Publications by authors named "Jun-Ho Kim"

189 Publications

Does postoperative quantitative bone scintigraphy reflect outcomes following medial open-wedge high tibial osteotomy?

PLoS One 2021 14;16(9):e0257315. Epub 2021 Sep 14.

Department of Nuclear Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.

Purpose: The present study evaluated changes in bone tracer uptake (BTU) after medial open-wedge high tibial osteotomy (MOWHTO) and determined whether postoperative BTU correlates with clinical symptoms, radiologic parameters, or cartilage regeneration following MOWHTO.

Methods: A total of 210 knees underwent MOWHTO for medial compartmental osteoarthritis (OA) were enrolled in this study. Mean follow-up period was 42.7 months. We assessed BTU for the medial compartment of the knee before MOWHTO and at the time of plate removal. Radiologic parameters included Kellgren-Lawrence (K-L) grade and Hip-Knee-Ankle angle (HKAA). Clinical evaluation included American Knee Society (AKS) score and cartilage status was graded at the time of MOWHTO and second-look arthroscopy according to the International Cartilage Repair Society (ICRS) grading system and articular cartilage regeneration stage. Statistical analysis performed to assess the relationships among postoperative BTU of the medial compartment, radiologic parameters, arthroscopic changes and clinical outcomes.

Results: BTU of medial femoral condyle and tibial plateau were significantly decreased at 2 years after MOWHTO (p<0.001). AKS scores and arthroscopic cartilage status were also significantly improved following MOWHTO. BMI and postoperative HKAA showed significant correlations with postoperative changes of BTU in uni- and multi-variable analysis. Meanwhile, postoperative changes of BTU did not show significant correlation with clinical outcomes or cartilage regeneration following MOWHTO.

Conclusion: Lower BMI and postoperative valgus alignment were significant predictor for postoperative BTU decrease of the medial compartment following MOWHTO. However, postoperative changes of BTU did not reflect cartilage regeneration or clinical outcomes until the midterm follow-up.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0257315PLOS
September 2021

Tranexamic acid in a periarticular multimodal cocktail injection for blood management in total knee arthroplasty: a prospective randomized study.

BMC Musculoskelet Disord 2021 Aug 10;22(1):675. Epub 2021 Aug 10.

Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Republic of Korea.

Background: This study aimed to assess the efficacy of tranexamic acid (TXA) mixed in a periarticular multimodal cocktail (PAMC) as a topical administration and to determine whether combined use of intravenous and topical administration is more effective than a single administration of TXA.

Methods: A total of 240 patients who underwent primary total knee arthroplasty (TKA) was enrolled for this prospective randomized controlled study. Patients were divided into three groups of 80 patients each. Baseline data were comparable for all groups. Average follow-up was 18.7 months. Group 1 consisted of patients who received intravenous (IV) TXA, Group 2 patients were those who received TXA in a PAMC injection for topical administration, and Group 3 consisted of patients who received a combination of both intravenous and topical administration of TXA. Primary outcomes were postoperative hemoglobin drop and amount of suction drainage. Secondary outcomes were estimated blood loss (EBL), postoperative transfusion rate, and complications.

Results: The mean postoperative hemoglobin drop was significantly lower in Group 3 (2.13 ± 0.77 g/dL, p=0.004), and there was no difference between Group 1 and Group 2 (2.56 ± 1.07 g/dL vs 2.55 ± 0.86 g/dL, p=0.999). The mean drainage amount was significantly lower in Group 3 (326.58 ± 57.55 ml, p<0.001), and there was no difference between Group 1 and Group 2 (367.93 ± 87.26 ml vs 397.66 ± 104.10 ml, p=0.072). Similarly, the mean EBL was significantly lower in Group 3 (p=0.003), and there was no significant difference between Group 1 and Group 2 (p=0.992). There were no significant differences in requirement for postoperative transfusion rate or incidence of complications among the three groups.

Conclusion: TXA mixed in a PAMC injection showed a similar effect to IV administration of TXA following TKA. Furthermore, combined use of both IV and PAMC injection provided better perioperative bleeding control with similar safety in patients without relevant comorbidities.

Trial Registration: WHO ICTRP identifier KCT0005703 . Retrospectively registered: 12/24/2020.
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http://dx.doi.org/10.1186/s12891-021-04551-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8356435PMC
August 2021

NonSurgical Approach to Treat Lip Vascular Complication Caused by Hyaluronic Acid Filler.

J Craniofac Surg 2021 Jul 30. Epub 2021 Jul 30.

Pròspere Facial Institute, No 300, Avenida Moema Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Mater Dei Hospital, Malta Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital, Seoul National University, Seoul, South Korea.

Abstract: The use of hyaluronic acid (HA) fillers in lip augmentation represents today 1 of the most widely used nonsurgical aesthetic procedures in the world. Regarding the severe complications are rare, insufficient professional experience for recognizing signs of vascular impairment and inadequate technique could lead to severe lip skin necrosis complications. Several of existing treatment protocols in the literature to treat vascular complication are mainly based on the use of hyaluronidase. Nevertheless, there is no consensus on dosage, interval between doses and complementary protocol among the aforementioned studies. This case aims to present a conservative approach for the clinical management of serious vasculature complications with HA injection. A high dose of hyaluronidase(11500 IU) with additional multimodal treatment was performed to the upper lip, nasolabial fold, and nose that successfully reversed a vascular complication process. The present findings suggest that the use of high doses of hyaluronidase with the complementary protocol used herein might be a promising approach in the treatment of severe vascular complication in the lips caused by HA filling.
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http://dx.doi.org/10.1097/SCS.0000000000008012DOI Listing
July 2021

Serial Improvement of Medial Meniscus Extrusion Following Medial Open-Wedge High Tibial Osteotomy Does not correlate with Clinical Outcomes and Arthroscopic Articular Cartilage Improvement.

Arthroscopy 2021 Jul 26. Epub 2021 Jul 26.

Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.

Purpose: To assess serial change up to 2 years in medial meniscus extrusion (MME) following medial open-wedge high tibial osteotomy (MOWHTO) and to determine whether postoperative changes in MME correlated with clinical outcomes and arthroscopic articular cartilage status.

Methods: This study included 26 patients from December 2016 to March 2018 who underwent MOWHTO for primary medial osteoarthritis with varus malalignment. Second-look arthroscopy with plate removal was performed at postoperative 2 years. MME was consecutively measured using coronal magnetic resonance imaging at preoperative and postoperative 3 months, 6 months, 1.5 years, and 2 years. We also assessed which preoperative parameters could reflect the postoperative changes in MME and evaluated whether postoperative clinical outcomes and arthroscopic articular cartilage improvement would be influenced by the MME changes.

