Background: The Knee injury and Osteoarthritis Outcome Score (KOOS) is a useful diagnostic tool to assess knee ligament injury and osteoarthritis, but no validated Indonesian version of the KOOS was available. Methods: We used the forward-backward translation protocol to develop the Indonesian version of the KOOS. The translated questionnaire was administered twice to 51 subjects diagnosed with a knee ligament injury and osteoarthritis. Validity of the questionnaire was assessed by analyzing the correlation between the score of each subscale and the overall score of the 36-Item Short Form Health Survey (SF-36) using the Pearson correlation coefficient. Reliability was measured by evaluating internal consistency (Cronbach α) and test-retest reliability (intraclass correlation coefficient). Results: For construct validity, moderate Pearson correlation coefficients were found between the KOOS subscales and the SF-36. Cronbach α was 0.84 to 0.97 for all subscales, indicating adequate internal consistency. The test-retest reliability was excellent, with intraclass correlation coefficients ranging from 0.91 to 0.99 for all subscales. No significant differences were found in the KOOS subscale responses between the first administration of the questionnaire and the second administration within 21 days. Conclusion: The Indonesian version of the KOOS was determined to be valid and reliable and is therefore an objective instrument for evaluating knee ligament injury and knee osteoarthritis in the Indonesian population.

Primary synovial osteochondromatosis is an uncommon benign joint disorder characterized by the formation of cartilaginous bodies within the synovial of the different joints, tendon sheaths, and bursae. Loose bodies occur in the late stage of the disease. Excision of loose bodies is needed to treat synovial osteochondromatosis. A 20-year-old female patient presented to us with a chief complaint of pain, swelling, and discomfort sensation in the left ankle while walking. Plain X-ray on her left ankle showed loose bodies surrounding the ankle. We performed excision to remove the loose bodies. Histological examination confirmed the diagnosis. The range of motion (ROM) of the ankle increased after surgery. The patient was able to walk more comfortably. Synovial osteochondromatosis is considered benign. In this case, open excision was chosen because the ankle joint is not amenable to arthroscopy. Follow up is needed to detect early recurrence and transformation of malignancy.

FIGURE 5. Plain radiographs of excised radial head after surgery.

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Musculoskeletal tumors are relatively rare, with 0.2%-0.5% of all malignant tumors in all ages. The geographic distribution of musculoskeletal tumors varies significantly around the world. This study aims to describe the musculoskeletal tumor profile in Saiful Anwar General Hospital. All data were obtained from the department of orthopaedic and traumatology database, Saiful Anwar general hospital. Thus, patients who were diagnosed with either bone tumor or soft tissue tumor between January 2011 to December 2018 were selected for the present study. The clinical-pathological conference (CPC) was carried out to ensure the validity of all the registered data. A total of 577 patients with tumors from January 2011 to December 2018 was obtained. Out of all the cases, 439 (76%) cases are bone tumors, and the remaining 138 (24%) cases are soft tissue tumors. The most frequent locations of the musculoskeletal tumors are the long bones of the thigh and lower leg. This study shows an increasing trend in musculoskeletal tumors incidence, despite decreasing numbers in several years. This result goes along with a rising trend in malignancy cases with a higher amount compared to the benign one. Moreover, MBD and osteosarcoma were found to be the most common tumor and primary bone tumors, respectively. However, the fact that there is some data loss in the study limited the study for a more accurate result.   Keywords: Musculoskeletal tumor; Bone tumor; Osteosarcoma; Malang; East Java