Jae Gyoon Kim

Bio: Jae Gyoon Kim is an academic researcher from Korea University. The author has contributed to research in topics: Anterior cruciate ligament & Anterior cruciate ligament reconstruction. The author has an hindex of 18, co-authored 49 publications receiving 917 citations.

Anterior Cruciate Ligament Reconstruction Using Remnant Preservation and a Femoral Tensioning Technique: Clinical and Magnetic Resonance Imaging Results

Abstract: Purpose The purpose of this study was to investigate the clinical and magnetic resonance imaging (MRI) results of anterior cruciate ligament (ACL) reconstruction with autogenous hamstring tendon by use of remnant preservation and a femoral tensioning technique. Methods A total of 53 patients who had ACL reconstruction by use of remnant ACL stump preservation and a femoral tensioning technique were evaluated. Clinical evaluation at a minimum of 2 years after surgery included range of motion, Lachman test, pivot-shift test, KT-2000 arthrometer testing (MEDmetric, San Diego, CA), and clinical scores. Plain radiographs were evaluated for tunnel enlargement. MRI was obtained for evaluation of graft continuity, cyclops-like mass lesion, and positioning of the tibial tunnel. Second-look arthroscopy was performed in 33 patients. Results The clinical scores improved postoperatively. There were statistically significant differences between preoperative and postoperative Lachman tests, pivot-shift tests, and KT-2000 arthrometer measurements. Postoperative MRI was available in 48 patients, and it showed intact graft in 45 patients, 2 partial tears, and 1 complete loss of graft. There were cyclops-like mass lesions in 12 patients, but none showed an extension limitation or pain at extension. The position of the tibial tunnel on the sagittal and coronal view was similar to the position of the normal ACL tibial insertion. The measured tibial tunnel widening on the radiographs at final follow-up was 2.2 ± 1.5 mm. Conclusions Reconstruction of the ACL by use of preservation and femoral tensioning of the remnant tissue showed good clinical results without increased concerns regarding incorrect tunnel formation. Postoperative MRI showed an increased incidence of cyclops-like mass lesions, but no clinical significance was observed. Level of Evidence Level IV, case series.

Long-term results of anterior cruciate ligament reconstruction using bone-patellar tendon-bone: an analysis of the factors affecting the development of osteoarthritis.

Abstract: Purpose To evaluate the clinical outcomes and incidence of knee osteoarthritis (OA) and the factors associated with the onset of OA in the 3 compartments of the knee joint separately after anterior cruciate ligament (ACL) reconstruction with bone–patellar tendon–bone autograft. Methods Clinical and radiologic assessments were obtained from 117 patients (80.1%). At follow-up, knee function was evaluated with the Lysholm score, Hospital for Special Surgery (HSS) score, Tegner score, and International Knee Documentation Committee (IKDC) 2000 forms. We also evaluated stability and donor-site morbidity. On the follow-up radiographs, OA was assessed by IKDC grading. The factors affecting the onset of OA in the 3 compartments of the knee joint were evaluated. Results The mean follow-up period was 10.3 ± 1.0 years. The mean Lysholm and HSS scores significantly increased at final follow-up ( P P = .005) or sagittal tibial tunnel position (OR, 1.18; P = .02) in the medial compartment and body mass index (BMI) (OR, 1.56; P = .02) in the lateral compartment. Conclusions ACL reconstruction with bone–patellar tendon–bone autograft showed satisfactory clinical results after a mean of 10.3 years. However, pain when walking on hard ground (38.4%) and numbness of the skin (37.6%) were reported. Moreover, the onset of OA appeared in over 40% of the patients. The onset of OA in the medial compartment was correlated with partial meniscectomy and sagittal tibial tunnel position, and the onset of OA in the lateral compartment was correlated with higher BMI. Level of Evidence Level IV, therapeutic case series.