Results: Regarding the postoperative serial changes in MME values, significant improvement in MME was noted from postoperative 6 months (P = .003), and thereafter, mean MME was further improved with time until postoperative 2 years (P < .001). Regarding the correlation between preoperative parameters and MME changes, preoperative medial proximal tibial angle (MPTA) showed significant correlations in univariate and multivariate analysis (P = .004 and P = .004, respectively). Meanwhile, changes in MME were not correlated with postoperative clinical outcomes or arthroscopic articular cartilage improvement.

Conclusion: After MOWHTO, MME improved with time and was significantly correlated with preoperative MPTA. However, the changes in MME after MOWHTO did not reflect postoperative clinical and arthroscopic articular cartilage improvement.

Level Of Evidence: IV, case series.
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http://dx.doi.org/10.1016/j.arthro.2021.07.024DOI Listing
July 2021

Adverse Reactions and Clinical Outcomes for Leukocyte-Poor Versus Leukocyte-Rich Platelet-Rich Plasma in Knee Osteoarthritis: A Systematic Review and Meta-analysis.

Orthop J Sports Med 2021 Jun 30;9(6):23259671211011948. Epub 2021 Jun 30.

Department of Orthopedic Surgery, Madisesang Hospital, Seoul, Republic of Korea.

Background: Platelet-rich plasma (PRP) has gained attention as a therapeutic option for knee osteoarthritis; however, its efficacy varies widely. Leukocytes in PRP raise the concern of aggravating proinflammatory activity. To date, PRP has rarely been investigated with regard to leukocyte concentration.

Purpose: To provide clinical evidence of the intra-articular injection of PRPs containing different leukocyte concentrations.

Study Design: Systematic review; Level of evidence, 4.

Methods: We systematically searched the MEDLINE, Embase, Cochrane Library, CINAHL, and Scopus databases. PRP was classified into leukocyte-poor (LP-PRP) and leukocyte-rich (LR-PRP). Clinical outcomes including Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain score, International Knee Documentation Committee (IKDC) subjective score, and adverse reactions were evaluated. The Methodological Index for Non-Randomized Studies criteria were used for quality assessment.

Results: Included were 32 studies with an evidence level between 1 and 4. Both LP-PRP and LR-PRP showed improvements above the minimal clinically important difference (MCID) in VAS pain score. No significant intergroup difference was seen at 3, 6, or 12 months of follow-up. Regarding function, both LP-PRP and LR-PRP showed improvements above the MCID in the WOMAC and IKDC scores, with no significant difference between the groups. Adverse reactions for pain were significantly higher in LR-PRP than in LP-PRP (odds ratio, 1.64; 95% confidence interval, 1.29-2.10; = .01). After intra-articular PRP injection, LR-PRP showed a significantly higher rate of swelling than LP-PRP (odds ratio, 1.56; 95% confidence interval, 1.22-1.99; = .02). The mean Methodological Index for Non-Randomized Studies score of the included studies was 18.6 (range, 10-24).

Conclusion: Intra-articular PRP injection resulted in improvements above the MCID in terms of pain and function in patients with knee osteoarthritis up to 12 months. The risk of local adverse reactions appeared to be increased after LR-PRP compared with LP-PRP injection. The findings of this review can support the potential use of intra-articular PRP injection for the treatment of knee osteoarthritis. In clinical application, clinicians need to consider selecting a specific type of PRP for knee osteoarthritis.
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http://dx.doi.org/10.1177/23259671211011948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255589PMC
June 2021

Migration of substances from food contact plastic materials into foodstuff and their implications for human exposure.

Food Chem Toxicol 2021 Aug 25;154:112373. Epub 2021 Jun 25.

Food Additives Standard Division, Food Standard Planning Office, Ministry of Food and Drug Safety, Osong, Cheongju, 28159, Republic of Korea.

The safety of food contact plastic materials, including PP, PE, PET, PCT, PLA, PBT and cross-linked polyester, was assessed with regard to migrated substances. The migrated concentrations of overall migrants (OMs), terephthalic acid, acetaldehyde, 1,4-butanediol and lead, were determined according to the standards and specifications for utensils, containers and packages in Korea. Food simulants of 4% acetic acid, water and n-heptane were used for the analysis of the substances. The dietary exposures of terephthalic acid, acetaldehyde and 1,4-butanediol were assessed using the dietary concentrations and the food consumption data. As a result, the dietary exposures were considered to be safe comparing to the health-based guidance values. In the case of lead, the margin of exposure (MOE) approach was applied. The MOEs calculated using the UB concentration and mean consumption data were ranged from 3 to 1000, which indicated low concern for health risk. Moreover, in this study, the dietary exposures were estimated by the Korean MFDS and U.S. FDA methods, respectively. As a result, the assessed risks were considered to be low in both cases. Based on the results of current exposure assessments, it could be considered that the food contact plastic materials are properly controlled by the regulatory authorities.
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http://dx.doi.org/10.1016/j.fct.2021.112373DOI Listing
August 2021

Femoral Tunnel Widening Via Transcondylar Cross-Pin Fixation Versus Extracortical Suspensory Fixation After Single-Bundle ACLR: A Systematic Review and Meta-analysis.

Orthop J Sports Med 2021 Apr 2;9(4):2325967121993811. Epub 2021 Apr 2.

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Compared with extracortical suspensory fixation, the close-to-joint transcondylar cross-pin fixation method in anterior cruciate ligament reconstruction (ACLR) is believed to entail less intratunnel graft motion and subsequently lead to less tunnel widening.

Purpose: To assess femoral tunnel widening via the transcondylar cross-pin method or the suspensory femoral fixation method in patients who had undergone ACLR.

Study Design: Systematic review; Level of evidence, 4.

Methods: This review focused on studies on femoral-tunnel widening after single-bundle ACLR with cross-pin (Rigidfix or Transfix) and/or Endobutton closed loop (CL). Two reviewers independently recorded data from each study, including the sample size and magnitude of tunnel widening after ACLR.

Results: Overall, 19 studies were included in this meta-analysis. There was no significant difference between cross-pin and Endobutton CL fixations in the pooled absolute change in tunnel widening from the immediate postoperative period to the final follow-up; this was true at both the tunnel aperture (2.48 mm [95% CI, 1.76-3.2 mm] vs 2.93 mm [95% CI, 1.73-4.13 mm], respectively; = .527) and the midpoint of the femoral tunnel (2.43 mm [95% CI, 1.77-3.1 mm] vs 2.54 mm [95% CI, -0.33 to 5.42 mm], respectively; = .937). No significant difference was found in the relative percentage of femoral-tunnel widening between the 2 fixation methods (cross-pin, 43.3% [95% CI, 25.8%-60.8%] vs Endobutton CL, 42.0% [95% CI, 34.1%-49.9%]; = .965).

