Kwok-Man Tong - Academia.edu (original) (raw)

Papers by Kwok-Man Tong

Diffuse pigmented villonodular synovitis of the shoulder: a case report

PubMed, Mar 1, 1994

Pigmented villonodular synovitis (PVNS) of the shoulder is an uncommon disorder with unknown etio... more Pigmented villonodular synovitis (PVNS) of the shoulder is an uncommon disorder with unknown etiology. It is characterized by synovial proliferation and hemosiderin deposition into the synovial tissues of the affected joints. PVNS affects mainly the knee joint and shoulder involvement is rare. There are only 12 cases of shoulder involvement reported in the English-language literature. A case of PVNS of the shoulder with simultaneous rotator cuff tear is presented and the literature is reviewed.

Knee, 2020

This study evaluated the long-term clinical follow-up results of patients who underwent double-bu... more This study evaluated the long-term clinical follow-up results of patients who underwent double-bundle posterior cruciate ligament (PCL) reconstruction using the Ligament Advanced Reinforcement System (LARS). Methods: Patients were assessed using clinical scores that included the Tegner activity level scale, the Lysholm score, and the International Knee Documentation Committee (IKDC) score. KT-1000 was adopted to assess stability. Radiographs and magnetic resonance imaging (MRI) were used to evaluate osteoarthritis and LARS condition. Results: This study examined 38 patients, of which follow-up procedures were completed for 33 patients, resulting in a follow-up rate of 86.8%. The average follow-up period was 11.9 ± 1.2 years (range: 10.3-14.2 years). The median scores of the clinical scales were as follows: Tegner activity score, 6 (range: five to seven); Lysholm score, 90 (range: 67-100); and IKDC score, 89.7 (range: 46-100). The median of the side-to-side difference (SSD) was four millimeters (range: 0-10 mm). In radiographs, the moderate OA rate was 6.9%. MRI results revealed that 26 patients exhibited ingrowth and 11 patients exhibited partial rupture of the LARS. With SSD ≤ 3 mm set as the standard for successful knee stabilization, the optimal cutoff point of LARS midsubstance thickness in the receiver operating characteristic (ROC) curve analysis was 14.3 mm. Conclusions: Long-term follow-up of the studied patients demonstrated the durability of LARS. However, clinical outcomes showed no enhancement using LARS, so it is not recommended for routine use in PCL reconstruction.

Unmasking the silent invader: A rare encounter of Neisseria gonorrhoeae in joint fluid

The Kaohsiung Journal of Medical Sciences

BMC Musculoskeletal Disorders, 2020

Background The kinematic alignment (KA) technique in total knee arthroplasty (TKA) aims to restor... more Background The kinematic alignment (KA) technique in total knee arthroplasty (TKA) aims to restore the native alignment of pre-disease knee joint anatomy. Determining the individualized alignment targets is crucial for pre-operative planning, which can be set according to different original knee phenotypes. Five most common knee phenotypes have been categorized for KA-TKA alignment target setting in our previous study. The purpose of this study was to investigate the distribution of the five phenotypes in advanced OA knee patients and evaluate the clinical outcomes of this phenotype-oriented KA-TKA using the generic instrument, with particular emphasis on alignment strategy, surgical technique, survivorship, radiographic and functional outcomes. Methods The clinical data of 123 patients (88 women, 35 men) who had undergone 140 TKAs in our hospital were reviewed. All the TKAs were performed with alignment targets set according to the original phenotypes of the knee, with the KA metho...

Journal of Orthopaedic Surgery Taiwan, 2003

Palmar transscaphoid perilunate fracture dislocation is uncommon. We described a case presented 4... more Palmar transscaphoid perilunate fracture dislocation is uncommon. We described a case presented 4 weeks after wrist injury involved a palmar lunate dislocation associated with fractures of the scaphoid and triquetrum. Avulsion fracture of the radial styloid process was also noted. We performed open reduction for lunate dislocation and Kirschner wires fixation for scaphoid and triquetrum fractures. External fixator was applied for traction and immobilization. The Kirschner wires and external fixator were removed at 6 weeks. Due to residual wrist pain and local tenderness over distal ulnar end and distal radioulnar joint during wrist pronation, arthrography was performed and showed dorsal distal radioulnar joint subluxation. Arthroscopic examination and distal radioulnar joint fixation with a FASTak suture were done at 3 months after our first operation. The outcome at 6 months was satisfied in our patient.

