1.The applications of International Classification of Functioning, Disability and Health (ICF) by World Health Organization (WHO) in rehabilitation medicine practice
Journal of University of Malaya Medical Centre 2007;10(2):16-21
Context: Rehabilitation Medicine is dedicated to optimise patients function and health in the most
comprehensive manner. ICF, the latest International Classification by World Health Organization (WHO)
is a conceptual framework for the assessment of functioning, disability and health. The purpose of this
paper is to describe the applications of ICF in Rehabilitation Medicine practice in the Medical
Rehabilitation Unit, University of Malaya Medical Centre (UMMC), Kuala Lumpur. Issues: ICF
consists of body function, structure, activity, participation and environmental factor. ICF categories
are exhaustive, but are not practical to be used entirely and not applicable in clinical practice on their
own. How is ICF used from the clinical perspective? It has to be adapted to make it usable. In
Rehabilitation Medicine settings, the following are ways ICF is applied in clinical practice: research
in terms of validating the use of available ICF Core Sets and development of new ICF Core Set;
clinical practice based on the ICF-based sheet; and educational tools. Conclusion: The practice of
Rehabilitation Medicine is in line and compatible with the concept of ICF and can serve as a new
important language that can improve the practice of Rehabilitation Medicine. It can be a universal
language in functioning, disability and health and can improve understanding in addressing issues on
disability within the medical community, improve multi professionals’ communication among patients,
healthcare providers and stakeholders.
2.Autologous chondrocyte implantation for knee focal cartilage defects: 3 years' follow-up at the University Malaya Medical Centre.
Abbas Aa ; Mohamad Ja ; Lydia Al ; Selvaratnam L ; Razif A ; Ab-Rahim S ; kavitha G ; Shilpa Pn ; Kamarul T
Journal of University of Malaya Medical Centre 2014;17(1):8-13
Autologous chondrocyte implantation (ACI) is a widely accepted procedure for the treatment of large, fullthickness
chondral defects involving various joints, but its use in developing countries is limited because of high
cost and failure rates due to limited resources and support systems. Five patients (age <45 years) with focal
cartilage defects received ACI at University of Malaya from 2006 to 2007 and followed up for 36 months. The
average presubjective Knee Evaluation Forms (IKDC) improved from 38.44±6.29 to 25.6±8.04 postoperatively,
the Oxford Knee Score (OKS) went from 25.6±8.04 to 13.96±1.63 and the American Knee Society Score (AKSS)
improved from 80±14.33 to 92.96±5.82 post-operatively. Thus improvements were seen in the IKDC and
AKSS score but not in the OKS. Magnetic resonance images showed the presence of cartilage tissue filling in
the lateral and medial patellar facet and medial femoral condyle in three patients. Failures were seen in two
patients, both with patellar defects and over the age of 36 years. Treatment with autologous chondrocyte
implantation for focal cartilage defect in lateral and medial patellar facet and medial femoral condyle showed
early improvement which was maintained at 3 yrs follow-up. ACI provided satisfactory outcome in focal cartilage
defects involving the femoral condyle.
Chondrocytes