Conclusion: No significant difference in femoral tunnel widening was found to be associated with the use of either cross-pin or extracortical suspensory fixation in patients who underwent single-bundle ACLR.
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http://dx.doi.org/10.1177/2325967121993811DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8020256PMC
April 2021

Femoral Tunnel Widening After Double-Bundle Anterior Cruciate Ligament Reconstruction With Hamstring Autograft Produces a Small Shift of the Tunnel Position in the Anterior and Distal Direction: Computed Tomography-Based Retrospective Cohort Analysis.

Arthroscopy 2021 08 18;37(8):2554-2563.e1. Epub 2021 Mar 18.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Health Science and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea; Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea. Electronic address:

Purpose: To determine whether the femoral tunnel position remains in an anatomical footprint after tunnel widening and shifting.

Methods: Patients who underwent unilateral double-bundle anterior cruciate ligament reconstruction with hamstring autograft and performed computed tomography scan evaluation at the time of 5 days and 1 year postoperatively were included in this retrospective cohort study. Three-dimensional models of the femur and femoral tunnels were reconstructed from computed tomography scan data. The location of the tunnel center and tunnel margins in the anatomical coordinate system, and the mean shifting distance of tunnel center and margin were measured with image analysis software during the period. The change of tunnel center location in Bernard quadrant was confirmed if the tunnel center remained within the boundaries of anatomical position after tunnel widening.

Results: A total of 56 patients satisfied the inclusion criteria. The mean shifting distance of AM and PL tunnel centers were 1.7 ± 0.9 mm and 1.6 ± 0.6 mm. The Tunnel margin of the anteromedial (AM) and posteromedial (PL) tunnels were shifted to 2.5 ± 1.3 mm and 2.6 ± 1.4 mm in the anterior direction, and 1.4 ± 0.9 mm and 1.0 ± 0.7 mm in the distal direction, respectively. Among the anatomical located tunnel, 97% (32/33) and 87.1% (27/31) of AM and PL tunnel centers remained in a range of anatomical footprint. The tunnel center was shifted from the anatomical position into a nonanatomical position in 3% (1/33) of the AM tunnel and 12.9% (4/31) of PL tunnel after tunnel widening. The tunnel location which shifted nonanatomically were relatively anterior and distal position.

Conclusions: Tunnel widening shifts the tunnel position to the anterior and distal direction, which could change the initial tunnel position. Nevertheless, the majority of tunnel positions remained in the anatomical position after tunnel widening and shifting.

Level Of Evidence: Level III, retrospective cohort study.
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http://dx.doi.org/10.1016/j.arthro.2021.03.008DOI Listing
August 2021

Clinical Management of Nasal Skin Necrosis Caused by Hyaluronic Acid Filler.

J Craniofac Surg 2021 Mar-Apr 01;32(2):e120-e122

Department of Stomatology, School of Dentistry, University of São Paulo, No 2227, Avenida Professor Lineu Prestes, São Paulo, SP, Brazil.

Abstract: Nose augmentation with Hyaluronic acid (HA) fillers has been considered the preferred technique for minimally invasive cosmetic procedures. Despite severe complications related to HA injection are rare, none of the existing treatment protocols has been established as standard. The aim of this report is to present an alternative approach to treat nasal skin necrosis related to HA injection. A high dose of hyaluronidase - 6000 IU was applied in the nose, for the purpose of reversing a necrotic process. The present findings suggest that a high dose of hyaluronidase could be a promising approach to treat severe nasal skin necrosis caused by HA filler.
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http://dx.doi.org/10.1097/SCS.0000000000006847DOI Listing
June 2021

Effect Of Different Milling Devices On Marginal Fit Of CAD-CAM Zirconia Copings On Implant Stock Abutments.

Int J Prosthodont 2021 02 23. Epub 2021 Feb 23.

Purpose: To compare the marginal fit and internal surface roughness of CAD/CAM zirconia copings milled with 3- and 5-axis milling devices.

Materials And Methods: Forty titanium implant stock abutments (4.8 mm in diameter, 4 mm in height) screwed to dental implants (4.1 mm in diameter) embedded in resin were considered phantoms and included in this in vitro study. All 40 phantoms were scanned with the same intraoral scanner, from which images of the virtual wax-up of zirconia copings were obtained and exported as standard tessellation language (STL) files. From each resulting STL file, two copings were milled: one using a 3-axis milling device, and the other using a 5-axis milling device. After milling, zirconia copings underwent high-speed sintering before being analyzed for marginal fit (ie, marginal gap measurement), and internal surface roughness was assessed with a scanning electron microscope (SEM). Statistical comparisons between groups were assessed with Mann-Whitney test.

Results: Median marginal gap values were 34.80 μm (95% CI: 0.00 to 173.98) for the 5-axis milling device group and 141.97 μm (95% CI: 82.13 to 163.46) for the 3-axis milling device group. A statistically significant difference in marginal gap was found between both milling device groups (P = .039). In addition, qualitative SEM analysis indicated higher internal surface roughness for the 3-axis milling device group.

Conclusion: Within the limitations of this study, the present findings suggest that 5-axis milling devices outperform 3-axis milling devices for milling CAD/CAM zirconia copings from intraoral scans of implant stock abutments.
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http://dx.doi.org/10.11607/ijp.7069DOI Listing
February 2021

Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid.

Am J Sports Med 2021 02;49(2):487-496

Department of Orthopedic Surgery, Himchan Hospital, Busan, Republic of Korea.

Background: Although platelet-rich plasma (PRP) has potential as a regenerative treatment for knee osteoarthritis, its efficacy varies. Compositional differences among types of PRP could affect clinical outcomes, but the biological characterization of PRP is lacking.

Purpose: To assess the efficacy of intra-articular PRP injection in knee osteoarthritis as compared with hyaluronic acid (HA) injection and to determine whether the clinical efficacy of PRP is associated with its biological characteristics.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 110 patients with symptomatic knee osteoarthritis received a single injection of leukocyte-rich PRP (1 commercial kit) or HA. Clinical data were assessed at baseline and at 6 weeks and 3 and 6 months after injection. The primary endpoint was an improvement in the International Knee Documentation Committee (IKDC) subjective score at 6 months, and the secondary endpoints were improvements in scores based on the Patient Global Assessment, the visual analog scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Samsung Medical Center patellofemoral score. Cell counts and concentrations of growth factors and cytokines in the injected PRP were assessed to determine their association with clinical outcomes.

