Patrick Yoon
University of Minnesota, Orthopaedic Surgery, Faculty Member
Research Interests:
Research Interests:
Despite the success of Sir John Charnley's cemented total hip arthroplasty (THA), large numbers of patients demonstrated mechanical failure due to loosening. The two main initial concerns were infection and wear. With the recent advances... more
Despite the success of Sir John Charnley's cemented total hip arthroplasty (THA), large numbers of patients demonstrated mechanical failure due to loosening. The two main initial concerns were infection and wear. With the recent advances in antibiotics and aseptic techniques and with improvement in surgical technique, the incidence of infection has decreased tremendously. Subsequently, the issues of wear and osteolysis have become the main concern. Initially attributing these problems to so-called "cement disease," clinicians sought out alternative methods of fixation; hence arose cementless femoral stem fixation. This article provides an overview of our modern understanding of cementless femoral stem fixation, focusing on design issues and outcomes. Particular attention is paid to three areas of continuing controversy with regard to the uncemented femoral stem: geometric design, material composition, and type and extent of porous coating.
Research Interests:
... Articles. Late Reconstruction for Sequelae of Compartment Syndrome. Yoon, Patrick MD. ... The author declares that he has nothing to disclose. Address correspondence and reprint requests to Patrick Yoon, MD, Hennepin County Medical... more
... Articles. Late Reconstruction for Sequelae of Compartment Syndrome. Yoon, Patrick MD. ... The author declares that he has nothing to disclose. Address correspondence and reprint requests to Patrick Yoon, MD, Hennepin County Medical Center, Minneapolis, MN 55415. ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Orthobiologics are biologically-derived materials intended to promote bone formation and union. We review evidence on effectiveness and harms of orthobiologics compared to no orthobiologics for foot and ankle arthrodesis. We searched... more
Orthobiologics are biologically-derived materials intended to promote bone formation and union. We review evidence on effectiveness and harms of orthobiologics compared to no orthobiologics for foot and ankle arthrodesis. We searched multiple databases (1995-2019) and included clinical trials and other studies with concurrent controls, English language, and reporting patient-centered outcomes, union/time to union, costs/resource utilization, or harms. Studies were organized by orthobiologic used. We describe quality and limitations of available evidence but did not formally rate risk of bias or certainty of evidence. Most of the 21 studies included were retrospective chart reviews with orthobiologics used at surgeon's discretion for patients considered at higher risk for nonunion. Ten studies compared autologous bone graft versus no graft and 2 compared remote versus local graft with few studies of other orthobiologics. All studies reported a measure of fusion and about half reported on function/quality of life. Few studies reported harms. Due to limited reporting, we were unable to assess whether effectiveness varies by risk factors for nonunion (eg, age, gender, smoking status, obesity, diabetes) or whether orthobiologics were cost-effective. Available evidence is of poor quality with small sample sizes, inadequate reporting of risk factors for nonunion, variations in orthobiologics, surgical techniques used, and outcome assessment, and potential selection bias. Research is needed to adequately inform surgeons about benefits and harms and guide patient selection for use, or type, of orthobiologics. Careful assessment of individual patient risk for nonunion is critical prior to orthobiologic use.
Research Interests:
The treatment of ankle fractures in the presence of diabetes mellitus can be difficult because of a higher complication rate with this subset of the population. When peripheral neuropathy is present at the time of trauma, there is an... more
The treatment of ankle fractures in the presence of diabetes mellitus can be difficult because of a higher complication rate with this subset of the population. When peripheral neuropathy is present at the time of trauma, there is an increased risk of developing Charcot arthropathy, a limb-threatening complication that often creates breakdown, instability, and chronic ulceration of the limb. The authors present a case report of a diabetic patient who sustained an unstable ankle fracture with subsequent neuroarthropathic event that required multiple surgical procedures for salvage of the limb.
