibatasi oleh ukuran sampel yang kecil, durasi tindak lanjut jangka pendek, dan fakta bahwa itu hanya berlaku untuk desain implan yang dengan semen sebelumnya. Mengingat bahwa penelitian sebelumnya menunjukkan bahwa tingkat kegagalan pada cup dengan semen berbeda dari cup tanpa semen karena daerah kontak semen tulang terganggu oleh penyakit inflamasi sendi[8], tingkat migrasi cup pada yang dengan semen dan tanpa semen setelah THA pasien RA cenderung berbeda. Oleh karena itu, mendokumentasikan hasil cohort jangka panjang yang lebih besar dan membandingkan migrasi cup tanpa semen antara pasien RA dan OA diperlukan.
Perangkat lunak Einzel-Bild-Röntgen-Analyze (EBRA) telah digunakan untuk mengukur migrasi komponen asetabular [9, 10]. EBRA adalah metode yang sangat akurat dengan batas kepercayaan 1-mm dan 0,8-mm untuk migrasi longitudinal dan transversal, masing-masing [9]. Baru-baru ini, EBRA dilaporkan menjadi alat diagnostik yang akurat untuk memprediksi aseptik loosening dari komponen acetabular tanpa semen [11]. Kami bertujuan untuk membandingkan profil migrasi radiografi dari cup tanpa semen menggunakan perangkat lunak EBRA antara pasien RA dan OA dan untuk mengidentifikasi faktor-faktor yang mempengaruhi yang terkait dengan migrasi cup pada pasien RA.
Pasien dan metode
Pasien yang menjalani THA primer untuk OA atau RA dievaluasi untuk dimasukkan. Studi perbandingan retrospektif ini mencakup 94 pasien (109 pinggul) dengan RA yang menjalani THA primer di lembaga kami antara Januari 2001 dan Desember 2010 dan ditindaklanjuti selama minimal 5,5 tahun. Diagnosis RA didasarkan pada kriteria American College of Rheumatology 1987 [12] atau 2010 ACR / European League Against Rheumatism (EULAR) kriteria [13]. Kelompok RA dibandingkan dengan 103 pasien (106 pinggul) yang menjalani THA primer untuk OA, dan yang dianggap sebagai kelompok kontrol dan disesuaikan dengan usia, jenis kelamin, indeks massa tubuh (BMI), kepadatan mineral tulang (BMD), riwayat merokok dan diabetes, durasi penyakit, dan desain implan. Data demografis kedua kelompok dirangkum dalam Tabel 1.
Pembedahan dilakukan melalui pendekatan lateral dengan osteotomi trokanter oleh seorang ahli bedah senior. Untuk memasang kembali greater trokanter, wire baja stainless dimasukkan melintang melalui femur proksimal, kemudian melewati lubang di greater trokanter. Kabel dikencangkan dan diikat dua kali dengan simpul persegi menggunakan Bow Kirschner wire. Cup ABG II (Stryker Orthopaedics, Mahwah, NJ) digunakan dalam semua kasus dengan femur stem ABG II (Stryker Orthopedics). Kami juga memanfaatkan sisipan keramik Biolox Forte (Stryker Orthopedics) dengan soket yang didukung logam. Kepala femoralis keramik V40™ (Stryker Orthopedics) digunakan di semua pinggul. Program rehabilitasi pasca operasi diterapkan secara merata pada kedua kelompok. Latihan rentang gerak aktif pinggul dianjurkan. Pasien diizinkan untuk berjalan menggunakan alat bantu jalan setelah 5 hari dengan weight-bearing parsial, dan weight-bearing full diizinkan enam minggu pasca operasi.
Dua penulis yang tidak berpartisipasi dalam operasi secara independen meninjau penilaian radiografi. Semua radiograf anteroposterior pinggul yang diperoleh pada follow-up dievaluasi untuk melonggarnya cangkir asetabular, yang secara radiologis didefinisikan sebagai migrasi cup 3 mm,> 5 ° perubahan kecenderungan cangkir, atau garis radiolusen tebal> 1 mm di ketiga zona [14]. Tindak lanjut rutin dilakukan pada hari pertama pasca operasi, minggu kedua, bulan ketiga dan enam, dan setiap tahun sesudahnya. Migrasi komponen asetabular diukur pada radiograf anteroposterior panggul menggunakan EBRA. Poin waktu untuk analisis migrasi adalah mereka yang secara rutin digunakan untuk tindak lanjut klinis. Radiografi dikonversi ke file grafik menggunakan pengarsipan gambar dan sistem komunikasi rumah sakit (PACS) (Agfa IMPAX; AGFA-
Gevert N.V., Mortesl, Belgia) dan pengaturan dengan kualitas sangat tinggi dan dianalisis menggunakan EBRA (Universität Innsbruck, Innsbruck, Austria). Total migrasi komponen asetabular dievaluasi. Teori Pythagoras diterapkan untuk menghitung total migrasi. Migrasi cup awal dalam analisis EBRA didefinisikan sebagai total migrasi> 1 dan> 2 mm pada dua dan empat tahun, masing-masing [10].
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I'm an orthopedic surgeon, work in a public hospital in South Celebes Indonesia. I graduated as my Orthopedic and Traumatology Surgeon in 2018 and a part-time member of the Association of Indonesian Translators since 2014. While studying I knew that translation in medical is different from general translation because it required the understanding of Medical terms combine with Fluent English, and that becomes my passion now, instead of just used them for my studies before, I have a willingness to provide translation for others, especially for medical students in my country. Every month there is a lot of updates that comes in form of journals, articles, and also Textbooks, better translation means better understanding, better understanding lead to perfect assessment.