Results: PRP showed significantly improvement in IKDC subjective scores at 6 months (11.5 in the PRP group vs 6.3 in the HA group; = .029). There were no significant differences between groups in other clinical outcomes. The Patient Global Assessment score at 6 months was better in the PRP group ( = .035). The proportion of patients who scored above the minimal clinically important difference (MCID) for VAS at 6 months was significantly higher in the PRP group ( = .044). Within the PRP group, the concentrations of platelet-derived growth factors were high in patients with a score above the MCID for VAS at 6 months. The incidence of adverse events did not differ between the groups ( > .05).

Conclusion: PRP had better clinical efficacy than HA. High concentrations of growth factors were observed in patients who scored above the MCID for clinical outcomes in the PRP group. These findings indicate that concentration of growth factors needs to be taken into consideration for future investigations of PRP in knee osteoarthritis.

Registration: NCT02211521 (ClinicalTrials.gov identifier).
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http://dx.doi.org/10.1177/0363546520986867DOI Listing
February 2021

Metabolic Engineering of Extremophilic Bacterium for the Production of the Novel Carotenoid Deinoxanthin.

Microorganisms 2020 Dec 25;9(1). Epub 2020 Dec 25.

School of Environmental Engineering, University of Seoul, Seoul 02504, Korea.

Deinoxanthin, a xanthophyll derived from species, is a unique organic compound that provides greater antioxidant effects compared to other carotenoids due to its superior scavenging activity against singlet oxygen and hydrogen peroxide. Therefore, it has attracted significant attention as a next-generation organic compound that has great potential as a natural ingredient in a food supplements. Although the microbial identification of deinoxanthin has been identified, mass production has not yet been achieved. Here, we report, for the first time, the development of an engineered extremophilic microorganism, strain R1, that is capable of producing deinoxanthin through rational metabolic engineering and process optimization. The genes and were first introduced into the genome to reinforce the metabolic flux towards deinoxanthin. The optimal temperature was then identified through a comparative analysis of the mRNA expression of the two genes, while the carbon source was further optimized to increase deinoxanthin production. The final engineered strain R1 was able to produce 394 ± 17.6 mg/L (102 ± 11.1 mg/g DCW) of deinoxanthin with a yield of 40.4 ± 1.2 mg/g sucrose and a productivity of 8.4 ± 0.2 mg/L/h from 10 g/L of sucrose. The final engineered strain and the strategies developed in the present study can act as the foundation for the industrial application of extremophilic microorganisms.
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http://dx.doi.org/10.3390/microorganisms9010044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823818PMC
December 2020

Computed Tomography Detects Hinge Fractures After Medial Opening Wedge High Tibial Osteotomy: A Systematic Review.

Arthroscopy 2021 04 23;37(4):1337-1352. Epub 2020 Nov 23.

Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University, Seoul, Republic of Korea. Electronic address:

Purpose: To quantify the increased detection rate of lateral hinge fractures (LHFs) owing to additional computed tomography (CT), determine factors associated with LHFs, and compare radiologic and clinical outcomes of LHFs after medial opening wedge biplanar high tibial osteotomy (MOW-HTO).

Methods: The MEDLINE, Embase, Cochrane Library, and Web of Science databases were systematically searched to identify studies reporting the incidence of LHFs detected using additional CT, showing radiologic factors, or comparing radiologic and clinical outcomes between LHFs and non-LHFs after MOW-HTO. Subgroup analyses were performed to compare stable and unstable LHFs. Two reviewers performed the study screening, risk-of-bias assessment, and data extraction processes.

Results: Eleven studies were included in this review. The weighted estimate of the apparent incidence of LHFs in the pooled studies was 24.8%. The weighted estimate of the incidence was increased by 9.9% owing to the use of CT detection, which indicated that approximately 40% of total diagnosed LHFs were missed on plain radiographs or fluoroscopy. The pooled mean opening gap distance ranged from 11.40 to 12.60 mm in the LHF group and from 9.80 to 11.12 mm in the non-LHF group, and the mean difference in the opening gap distance was significantly larger in the LHF group (95% confidence interval, 0.64-1.84 mm; P < .0001). However, no significant differences in correction loss, bone union duration, and clinical outcomes were observed between the LHF and non-LHF groups. Subgroup analyses showed no significant differences between stable and unstable LHFs.

Conclusions: Postoperative CT evaluations increase the detection rate of LHFs compared with plain radiography alone. Furthermore, the opening gap distance was larger in the LHF group than in the non-LHF group, suggesting the need for attention when opening the wedge by more than 11.4 mm. However, the consequences of LHFs after MOW-HTO were not major concerns when proper management was provided.

Level Of Evidence: Level III, systematic review.
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http://dx.doi.org/10.1016/j.arthro.2020.11.031DOI Listing
April 2021

Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis.

Orthop J Sports Med 2020 Nov 11;8(11):2325967120962078. Epub 2020 Nov 11.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Given the superiority of meniscal repair over partial meniscectomy according to biomechanical data, the clinical outcomes of meniscal repair are likely to be better than those of partial meniscectomy for a medial meniscus root tear (MMRT).

Purpose/hypothesis: This review was designed to compare the clinical and radiological results between meniscal repair and partial meniscectomy for MMRTs. It was hypothesized that meniscal repair would result in better clinical and radiological results compared with partial meniscectomy.

Study Design: Systematic review; Level of evidence, 4.

Methods: Studies were included in the review if they (1) included patients with MMRTs who underwent primary arthroscopic meniscal repair or partial meniscectomy and (2) analyzed validated patient-reported outcomes and/or radiological evaluations. Summary odds ratios (ORs) with 95% CIs were calculated to compare partial meniscectomy with meniscal repair for each outcome.

Results: A total of 13 studies were included. The mean duration of follow-up was 33.5 and 47.2 months in the meniscal repair group and partial meniscectomy group, respectively. The change in the Lysholm score from preoperatively to postoperatively was statistically significantly in favor of meniscal repair (OR, 2.20 [95% CI, 1.55-3.12]), while no difference was found with respect to the change in the Tegner score between the 2 surgical approaches (OR, 1.21 [95% CI, 0.65-2.24]). The prevalence of postoperative severe knee osteoarthritis (OR, 0.31 [95% CI, 0.17-0.54]) as well as that of reoperations (OR, 0.05 [95% CI, 0.01-0.19]) were significantly in favor of meniscal repair.

Conclusion: Better outcomes were seen after meniscal repair compared with partial meniscectomy for MMRTs, with greater improvements in Lysholm scores, and lower rates of progression to knee osteoarthritis, and lower reoperation rate.
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http://dx.doi.org/10.1177/2325967120962078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675875PMC
November 2020

Remnant-Tensioning Single-Bundle Anterior Cruciate Ligament Reconstruction Provides Comparable Stability to and Better Graft Vascularity Than Double-Bundle Anterior Cruciate Ligament Reconstruction in Acute or Subacute Injury: A Prospective Randomized Controlled Study Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

Arthroscopy 2021 01 19;37(1):209-221. Epub 2020 Nov 19.

Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea; Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea; Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Korea. Electronic address:

Purpose: To compare the clinical, second-look arthroscopic, magnetic resonance imaging (MRI), and dynamic-contrast-enhanced MRI (DCE-MRI) findings between remnant-tensioning single-bundle (RT-SB) and double-bundle (DB) anterior cruciate ligament reconstruction (ACLR).

Methods: Sixty-seven patients with acute or subacute anterior cruciate ligament (ACL) injury were randomized to undergo RT-SB or DB ACLR. Twenty-six patients in the RT-SB group and 28 in the DB group were evaluated using stability tests (Lachman test, pivot-shift test, and KT-2000 arthrometer) and multiple clinical scores. One year postoperatively, all 54 patients underwent MRI for evaluation of graft continuity and graft signal/noise quotient and DCE-MRI for the calculation of normalized area under the curve (nAUC) as a marker of graft vascularity. Among them, 41 patients underwent second-look arthroscopy for the evaluation of graft continuity, graft tension, and synovialization. The results were compared between the 2 groups.

Results: At the minimum 2-year follow-up (28.7 ± 6.4 months), the stability tests, clinical scores, second-look arthroscopic findings, and MRI findings were not significantly different between the groups. However, the mean nAUC values on DCE-MRI for the ACL graft were significantly higher in the RT-SB group than those in the DB group in all 3 zones (nAUC, P = .005; nAUC, P = .021; nAUC, P = .027; and nAUC, P = .008).

Conclusion: For acute or subacute ACL injury, the RT-SB ACLR showed an outcome comparable to that of DB ACLR in terms of knee stability, clinical scores, MRI findings, and second-look arthroscopic findings. Moreover, RT-SB ACLR showed better graft vascularity 1 year postoperatively than DB ACLR using DCE-MRI.

Level Of Evidence: II, prospective randomized controlled trial.
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http://dx.doi.org/10.1016/j.arthro.2020.08.035DOI Listing
January 2021

Clinical and Radiological Outcomes After Autologous Matrix-Induced Chondrogenesis Versus Microfracture of the Knee: A Systematic Review and Meta-analysis With a Minimum 2-Year Follow-up.

Orthop J Sports Med 2020 Nov 4;8(11):2325967120959280. Epub 2020 Nov 4.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Microfracture (MFx) is the most common procedure for treating chondral lesions in the knee; however, initial improvements decline after 2 years. Autologous matrix-induced chondrogenesis (AMIC) may overcome this shortcoming by combining MFx with collagen scaffolds. However, the outcomes of AMIC and MFx in the knee have not been compared.

Purpose: To compare the clinical and radiological outcomes of AMIC and MFx over a minimum 2-year follow-up.

Study Design: Systematic review; Level of evidence, 4.

Methods: A systematic search of the MEDLINE, Embase, and Cochrane Library databases identified studies of patients who underwent AMIC or MFx and that reported validated clinical outcome measure and/or radiological evaluation findings at a follow-up of ≥2 years. There were 2 reviewers who performed study selection, a risk of bias assessment, and data extraction.

Results: Overall, 29 studies were included in this systematic review. The mean improvement on the Lysholm score, Tegner activity scale, and visual analog scale for pain did not differ significantly between the 2 procedures. The mean improvement on the International Knee Documentation Committee (IKDC) subjective score was significantly greater in the AMIC (45.9 [95% CI, 36.2-55.5]) than in the MFx (27.2 [95% CI, 23.3-31.1]) group ( < .001). In addition, the mean magnetic resonance observation of cartilage repair tissue score was significantly higher in the AMIC (69.3 [95% CI, 55.1-83.5]) versus MFx (41.0 [95% CI, 27.3-54.7]) group ( = .005), and the mean adequate defect filling rate on magnetic resonance imaging scans was significantly better in the AMIC (77.3% [95% CI, 66.7%-87.9%]) versus MFx (47.9% [95% CI, 29.2%-66.6%]) group ( = .008) (odds ratio, 1.58 [95% CI, 1.07-2.33]).

Conclusion: No significant differences in clinical outcomes, except for the IKDC subjective score, were found between the AMIC and MFx groups. Greater improvement in IKDC subjective scores and magnetic resonance imaging findings were seen in patients treated with AMIC compared with MFx at a minimum 2-year follow-up.
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http://dx.doi.org/10.1177/2325967120959280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645765PMC
November 2020

The relationship between graft synovialization and graft revascularization after ACL reconstruction: Assessment using dynamic contrast enhanced-MRI and second-look arthroscopy.

Eur J Radiol 2020 Dec 16;133:109346. Epub 2020 Oct 16.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Health Sciences and Technology and Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, South Korea; Investigation Performed at the Department of Orthopedic Surgery, Samsung Medical Center, College of Sungkyunkwan University, Seoul, South Korea. Electronic address:

Purpose: To assess graft vascularity via dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) at 1-year and 2-year postoperatively and to evaluate the relationship between the vascularity using DCE-MRI and the synovialization using second-look arthroscopy.

Materials And Methods: Fifty-four patients from prospective data included who underwent anterior cruciate ligament reconstruction (ACLR) and DCE-MRI. The graft was divided into proximal, middle, and distal zones; average of three zones was calculated. Signal/noise quotient (SNQ) was measured on proton-density image and normalized area under the curve (nAUC) was calculated from DCE-MRI. The results at 1-year (SNQ-1 and nAUC-1) and 2-year (SNQ-2 and nAUC-2) postoperatively were compared between two time points. Forty-one patients underwent second-look arthroscopy were classified into three groups according to the synovialization: Excellent (n = 17), Fair (n = 16), and Poor (n = 8). The SNQs and nAUCs were compared between three groups.

Results: Fifty-four and 23 patients underwent DCE-MRI at 1-year and 2-year, respectively. A significant decrease was observed from nAUC-1 to nAUC-2 (95 % confidential interval, 0.4-2.3; P = .007). Both SNQ-1 and SNQ-2 were significantly lower in the excellent than in the poor (SNQ-1, P < .001; SNQ-2, P = .003). Both SNQ-1 and SNQ-2 were significantly lower in the fair than in the poor (SNQ-1, P=.032; SNQ-2, P = .012). Both nAUC-1 and nAUC-2 were significantly higher in the excellent than in the poor (nAUC-1, P < .001; nAUC-2, P = .010). The nAUC-1 was significantly higher in the excellent than the fair (nAUC-1, P < .001).