Comparison of femoral graft bending angle and tunnel length between transtibial technique and transportal technique in anterior cruciate ligament reconstruction

Abstract: To investigate which technique would reduce bending stress at the femoral tunnel aperture and make short tunnel length after ACL reconstruction by comparing the femoral graft bending angle and tunnel length between the single-bundle (SB) transtibial (TT) and double-bundle (DB) transportal (TP) technique using three-dimensional-computed tomography using OsiriX® imaging software. Forty-nine patients underwent an ACL reconstruction using a SB TT (Group I, 20 patients) and DB TP (Group II, 29 patients) technique. Femoral graft bending angle and femoral tunnel length were measured by CT image using OsiriX® imaging software. Groups I and II were compared, and statistical analysis was performed using SPSS software. The mean anteromedial (AM) and posterolateral (PL) femoral graft bending angle of group II (111.5 ± 8.8° and 118.9 ± 9.8°, respectively) was significantly more acute than that of group I (125.3 ± 11.1°) (P < 0.001, P = 0.04). The mean femoral tunnel length of group I was significantly longer than that of group II (P = 0.001). The femoral graft bending angle and the femoral tunnel length of the TP technique performed in the maximally flexed knee position was more acute and shorter than those of the TT technique after ACL reconstruction. This might increase the bending stress at the femoral tunnel aperture and shorter graft length in the tunnel after an ACL reconstruction using TP technique compared to the TT technique. III.

Gender differences of the morphology of the distal femur and proximal tibia in a Korean population

Abstract: Purpose We conducted this study to determine whether the sizes of distal femurs and proximal tibiae in Korean men and women are different, and to assess suitability of the sizes of prostheses currently used in Korea. Materials and methods We performed morphological analysis of proximal tibia and distal femur on 115 patients (56 male, 59 female) using MRI to investigate a gender difference. Tibial mediolateral dimension (tMAP), tibial medial anteroposterior dimension (tMAP), tibial lateral anteroposterior dimension (tLAP) femoral mediolateral dimension (fML), femoral medial anteroposterior dimension (fMAP), and femoral lateral anteroposterior dimension (fLAP) were measured. The ratio of tMAP and tLAP to tML (plateau aspect ratio, tAP/tML × 100%), and that of fMAP and fLAP to fML (condylar aspect ratio, fAP/fML × 100%) were calculated. The measurements were compared with the similar dimensions of four total knee implants currently used. Results The tML and tAP lengths showed a significant gender difference (P Conclusions Korean population revealed that women have smaller dimensions than male counterparts. In both genders, a relatively small size of prostheses matches distal femur and proximal tibia better among the implants currently used in Korea.

Femoral graft bending angle and femoral tunnel geometry of transportal and outside-in techniques in anterior cruciate ligament reconstruction: an in vivo 3-dimensional computed tomography analysis.

Abstract: Purpose To compare femoral graft bending angles and femoral tunnel geometries between the transportal (TP) and outside-in (OI) techniques after anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. Methods Thirty-nine patients underwent DB ACL reconstruction with the TP and OI techniques. They were randomized on the day of surgery to either the TP group (group I, 21 cases) or the OI group (group II, 18 cases). Femoral graft bending angle, femoral tunnel geometry, posterior wall breakage, and tunnel communication were assessed by computed tomography imaging with OsiriX imaging software (Pixmeo, Geneva, Switzerland). Results The mean anteromedial (AM) and posterolateral (PL) femoral graft bending angles of group II (97.3° ± 8.3° and 97.4° ± 8.6°, respectively) were significantly more acute than those of group I (108.2° ± 8.4° and 109.9° ± 8.8°, respectively) ( P P = .02). However, the mean PL femoral tunnel lengths did not differ between groups. In 7 cases—4 cases (19.0%) in group I and 3 cases (16.6%) in group II—the femoral tunnel communication was found around the intra-articular aperture. Posterior wall breakage was observed in 5 cases (23.8%), which were all in AM femoral tunnels of group I. Conclusions The OI technique resulted in more acute femoral graft bending angles (difference of 10.9° and 12.5° for AM and PL, respectively) and longer mean AM femoral tunnel lengths (difference of 2.4 mm) than the TP technique after anatomic DB ACL reconstruction, even though these small differences might be unlikely to be of clinical significance. Femoral tunnel communication was found in both groups, and posterior wall breakage was observed in AM femoral tunnels with the TP technique. Level of Evidence Level I, prospective randomized trial.

