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ANATOMI FISIOLOGI SENDI

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SENDI LUTUT NORMAL

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Adalah suau pen!aki ulan" k#onik di$ana e#%adi pelunakan dan desine"#asi da#i ulan" #a&an sendi

dise#ai pe$'enukan ulan" dan ulan" #a&an 'a#u pada epi sendi (oseo)i* dan e#%adi )i'#osis kapsulsendi.

OSTEOARTRITIS

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PENYEBAB

Mekanisme abnormal pada proses

penuaan

 Trauma

Kerusakan ulan! ra"an sendi

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Kelainan yang dapatmenimbulkan

osteoartritis  Ter#adin$a kerusakan pada ulan!

sub%arikuler Menin!kan$a ekanan pada iik

erenu pada ra"an sendi

Beban berlebi&an aau kerusakanulan! ra"an sendi ole& karenasuau &al'

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  A B C

Oseoarriis akiba (

A' Kerusakan pada ulan! sub%arikuler

B' Menin!kan$a ekanan pada iik erenu

)' Kerusakan ulan! ra"an sendi ole& karenasuau &al

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 KLASIFIKASI1. Osteoartritis Primer

 Tidak dikea&ui pen$ebabn$a*ania kuli pui&

Usia peren!a&an PoliarikularNodus +eberden

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. OsteoartritisSekunder

Disebabkan ole& pen$aki$an! men$ebabkan

kerusakan pada sino,ial'

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Beberapa pen$ebab (  Trauma - insabilias

.akor !eneik -perkemban!an

Pen$aki meabolik - endokin

Oseonekrosis

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ETIOLO!IFaktor predisposisi" Umur  /enis kelamin Ras .akor keurunan .akor meabolik-endokrin

 Trauma dan 0akor okupasi )ua1a-iklim Die

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I#SI$E#S  Teruama di aas 23 a&un

Dapa pada usia muda akiba kerusakan

ulan! ra"an sendi 

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PATO4ENESIS

FAKTOR

!E#ETIK 

PE#%E&A&

EKSTER#AL

Peruba'an (ungsik'ondrosit melepasen)im peng'an*ur

Stressmekanik 

Peruba'anmatriks

proteogly*an

Peruba'anmatrikskolagen

+ineralisasi

Radang syno,ia

Peruba'antulang ra-an

$estruksikartilago

!eala OA

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PATOLO!I

5'  Tulan! ra"an sendi

6'  Tulan!

7' Membran sino,ial8' Kapsul sendi

2' Badan lepas 9loose bodies:

;' E0usi<' Nodus +eberden dan Bou1&ard

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 Tulan! ra"an sendi

Berkuran!n$a kondroiin sul0a

 Ter#adi perlunakan danire!ularias pada ra"an sendi

Permukaan sendi men#adi kasar

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 Tulan!

 Ter#adi penin!kaan ,askularisasi

dan pembenukan oseo=  Terbenuk kisa $an! ber&ubun!an

den!an sendi dan berisi 1airan

sino,ial melalui de0ek pada ulan!

subkondral

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Membran sino,ial

  Ter#adi &iperro= ,ilus

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Kapsul Sendi

 Ter#adi =brosis dankonrakur kapsul sendi

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Badan lepas 9loose

bodies:  Tulan! ra"an $an! nekrosis

men!alami abrasi dan erlepas ke

dalam ruan! sendi> menimbulkanreaksi pada membran sino,ial'

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E0usi

Pada sadium a"al

Pada eksaserbasi in?amasi aku

)airan bersi0a #erni& @iskosias in!!i

Proein renda&

Pada oran! ua dapa&emora!ik

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Nodus +eberden dan

Bou1&ard Akiba de!enerasi membran kapsul

dan #arin!an lunak sendi

Membenuk kisa men!andun!asam &ialurona

 Ter#adi meaplasia ulan! dan ulan!

ra"an

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Normal Oseoarriis

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!E/ALA KLI#IS N$eri

Kaku sendi Pemben!kakan 4an!!uan per!erakan

De0ormias Nodus +eberden dan Bou1&ard

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#odus 0eberden dan&ou*'ard

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LA&ORATORI+ La#u endap dara& biasan$a normal

Serum koleserol sediki menin!!i

.akor reumaoid 9%:

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PE+ERIKSAA#

RA$IOLO!IK 1. Foto polos

. Radionuklidas*anning

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Foto PolosDensias ulan! normal aau menin!!iPen$empian ruan! sendiSklerosis ulan! subkondralOseo= pada epi sendi

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Radionuklida

S*anning Men!!unakan m T1%+DP

 Terli&a penin!kaan aki,ias ulan!

pada subkondral sendi

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Oseoarriis Pan!!ul

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Oseoarriis pan!!ul

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Oseoarriis luu

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Oseoarriis luu

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Oseoar&riis ba&u kanan

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Oseoarriis pada sendi iner0alan!

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PE#!O&ATA#5' Pen!obaan Umum

6' Oba%obaan

7' Aspirasi bila ada 1airan sendi

8' Bidai

2'  Tindakan operasi

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Pengobatan

mum5' Isira&a eraur

6' Men!uran!i beban pada

sendi7' Lai&an sais

8' .isioerapi

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Obat2obatan

Anal!eik dan ani in?amasi

In#eksi seroid

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IN/EKSI INTRA%ARTIKULAR

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Aspirasi bila ada*airan sendi

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Bidai

Pada n$eri aku

Men!oreksi de0ormias

Men!uran!i beban ubu&

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 Tindakan operasi

N$eri $an! idak eraasi den!an oba aau

indakan lokal

Sendi $an! idak sabil karena subluksasi aau

de0ormias

Kerusakan sendi lan#u

Men!oreksi beban pada sendi a!ar

disribusin$a erba!i sama raa

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Sendi

panggul"Oseoomi

9A5>A6:Arroplasi

Arrodesis 9B:

A5 A6 B

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Sendi luu( Oseoomi in!!i ibia 9): +emiarroplasi Arroplasi oal 9D: Arrodesis

D

)6)5

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Oseoomi pan!!ul

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Oseoomi ibia

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+ip #oin repla1emen

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+ip ar&roplas$

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Arroplasi luu

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Knee #oin repla1emen

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Knee ar&roplas$

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S&oulder ar&roplas$

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Arrodesis pan!!ul

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Arrodesis luu

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*ASSALAM'