Conclusion: Well-synovialized grafts showed significantly lower SNQs and significantly higher nAUCs than did poor-synovialized grafts based on the second-look arthroscopic findings. We can indirectly infer from this result that well-synovialized grafts may have better biomechanical properties.
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http://dx.doi.org/10.1016/j.ejrad.2020.109346DOI Listing
December 2020

An unperforated suprapatellar plica presenting as a mass: A case report.

J Med Imaging Radiat Oncol 2021 Feb 21;65(1):82-85. Epub 2020 Oct 21.

Department of Orthopedic Surgery, Seoul Medical Center, Jungnang-gu, Seoul, Korea.

Unperforated suprapatellar plica leading to compartmentalization of the knee joint has been seldom reported and occasionally overlooked. We report a rare case of unperforated suprapatellar plica presenting as a suprapatellar mass after trauma in a 20-year-old male. Magnetic resonance imaging (MRI) revealed haemarthrosis without abnormalities. Despite one month of conservative treatment including joint aspiration, a palpable mass was discovered at knee flexion. MRI revealed haemorrhagic fluid in the localized suprapatellar recess with an unperforated suprapatellar plica. The patient underwent successful arthroscopic plica excision and had no recurrence or complaint at the 6-month follow-up visit.
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http://dx.doi.org/10.1111/1754-9485.13111DOI Listing
February 2021

Light-Induced Fluorescence-Based Device and Hybrid Mobile App for Oral Hygiene Management at Home: Development and Usability Study.

JMIR Mhealth Uhealth 2020 10 16;8(10):e17881. Epub 2020 Oct 16.

Dental Research Institute, Seoul National University, Seoul, Republic of Korea.

Background: Dental diseases can be prevented through the management of dental plaques. Dental plaque can be identified using the light-induced fluorescence (LIF) technique that emits light at 405 nm. The LIF technique is more convenient than the commercial technique using a disclosing agent, but the result may vary for each individual as it still requires visual identification.

Objective: The objective of this study is to introduce and validate a deep learning-based oral hygiene monitoring system that makes it easy to identify dental plaques at home.

Methods: We developed a LIF-based system consisting of a device that can visually identify dental plaques and a mobile app that displays the location and area of dental plaques on oral images. The mobile app is programmed to automatically determine the location and distribution of dental plaques using a deep learning-based algorithm and present the results to the user as time series data. The mobile app is also built with convergence of naive and web applications so that the algorithm is executed on a cloud server to efficiently distribute computing resources.

Results: The location and distribution of users' dental plaques could be identified via the hand-held LIF device or mobile app. The color correction filter in the device was developed using a color mixing technique. The mobile app was built as a hybrid app combining the functionalities of a native application and a web application. Through the scrollable WebView on the mobile app, changes in the time series of dental plaque could be confirmed. The algorithm for dental plaque detection was implemented to run on Amazon Web Services for object detection by single shot multibox detector and instance segmentation by Mask region-based convolutional neural network.

Conclusions: This paper shows that the system can be used as a home oral care product for timely identification and management of dental plaques. In the future, it is expected that these products will significantly reduce the social costs associated with dental diseases.
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http://dx.doi.org/10.2196/17881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600004PMC
October 2020

Discoid lateral meniscus: importance, diagnosis, and treatment.

J Exp Orthop 2020 Oct 12;7(1):81. Epub 2020 Oct 12.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, gangnam-gu, Seoul, 135-710, South Korea.

Discoid lateral meniscus (DLM) is a common anatomic variant in the knee typically presented in young populations, with a greater incidence in the Asian population than in other populations. As DLM is a congenital anomaly, the ultrastructural features and morphology differ from those of the normal meniscus, potentially leading to meniscal tears. Snapping and pain are common symptoms, with occasional limitations of extension, in patients with DLM. Examination of the contralateral knee is necessary as DLM affects both knees. While simple radiographs may provide indirect signs of a DLM, magnetic resonance imaging (MRI) is essential for diagnosis and treatment planning. Although DLM was traditionally classified into three categories, namely, complete, incomplete, and Wrisberg DLM, a recent MRI classification provides useful information for surgical planning because the MRI classification was based on the peripheral detachment in patients with DLM, as follows: no shift, anterocentral shift, posterocentral shift, and central shift. Asymptomatic patients require close follow-up without surgical treatment, while patients with symptoms often require surgery. Total or subtotal meniscectomy, which has been traditionally performed, leads to an increased risk of degenerative arthritis; thus, partial meniscectomy is currently considered the treatment of choice for DLM. In addition to partial meniscectomy, meniscal repair of peripheral detachment is recommended for stabilization in patients with DLM to preserve the function of the meniscus. Previous studies have reported that partial meniscectomy with or without meniscal repair is effective and shows superior clinical and radiological outcomes to those of total or subtotal meniscectomy during the short- to long-term follow-up. Our preferred principle for DLM treatment is reduction, followed by reshaping with reference to the midbody of the medial meniscus and repair as firm as possible.
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http://dx.doi.org/10.1186/s40634-020-00294-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550551PMC
October 2020

External snapping hip: classification based on magnetic resonance imaging features and clinical correlation.

Hip Int 2020 Jul 23:1120700020944139. Epub 2020 Jul 23.

Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: With the increasing sport population, the number of patients with external snapping hip (ESH) has also increased. To detect and visualise pathological soft tissue changes, magnetic resonance imaging (MRI) has been 1 of the most useful modalities. However, only limited studies have investigated MRI and its clinical value in the treatment of ESH in the past.

Materials And Methods: Between May 2017 and November 2018, 104 patients were diagnosed with ESH at our institution. We excluded patients who did not undergo an MRI ( = 11), had complaint of bilateral symptom ( = 17), were not diagnosed hip problems previously  = 2), and were lost-follow-up within 6 months ( = 19). After applying the exclusion criteria, 55 patients remained. We classified the patients into 2 groups according-MRI findings: tensed iliotibial band (ITB) and hypertrophied gluteus maximus (GM). We investigated the clinical findings, such as mean age, symptom duration, pain score, grading based on symptom severity, and other radiological findings such as soft tissue signal change and ITB thickness. The variables were compared between the groups.

Results: Between the 2 groups defined by MRI findings, the group characterised by tense ITB showed a relatively short symptom duration than the hypertrophied GM group ( < 0.001). No significant differences in the other variables were found between the groups.

Conclusions: ESH has 2 types of MRI features. Compared with the hypertrophied GM group, the tense ITB group showed a shorter symptom duration and a more reversible status.
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http://dx.doi.org/10.1177/1120700020944139DOI Listing
July 2020

Full Digital Workflow for Anterior Immediate Implants Using Custom Abutments.

J Oral Implantol 2021 Apr;47(2):140-144

Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta.