Evolving concepts in bone infection: redefining "biofilm", "acute vs. chronic osteomyelitis", "the immune proteome" and "local antibiotic therapy".

Abstract: Osteomyelitis is a devastating disease caused by microbial infection of bone While the frequency of infection following elective orthopedic surgery is low, rates of reinfection are disturbingly high Staphylococcus aureus is responsible for the majority of chronic osteomyelitis cases and is often considered to be incurable due to bacterial persistence deep within bone Unfortunately, there is no consensus on clinical classifications of osteomyelitis and the ensuing treatment algorithm Given the high patient morbidity, mortality, and economic burden caused by osteomyelitis, it is important to elucidate mechanisms of bone infection to inform novel strategies for prevention and curative treatment Recent discoveries in this field have identified three distinct reservoirs of bacterial biofilm including: Staphylococcal abscess communities in the local soft tissue and bone marrow, glycocalyx formation on implant hardware and necrotic tissue, and colonization of the osteocyte-lacuno canalicular network (OLCN) of cortical bone In contrast, S aureus intracellular persistence in bone cells has not been substantiated in vivo, which challenges this mode of chronic osteomyelitis There have also been major advances in our understanding of the immune proteome against S aureus, from clinical studies of serum antibodies and media enriched for newly synthesized antibodies (MENSA), which may provide new opportunities for osteomyelitis diagnosis, prognosis, and vaccine development Finally, novel therapies such as antimicrobial implant coatings and antibiotic impregnated 3D-printed scaffolds represent promising strategies for preventing and managing this devastating disease Here, we review these recent advances and highlight translational opportunities towards a cure

Bone-patellar tendon-bone autograft versus allograft in outcomes of anterior cruciate ligament reconstruction: a meta-analysis of 5182 patients.

Abstract: Background:Bone–patellar tendon–bone (BPTB) is a common autograft and allograft source used for anterior cruciate ligament (ACL) reconstruction. Although the failure rate is generally higher for allografts, donor site morbidity and anterior knee pain can be issues with BPTB autografts. Controversy exists regarding the functional outcomes, complications, and knee stability of these grafts, previous comparisons of which have been based on smaller samples of case series.Purpose:To compare BPTB autografts to allografts for ACL reconstruction, specifically with regard to patient satisfaction, return to preinjury activity level, and postoperative functional outcomes.Study Design:Meta-analysis.Methods:A total of 76 studies published between 1998 and 2012, including a total of 5182 patients, were reviewed. It was not required for studies to be comparative in nature. Outcomes evaluated were graft rupture rate, return to preinjury activity level, overall and subjective International Knee Documentation Committee (IK...

Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis

Abstract: Background Abnormal gait after anterior cruciate ligament reconstruction (ACLR) may contribute to development and/or progression of knee osteoarthritis. Objective To conduct a systematic review and meta-analysis of knee kinematics and joint moments during walking after ACLR. Methods We searched seven electronic databases and reference lists of relevant papers, for cross-sectional, human-based observational studies comparing knee joint kinematics and moments during level walking in individuals with ACLR, with the uninjured contralateral knee or healthy individuals as a control. Two independent reviewers appraised methodological quality (modified Downs and Black scale). Where possible, data were pooled by time post-ACLR (RevMan), otherwise narrative synthesis was undertaken. Results Thirty-four studies were included. Meta-analysis revealed significant sagittal plane deficits in ACLR knees. We found greater knee flexion angles (standardised mean difference: 1.06; 95% CI 0.39 to 1.74) and joint moments (1.61; 0.87 to 2.35) 3 years after ACLR (vs healthy controls) (0.09; −0.63 to 0.81). No transverse plane conclusions could be drawn. Conclusions Sagittal plane biomechanics, rather than the knee adduction moment, appear to be more relevant post-ACLR. Better understanding of sagittal plane biomechanics is necessary for optimal post-operative recovery, and to potentially prevent early onset and progression of knee OA after ACLR. Trial registration number PROSPERO systematic review protocol registration number CRD4201400882 2.