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- 저자 : Yee Han Dave Lee (검색결과 3 건)
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Han Audrey Xinyun,Tan Tien Jin,Nguyen Tiep,Lee Dave Yee Han 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-
We aimed to identify the anterolateral ligament (ALL) tears in anterior cruciate ligament (ACL)-deficient knees using standard 1.5-Tesla magnetic resonance imaging (MRI). We included all patients who underwent primary ACL reconstruction at our center between 2012 and 2015. Exclusion criteria included patients with multiple ligament injuries, lateral collateral ligament, posterolateral corner, and infections, and patients who underwent MRI more than 2 months after their injury. All patients ( n = 148) had ACL tears that were subsequently arthroscopically reconstructed. The magnetic resonance (MR) images of the injured knees performed within 2 months of injury were reviewed by a musculoskeletal radiologist and an orthopedic surgeon. The patients were divided into two groups. The first group of patients had MRI performed within 1 month of injury. The second group of patients had MRI performed 1–2 months after the index injury. Both assessors were blinded and the MR mages were read separately to assess the presence of ALL, presence of a tear and the location of the tear. Based on their readings, interobserver agreement (kappa statistic (K)), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were compared. The ALL was identified in 100% of the patients. However, there was a discrepancy of up to 15% in the identification of tear of the ALL. In the first group in which MRI scans were performed within 1 month of injury, the ALL tear was identified by the radiologist in 92% of patients and by the surgeon in 90% of patients (Κ = 0.86). In the second group in which MRI scans were performed within 1–2 months of the injury, the ALL tear was identified by the radiologist in 78% of patients and by the surgeon in 93% of patients (K = 0.62).The ALL can be accurately identified on MRI, but the presence and location of ALL tear and its location cannot be reliably identified on MRI. The accuracy in identification and characterization of a tear was affected by the interval between the time of injury and the time when the MRI was performed.Diagnostic, level IIIb, retrospective.
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Stacy W L Ng,Dave Lee Yee Han 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.1
Infections following anterior cruciate ligament reconstruction are rare, with no previous reports citing Mycobacterium abscessusas the culprit pathogen. A 22-year-old man presented twice over three years with a painful discharging sinus over his right tibiatunnel site necessitating repeated arthroscopy and washout, months of antibiotic therapy, and ultimately culminating in the removalof the implants. In both instances, M. abscessus was present in the wound cultures, along with a coinfection of Staphyloccocusaureus during the second presentation. Though rare, M. abscessus is an important pathogen to consider in postoperative woundspresenting with chronic discharging sinuses, even in healthy non-immunocompromised patients. This case illustrates how the organismcan cause an indolent infection, and how the removal of implants can be necessary to prevent the persistence of infection. Coinfection with a second organism is not uncommon and necessitates a timely change in treatment regime as well.
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Methods for evaluating effects of unloader knee braces on joint health: a review
Rizuwana Parween,Duraisamy Shriram,Rajesh Elara Mohan,Yee Han Dave Lee,Karupppasamy Subburaj 대한의용생체공학회 2019 Biomedical Engineering Letters (BMEL) Vol.9 No.2
The paper aims to provide a state-of-the-art review of methods for evaluating the eff ectiveness and eff ect of unloaderknee braces on the knee joint and discuss their limitations and future directions. Unloader braces are prescribed as a nonpharmacologicalconservative treatment option for patients with medial knee osteoarthritis to provide relief in terms of painreduction, returning to regular physical activities, and enhancing the quality of life. Methods used to evaluate and monitorthe eff ectiveness of these devices on patients’ health are categorized into three broad categories (perception-, biochemical-,and morphology-based), depending upon the process and tools used. The main focus of these methods is on the short-termclinical outcome (pain or unloading effi ciency). There is a signifi cant technical, research, and clinical literature gap in understandingthe short- and long-term consequences of these braces on the tissues in the knee joint, including the cartilage andligaments. Future research directions may complement existing methods with advanced quantitative imaging (morphological,biochemical, and molecular) and numerical simulation are discussed as they off er potential in assessing long-term andpost-bracing eff ects on the knee joint.
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