The full digital workflow involves the combination of intraoral and cone beam computerized tomography scans. In the present case report, a second intraoral scan is performed after soft tissue management facilitated by the use of a 3-dimensional-printed interim implant restoration. The new STL file resulting from the second intraoral scan can be associated with the previous STL from the initial intraoral scan. The custom abutment was also digitally designed as an STL file, and no implant scan bodies were required for intraoral scanning.
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http://dx.doi.org/10.1563/aaid-joi-D-19-00249DOI Listing
April 2021

Comparison between different cone-beam computed tomography devices in the detection of mechanically simulated peri-implant bone defects.

Imaging Sci Dent 2020 Jun 18;50(2):133-139. Epub 2020 Jun 18.

Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.

Purpose: This study compared 2 cone-beam computed tomography (CBCT) systems in the detection of mechanically simulated peri-implant buccal bone defects in dry human mandibles.

Materials And Methods: Twenty-four implants were placed in 7 dry human mandibles. Peri-implant bone defects were created in the buccal plates of 16 implants using spherical burs. All mandibles were scanned using 2 CBCT systems with their commonly used acquisition protocols: i-CAT Gendex CB-500 (Imaging Sciences, Hatfield, PA, USA; field of view [FOV], 8 cm×8 cm; voxel size, 0.125 mm; 120 kVp; 5 mA; 23 s) and Orthopantomograph OP300 (Intrumentarium, Tuusula, Finland; FOV, 6 cm×8 cm; voxel size, 0.085 mm; 90 kVp; 6.3 mA; 13 s). Two oral and maxillofacial radiologists assessed the CBCT images for the presence of a defect and measured the depth of the bone defects. Diagnostic performance was compared in terms of the area under the curve (AUC), accuracy, sensitivity, specificity, and intraclass correlation coefficient.

Results: High intraobserver and interobserver agreement was found (<0.05). The OP300 showed slightly better diagnostic performance and higher detection rates than the CB-500 (AUC, 0.56±0.03), with a mean accuracy of 75.0%, sensitivity of 81.2%, and specificity of 62.5%. Higher contrast was observed with the CB-500, whereas the OP300 formed more artifacts.

Conclusion: Within the limitations of this study, the present results suggest that the choice of CBCT systems with their respective commonly used acquisition protocols does not significantly affect diagnostic performance in detecting and measuring buccal peri-implant bone loss.
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http://dx.doi.org/10.5624/isd.2020.50.2.133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314605PMC
June 2020

Correlation between magnetic resonance imaging and cone-beam computed tomography for maxillary sinus graft assessment.

Imaging Sci Dent 2020 Jun 18;50(2):93-98. Epub 2020 Jun 18.

Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.

Purpose: Little is known regarding the accuracy of clinical magnetic resonance imaging (MRI) protocols with acceptable scan times in sinus graft assessment. The aim of this study was to evaluate the correlations between MRI and cone-beam computed tomographic (CBCT) measurements of maxillary sinus grafts using 2 different clinical MRI imaging protocols.

Materials And Methods: A total of 15 patients who underwent unilateral sinus lift surgery with biphasic calcium phosphate were included in this study. CBCT, T1-weighted MRI, and T2-weighted MRI scans were taken 6 months after sinus lift surgery. Linear measurements of the maximum height and buccolingual width in coronal images, as well as the maximum anteroposterior depth in sagittal images, were performed by 2 trained observers using CBCT and MRI Digital Imaging and Communication in Medicine files. Microcomputed tomography (micro-CT) was also performed to confirm the presence of bone tissue in the grafted area. Correlations between MRI and CBCT measurements were assessed with the Pearson test.

Results: Significant correlations between CBCT and MRI were found for sinus graft height (T1-weighted, r=0.711 and <0.05; T2-weighted, r=0.713 and <0.05), buccolingual width (T1-weighted, r=0.892 and <0.05; T2-weighted, r=0.956 and <0.05), and anteroposterior depth (T1-weighted, r=0.731 and <0.05; T2-weighted, r=0.873 and <0.05). The presence of bone tissue in the grafted areas was confirmed via micro-CT.

Conclusion: Both MRI pulse sequences tested can be used for sinus graft measurements, as strong correlations with CBCT were found. However, correlations between T2-weighted MRI and CBCT were slightly higher than those between T1-weighted MRI and CBCT.
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http://dx.doi.org/10.5624/isd.2020.50.2.93DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314607PMC
June 2020

Superolateral Hoffa Fat Pad Edema and Patellofemoral Maltracking: Systematic Review and Meta-Analysis.

AJR Am J Roentgenol 2020 09 6;215(3):545-558. Epub 2020 Jun 6.

Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon-si, 16247, Gyeonggi-do, Republic of Korea.

The purpose of this study is to clarify which imaging parameters of patellofemoral maltracking are associated with superolateral Hoffa fat pad (SHFP) edema. A systematic search of the MEDLINE, Embase, and Cochrane Library databases was performed to identify studies evaluating the relationship between SHFP edema and patellofemoral maltracking. Parameters for assessing patellofemoral maltracking on MRI were reviewed for each study. Two reviewers performed study selection, methodologic quality assessment, and data extraction. Nine studies were eligible for inclusion in the present study. From the included studies, nine parameters assessing patellofemoral maltracking were analyzed: lateral patellofemoral angle, patellar tilt, patellar lateralization, trochlear depth, sulcus depth, sulcus angle, lateral trochlear inclination, distance between the tibial tuberosity and trochlear groove, and the Insall-Salvati ratio. Patients with SHFP edema had greater patellar tilt (standardized mean difference, 0.89°; 95% CI, 0.38-1.40°; = 0.0006), greater patellar lateralization (standardized mean difference, 0.78 mm; 95% CI, 0.21-1.36 mm; = 0.008), greater distance between the tibial tuberosity and trochlear groove (standardized mean difference, 0.96 mm; 95% CI, 0.48-1.44 mm; < 0.0001), and higher Insall-Salvati ratio (standardized mean difference, 1.94; 95% CI, 1.29-2.60; < 0.00001) than patients without SHFP edema. Patellofemoral maltracking imaging parameters, such as a more laterally displaced patella, greater TTTG distance, and patella alta, are correlated with SHFP edema.
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http://dx.doi.org/10.2214/AJR.19.22263DOI Listing
September 2020

Automatic 360° Mono-Stereo Panorama Generation Using a Cost-Effective Multi-Camera System.

Sensors (Basel) 2020 May 30;20(11). Epub 2020 May 30.

Mixed Reality and Interaction Lab, Department of Software, Sejong University, Seoul 143-747, Korea.