Multiple Nodules of Foot Caused by Subcutaneous Granuloma Annulare: A Case Report and Review of the Literature

We report a case of a 10-year-old boy who presented with multiple asymptomatic nodules on the lef... more We report a case of a 10-year-old boy who presented with multiple asymptomatic nodules on the left ankle and dorsal aspect of left foot. He had no history of diabetes or other systemic diseases. Family history was unremarkable. Physical examination showed two palpable nodules about 2x1.5 cm and 1.5x1 cm in size without tenderness. These nodules were well defined and movable lesions with soft consistency. Excisional biopsy was done. Pathological finding of nodules showed subcutaneous granuloma annulare. No recurrence was noted after excision for three years. Subcutaneous granuloma annulare is a benign inflammatory granulomatous dermatoses. It is unfamiliar to most of surgeons. The clinician must recognize the clinical variants. This case is reported to keep us reminding the possibility of this kind of skin lesion when we face multiple nodules of lower limb in clinical practice.

Quantitative Evaluation of Bone Remodeling of Proximal Femur after Total Hip Arthroplasty Using Dual-Energy X-Ray Absorptiometry – A Preliminary Report

Journal of Orthopaedic Surgery Taiwan, 1996

Dual-Energy X-ray Absorptiometry (DEXA) has the ability to quantify regional bone mineral density... more Dual-Energy X-ray Absorptiometry (DEXA) has the ability to quantify regional bone mineral density (BMD) around the prosthesis after hip arthroplasty. The bone remodeling of the proximal femur of 15 patients who had underwent unilateral total hip artliroplasty during September 1987 to June 1990 at the Taichung Veterans General Hospital were retrospectively analysed by DEXA. The contralateral disease-free femur served as control. The BMD decreased over the proximal femur corresponded to the porous coating part of the prosthesis (zone 7 according to the zonal classification of Gruen) and showed no significant change in smooth portion of the porsthesis (zone 6) just distal to the porous coated part. The postoperative Harris hip score showed negative correlation with the percentage of bone loss in zone 6 (p=0.012). Hence, the presence of cortical densification around the smooth portion of the prosthesis just distal to the porous coated part indicated better clinical outcome.

A Simple Technique of Removal of Femoral Cement Plug-Two Cases Report

Journal of Orthopaedic Surgery Taiwan, 2004

To extract of a larger size of femoral cement plug that chokes in the femoral canal is not an eas... more To extract of a larger size of femoral cement plug that chokes in the femoral canal is not an easy task if a good removal tool is not available. To make it simple, quick and safe (no wide surgical exposure, no X-ray exposure), we propose a simple technique for removal of an inappropriate cement plug based upon the perforation of the cement plug by drilling a 5.0-mm AO Schanz screw that can introduce across it. If this procedure can be used correctly, it will help the surgeon to solve the difficult problem of removing the femoral cement plug with such an easily available tool.

Bowel Entrapment in Pelvic Fracture-A Case Report and Review of Literature

Bowel entrapment or herniation is a rare associated injury in pelvic frac-ture. We present a case... more Bowel entrapment or herniation is a rare associated injury in pelvic frac-ture. We present a case of bowel entrapment associated with pelvic fracture and review the literature. We report this case to emphasize the importance of early detection of bowel entrapment and hope it should be kept in mind when mang-ing the patient with pelvic fracture.