In recent years, 360° videos have gained the attention of researchers due to their versatility and applications in real-world problems. Also, easy access to different visual sensor kits and easily deployable image acquisition devices have played a vital role in the growth of interest in this area by the research community. Recently, several 360° panorama generation systems have demonstrated reasonable quality generated panoramas. However, these systems are equipped with expensive image sensor networks where multiple cameras are mounted in a circular rig with specific overlapping gaps. In this paper, we propose an economical 360° panorama generation system that generates both mono and stereo panoramas. For mono panorama generation, we present a drone-mounted image acquisition sensor kit that consists of six cameras placed in a circular fashion with optimal overlapping gap. The hardware of our proposed image acquisition system is configured in such way that no user input is required to stitch multiple images. For stereo panorama generation, we propose a lightweight, cost-effective visual sensor kit that uses only three cameras to cover 360° of the surroundings. We also developed stitching software that generates both mono and stereo panoramas using a single image stitching pipeline where the panorama generated by our proposed system is automatically straightened without visible seams. Furthermore, we compared our proposed system with existing mono and stereo contents generation systems in both qualitative and quantitative perspectives, and the comparative measurements obtained verified the effectiveness of our system compared to existing mono and stereo generation systems.
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http://dx.doi.org/10.3390/s20113097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309002PMC
May 2020

Incidental Gynecomastia on Thoracic Computed Tomography in Clinical Practice: Characteristics, Radiologic Features, and Correlation With Possible Causes in South Korean Men.

Am J Mens Health 2020 May-Jun;14(3):1557988320908102

Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, South Korea.

Gynecomastia is a common incidental finding on thoracic computed tomography (CT). This study aimed to retrospectively determine the prevalence, imaging characteristics, and possible causes of incidental gynecomastia on thoracic CT. Records of male patients who underwent thoracic CT in 2015 were reviewed. The size and morphologic types (nodular, dendritic, and diffuse) were recorded for patients with breast glandular tissue larger than 1 cm, and the cutoff value of gynecomastia was defined as 2 cm. Additionally, the possible causes of gynecomastia obtained by reviewing patients' charts were recorded. CT-depicted gynecomastia was identified in 12.7% (650 of 5,501) of patients. The median size of the breast glandular tissue was 2.5 cm (interquartile range 2.2-3.1), and 36.8% of patients (239 of 650) had unilateral gynecomastia. The age distribution provided a bimodal pattern with two peaks in the age groups from 20 to 29 years old and greater than 70 years old. Chronic liver disease (CLD; < .001), all stages of chronic kidney disease (CKD; < .001), and medications ( = .002) were significantly associated with gynecomastia. Gynecomastia did not correlate with body mass index ( = .962). The size of breast glandular tissue was identified to be correlated with the morphologic type of breast tissue and the severity of CLD or CKD. The prevalence of incidental gynecomastia seen on thoracic CT was 12.7%. CT-depicted gynecomastia is not associated with obesity but with CLD, CKD, and medications. When gynecomastia is detected on CT, further evaluations and management might be required for patients with a treatable cause.
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http://dx.doi.org/10.1177/1557988320908102DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278101PMC
June 2021

Are high-risk patient and revision arthroplasty effective indications for closed-incisional negative-pressure wound therapy after total hip or knee arthroplasty? A systematic review and meta-analysis.

Int Wound J 2020 Oct 13;17(5):1310-1322. Epub 2020 May 13.

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

To determine the effective indications of closed-incisional negative-pressure wound therapy (ciNPWT) following total hip or knee arthroplasty, this systematic review and meta-analysis was conducted. The systematic search was performed on MEDLINE, Embase, and Cochrane Library, and 11 studies were included. The studies comparing between ciNPWT and conventional dressings were categorised into following subgroups based on patient risk and revision procedures: routine vs high-risk patient; primary vs revision arthroplasty. Pooled estimates were calculated for wound complication and surgical site infection (SSI) rates in the subgroup analyses using Review Manager. In high-risk patients, the overall rates of wound complication (odds ratio [OR] = 0.38; 95% confidence interval [CI] 0.15-0.93; P = .030) and SSI (OR = 0.24; 95% CI = 0.09-0.64; P = .005) were significantly lower in the ciNPWT; however, there were no differences in routine patients. In cases involving revision arthroplasties, the overall rates of wound complication (OR = 0.33; 95% CI = 0.18-0.62; P < .001) and SSI (OR = 0.26; 95% CI = 0.11-0.66; P = .004) were significantly lower in the ciNPWT; however, there were no differences in cases involving primary arthroplasties. In summary, ciNPWT showed a positive effect in decreasing the rates of wound complication and SSI in high-risk patients and in revision arthroplasties.
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http://dx.doi.org/10.1111/iwj.13393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948573PMC
October 2020

A CARE-compliant article: a case report of pleural empyema secondary to Klebsiella pneumoniae liver abscess with a hepatopleural fistula.

Medicine (Baltimore) 2020 Apr;99(16):e19869

Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Jung-gu, Incheon, South Korea.

Introduction: Klebsiella pneumoniae liver abscess (KPLA) is often associated with accompanying metastatic complications such as septic pulmonary embolism, brain abscess, and endophthalmitis. Pleural empyema secondary to a KPLA is a very unusual finding, made even more rare with the presence of a hepatopleural fistula.

Patient Concerns: An 81-year-old woman presented with aggravated dyspnea.

Diagnosis: The patient was diagnosed with KPLA with empyema through computed tomography (CT) scan findings and pleural fluid culture.

Interventions: The empyema was drained by thoracostomy, and treatment with empirical antibiotics was initiated. After early removal of the chest tube, the liver abscess as well as the empyema increased. An additional liver abscess drainage procedure was performed.

Outcomes: The fever resolved and dyspnea improved following drainage of effusion. Three days later, the follow-up chest radiograph showed decreased pleural effusion.

Conclusion: Pleural empyema is a rare but fatal complication secondary to KPLA. Additionally, the discovery of a hepatopleural fistula on a CT scan (multiplanar reconstruction image) made this case even more rare. Both, the liver abscess and pleural empyema, were effectively drained through the fistula tract with drainage procedure, thoracostomy, and additional liver abscess drainage. Prompt diagnostic evaluation, using an imaging modality such as CT, and early drainage management with intravenous antibiotics can improve clinical outcome.
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http://dx.doi.org/10.1097/MD.0000000000019869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220185PMC
April 2020

Correction to: Correlation between the presence of herniation pit and femoroacetabular impingement: a systematic review and meta-analysis.

Knee Surg Sports Traumatol Arthrosc 2020 Oct;28(10):3374-3375

Department of Orthopedic Surgery, Armed Forces Daejeon Hospital, 90, Jaun-ro, Yuseong-gu, Daejeon, 34059, South Korea.

Authors would like to correct the errors in figure 4 legend.
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http://dx.doi.org/10.1007/s00167-020-05942-5DOI Listing
October 2020
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