Foreign Body Granuloma Formation after Excision of Bilateral Wrist Ganglia: A Case Report

Journal of Orthopaedic Surgery Taiwan, 2006

Adverse reaction to suture material was reported rarely because most reaction to suture material ... more Adverse reaction to suture material was reported rarely because most reaction to suture material was mild and subsided spontaneously. Severe reaction including abscess formation, wound dehiscence, or granuloma formation was reported in the incidence from 0.3% to 6%. Silk related granuloma could be seen in various surgeries including thyroid, hernioplasty, lung, and gingiva but there was no similar report in orthopedic literature especially after excision of wrist ganglia. We present a rare case of granuloma caused by an adverse reaction to silk after excision of bilateral wrist ganglia using the braided silk as suture material. The wounds of both wrists healed uneventfully after complete removal of granuloma and silk sutures. Surgeons should keep alert about this adverse reaction when using silk sutures and avoid using them in patients with past history of severe reaction to silk sutures. Making an early diagnosis and the complete removal of granuloma with sutures are important.

The Knee, 2019

Activity-related outcome in anterior cruciate ligament reconstruction with synthetic ligament advanced reinforcement system

Journal of the Chinese Medical Association, 2019

Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction with ligament advanced r... more Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction with ligament advanced reinforcement system (LARS) had revealed good results with low complication and failure rate in series of studies. The specific candidates for ACL reconstruction with LARS are still unknown anyway. The purpose of this study is to evaluate the activity-related outcome in ACL reconstruction using LARS ligament. Methods: A total of 43 unilateral arthroscopic ACL reconstructions with LARS were collected and divided into two groups: group A (preinjury Tegner score ≥ 6, n = 20) and group B (preinjury Tegner score < 6, n = 23). We had analyzed the stability of knee and functional outcome with a minimum of 2-years follow up. Results: All patients were aware of improvement over the knee stability immediately after ACL reconstruction with LARS. The functional outcome of knee was improved in both groups by analysis with the Lysholm score and modified International Knee Documentation Committee (IKDC) score. The postoperative grading of the knee examination form of modified IKDC grade showed no statistical difference in both groups. Conclusion: Arthroscopic ACL reconstruction with LARS was encouraged as an alternative option even in high sports demand patients.

Outcome of perioperative hemostatic management in patients with hemophilia without inhibitors undergoing 161 invasive or surgical procedures

Journal of the Chinese Medical Association, 2018

&NA; Perioperative management of persons with hemophilia (PWH) is a challenge for surgeons an... more &NA; Perioperative management of persons with hemophilia (PWH) is a challenge for surgeons and hematologists. Reductions in mortality rate and complications have been achieved since the introduction of clotting factor concentrates (CFCs), which improve hemostatic control. However, there is no clear consensus on the optimal dosing of CFC administration. The aim of this study was to evaluate the outcome of PWH without inhibitors in patients undergoing invasive or surgical procedures. A total of 161 procedures, including 57 major and 104 minor ones were retrospectively reviewed. The characteristics of PWH, age at procedure, duration and total amount of CFC administration during the perioperative period, hemostatic adequacy, and complications were summarized. The study showed a low rate of bleeding (1.2%), infection (0%), thromboembolic event (0%), and inhibitor development (0%). The results revealed the doses and duration of CFC administration for several major and minor procedures which were capable of achieving excellent hemostatic control.

Clinical and Applied Thrombosis/Hemostasis, 2018

Recurrent hemarthrosis in patients with hemophilia (PWH) results in chronic arthropathy requiring... more Recurrent hemarthrosis in patients with hemophilia (PWH) results in chronic arthropathy requiring total joint replacement (TJR). This study aimed to compare the difference in TJR rate between patients with hemophilia A (HA) and hemophilia B (HB). A final total of 935 PWH (782 HA and 153 HB) without inhibitors were collected from the Taiwan’s National Health Insurance Research Database between 1997 and 2013. Demographics, clinical characteristics, and TJR rate were compared between the 2 groups. The annual use of clotting factor concentrate was not different between HA and HB groups ( P = .116). The rate of comorbidities except for 29 PWH having HIV who were all in the HA group was also not different between the 2 groups. A total of 99 (10.6%) PWH had undergone 142 TJR procedures during the study period. All of them had received on-demand therapy. No difference was found in the cumulative incidence of TJR between HA and HB ( P = .787). After adjusting for various confounders includin...

$Research paper thumbnail of Integrated risk scoring model for predicting dynamic hip screw treatment outcome of intertrochanteric fracture$

Integrated risk scoring model for predicting dynamic hip screw treatment outcome of intertrochanteric fracture

Injury, 2016

Dynamic hip screw (DHS) is a common device for treating intertrochanteric fracture (ITF). Various... more Dynamic hip screw (DHS) is a common device for treating intertrochanteric fracture (ITF). Various risk factors have been reported to be associated with the operative treatment outcome. However, an integrated risk scoring prediction model is lacking. In this study, we aimed to develop a prediction model for treatment outcome of intertrochanteric fracture. We analyzed 442 AO/OTA 31-A1 and A2 fractures which were treated with DHS during the period January 2000 to June 2014 in a level I trauma center. Risk factors including age, gender, injured side, lag screw position, AO/OTA classification, tip-apex distance, postoperative lateral wall fracture, reduction patterns were analyzed to determine their influence on treatment outcome. Integrated risk scores of significant predictors were used to construct a prediction model. AO/OTA 31-A2 classification, postoperative lateral wall fracture, posteriorly inserted lag screw and varus reduction pattern were significant risk predictors for DHS failure. The failure risk for low- and high-risk groups were significantly different (P&amp;amp;amp;amp;amp;amp;amp;lt;0.001) CONCLUSION: AO/OTA 31-A2 classification, postoperative lateral wall fracture, posteriorly inserted lag screw and varus reduction pattern were significant risk predictors for DHS failure. We developed a model that integrates these factors to predict the treatment outcome, which had excellent prediction accuracy and discriminatory ability. The models may provide useful information for orthopedic doctors to identify patients who need early intervention as well as ITF patients who require more frequent follow-up in the postoperative period.

Clotting factor concentrate use and occurrence of thrombotic events in patients with hemophilia: A nationwide and 15-year cohort study

American journal of hematology, Jan 11, 2016

to infliximab therapy in luminal and fistulizing Crohn’s disease. Aliment Pharmacol Ther 2005;22:... more to infliximab therapy in luminal and fistulizing Crohn’s disease. Aliment Pharmacol Ther 2005;22:613–626. 4. Vega MI, Huerta-Yepez S, Jazirehi AR, et al. Rituximab (chimeric anti-CD20) sensitizes BNHL cell lines to Fas-induced apoptosis. Oncogene 2005;24:8114–8127. 5. Villa-Morales M, Gonz alez-Gugel E, Shahbazi MN, et al. Modulation of the FAS-apoptosissignalling pathway by functional polymorphisms at Fas, FasL and Fadd and their implication in T-cell lymphoblastic lymphoma susceptibility. Carcinogenesis 2010;31:2165–2171. 6. Heredia-Galvez B, Ruiz-Cosano J, Torres-Moreno D, et al. Association of polymorphisms in TRAIL1 and TRAILR1 genes with susceptibility to lymphomas. Ann Hematol 2014;93: 243–247.

Acupuncture in medicine : journal of the British Medical Acupuncture Society, Jan 24, 2015

To explore the point-specific clinical effect of 2 Hz electroacupuncture (EA) in treating postope... more To explore the point-specific clinical effect of 2 Hz electroacupuncture (EA) in treating postoperative pain in patients undergoing total knee arthroplasty (TKA), METHODS: In a randomised, partially single-blinded preliminary study, 47patients with TKA were randomly divided into three groups: control group (CG, n=17) using only patient-controlled analgesia (PCA); EA group (EAG, n=16) with 2 Hz EA applied at ST36 (Zusanli) and GB34 (Yanglingquan) contralateral to the operated leg for 30 min on the first two postoperative days, also receiving PCA; and non-point group (NPG, n=14), with EA identical to the EAG except given 1 cm lateral to both ST36 and GB34. The Mann-Whitney test was used to show the difference between two groups and the Kruskal-Wallis test to show the difference between the three groups. The time until patients first required PCA in the CG was 34.1±22.0 min, which was significantly shorter than the 92.0±82.7 min in the EAG (p<0.001) and 90.7±94.8 min in the NPG (p&l...

$Research paper thumbnail of Isolated supra-acetabular insufficiency fracture: a case report$

Journal of the Formosan Medical Association = Taiwan yi zhi, 2002

In the absence of trauma, fracture of the acetabulum is a rare injury, and an isolated insufficie... more In the absence of trauma, fracture of the acetabulum is a rare injury, and an isolated insufficiency fracture in the supra-acetabular region is extremely rare. We describe a 59-year-old postmenopausal woman with systemic lupus erythematosus (SLE) who developed a fracture in the roof of the acetabulum with underlying corticosteroid-induced bony insufficiency. Faint medullary sclerosis over the roof of the acetabulum was observed on plain roentgenograms. Diagnosis was made using magnetic resonance imaging. Irregular linear low signal intensity lines were observed on T1-weighted, T2-weighted, proton density, and contrast enhanced images, and these represented the fracture. The fracture healed with conservative management. Insufficiency fracture in this location should be suspected in an osteopenic woman with spontaneous hip pain.

Orthopedics, 2012

The purpose of this study was to assess the outcomes of posterior cruciate ligament (PCL) reconst... more The purpose of this study was to assess the outcomes of posterior cruciate ligament (PCL) reconstruction using the Ligament Augmentation and Reconstruction System (LARS) (JK Orthomedic Ltd, Dollard-des-Ormeaux, Quebec, Canada) artificial ligament. Compared with older artificial ligaments, the LARS, which has been used in Europe for 15 years, is more resistant to wear and tear, has satisfactory torsional fatigue resistance, and has good biocompatibility. The current is study included 38 doublebundle PCL reconstructions using the LARS artificial ligament in 38 patients. Mean patient age was 32.6 years, and mean time from injury to surgery was 6 months. Mean follow-up was 37 months (range, 30-68 months). The study endpoint was 2-year follow-up. Mean Tegner score improved from 3.460.6 preoperatively to 6.061.4 postoperatively (P,.001), and mean Lysholm score improved from 70.0611.0 preoperatively to 91.765.5 postoperatively (P,.001). Knee laxity decreased significantly postoperatively (P,.001), and no differences existed at 1-and 2-year follow-up. After surgery using the Y-type LARS artificial ligament, knee function and stability improved. Using the LARS artificial ligament for double-bundle reconstruction of the PCL avoids donor-site morbidity and disease transmission. The complication rate is low, and the results appear to be stable with time and comparable with those obtained with other grafts. Double-bundle PCL reconstruction with the LARS artificial ligament may be an alternative treatment option.

Incidence and survival of cancers among 1054 hemophilia patients: A nationwide and fourteen-year cohort study

American Journal of Hematology, 2015

As life expectancy increases in persons with hemophilia (PWH), more age-related diseases such as ... more As life expectancy increases in persons with hemophilia (PWH), more age-related diseases such as cancer emerge among this patient group. The aim of this study was to investigate incidence and survival of cancers among PWH in Taiwan. We analyzed data of 1,054 PWH retrieved from Taiwan&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s National Health Insurance Research Database between 1997 and 2010, by comparing variables to 10540 age- and gender-matched healthy individuals from the general population. There were 43 PWH and 178 individuals of general population with newly diagnosed cancer (RR 2.42, 95% CI 1.74-3.35). The cumulative incidences of cancer in PWH and the general population were 4.7 and 1.9%, respectively. Hepatocellular carcinoma (HCC) was the major type of cancer (17 cases) in PWH; cancer rate was still increased when HCC and HIV-related cancers were excluded (RR 1.66, 95% CI 1.06-2.59). There was no significant difference observed in lung, colorectal, or prostate cancer occurrence. Compared to the general population, PWH were younger at the time of cancer diagnosis (45.1 vs. 57.2 years old, P value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and had fewer co-morbidities. Nineteen PWH with cancers died during the study period, and no bleeding-related death was recorded among these patients. The survival rate was not different between PWH and the general population, P = 0.86. In conclusion, the cumulative incidence of cancer among PWH was higher than the general population. PWH with cancer were younger and had fewer comorbidities, but the survival rates were similar in the two groups.Am. J. Hematol. 90:E55-E59, 2015. © 2015 Wiley Periodicals, Inc.