Research Interests:
Research Interests:
RefDoc Bienvenue - Welcome. Refdoc est un service / is powered by. ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Surgery, Biomedical Engineering, Medicine, Humans, Female, and 15 moreMale, Follow-up studies, Patient Satisfaction, Arthroplasty, Clinical Sciences, Middle Aged, Time Factors, Workers Compensation, Range of Motion, Knee Joint, Control Group, Case Control Studies, Cohort Studies, Total Knee Arthroplasty, and Scoring system
Research Interests:
Orthobiologics are biologically-derived materials intended to promote bone formation and union. We review evidence on effectiveness and harms of orthobiologics compared to no orthobiologics for foot and ankle arthrodesis. We searched... more
Orthobiologics are biologically-derived materials intended to promote bone formation and union. We review evidence on effectiveness and harms of orthobiologics compared to no orthobiologics for foot and ankle arthrodesis. We searched multiple databases (1995-2019) and included clinical trials and other studies with concurrent controls, English language, and reporting patient-centered outcomes, union/time to union, costs/resource utilization, or harms. Studies were organized by orthobiologic used. We describe quality and limitations of available evidence but did not formally rate risk of bias or certainty of evidence. Most of the 21 studies included were retrospective chart reviews with orthobiologics used at surgeon's discretion for patients considered at higher risk for nonunion. Ten studies compared autologous bone graft versus no graft and 2 compared remote versus local graft with few studies of other orthobiologics. All studies reported a measure of fusion and about half reported on function/quality of life. Few studies reported harms. Due to limited reporting, we were unable to assess whether effectiveness varies by risk factors for nonunion (eg, age, gender, smoking status, obesity, diabetes) or whether orthobiologics were cost-effective. Available evidence is of poor quality with small sample sizes, inadequate reporting of risk factors for nonunion, variations in orthobiologics, surgical techniques used, and outcome assessment, and potential selection bias. Research is needed to adequately inform surgeons about benefits and harms and guide patient selection for use, or type, of orthobiologics. Careful assessment of individual patient risk for nonunion is critical prior to orthobiologic use.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Background In adults with diabetes, diabetic foot ulcer (DFU) and amputation are common and associated with significant morbidity and mortality. Purpose Identify tools predicting risk of DFU or amputation that are prognostically accurate... more
Background In adults with diabetes, diabetic foot ulcer (DFU) and amputation are common and associated with significant morbidity and mortality. Purpose Identify tools predicting risk of DFU or amputation that are prognostically accurate and clinically feasible. Methods We searched for systematic reviews (SRs) of tools predicting DFU or amputation published in multiple databases from initiation to July 2021. We assessed risk of bias (ROB) and provided a narrative review of reviews describing performance characteristics (calibration and discrimination) of prognostically accurate tools. For such tools, we additionally reviewed original studies to ascertain implementation clinical applicability and feasibility (variables included, score calculation, and risk categorization). Results We identified 3 eligible SRs predicting DFU or amputation risk. Two recent SRs (2020 and 2021) were rated as moderate and low ROB respectively. Four risk prediction models – Boyko, Martins-Mendes (simplifie...
Research Interests:
Component removal is a time-consuming yet necessary step during revision hip surgeries. Because of the diversity of the components and the methods used to secure them, an equal diversity of approaches and tools are necessary for component... more
Component removal is a time-consuming yet necessary step during revision hip surgeries. Because of the diversity of the components and the methods used to secure them, an equal diversity of approaches and tools are necessary for component removal. Careful and detailed preoperative planning is mandatory, the mode of failure must be understood, and detailed imaging should be available to the surgeon. Understanding the basic principles and indications for each of the techniques would optimize outcome. We review the approaches, tools, and techniques for component removal in revision hip procedures in stepwise sequence.
Research Interests:
Complications following hip arthroplasty have a wide variation and range in incidence from 1.1% for pulmonary embolism to over 70% for infrapopliteal deep vein thrombosis. Recognition of the risk factors and all of the possible types of... more
Complications following hip arthroplasty have a wide variation and range in incidence from 1.1% for pulmonary embolism to over 70% for infrapopliteal deep vein thrombosis. Recognition of the risk factors and all of the possible types of complications places the surgeon in a better position to detect such complications and formulate a plan to treat them. This article documents some ofthe complications that can occur during or after surgery following hip surgery. These complications are stratified as systemic and procedure specific.
Research Interests:
P roblems with the patellofemoral joint comprise the ost common complication in primary and revision otal knee arthroplasty (TKA). The difficulties can range rom instability and anterior knee pain at one end of pectrum of severity, to... more
P roblems with the patellofemoral joint comprise the ost common complication in primary and revision otal knee arthroplasty (TKA). The difficulties can range rom instability and anterior knee pain at one end of pectrum of severity, to fracture and extensor mechaism disruption at the other end. These complications re generally higher in revision TKA due to comproised bone stock and blood supply. Despite the particlar challenges posed by the bone-deficient patella, reaonable results can be achieved. 2003 Elsevier Inc. All rights reserved.
Research Interests:
Despite the success of Sir John Charnley's cemented total hip arthroplasty (THA), large numbers of patients demonstrated mechanical failure due to loosening. The two main initial concerns were infection and wear. With the recent... more
Despite the success of Sir John Charnley's cemented total hip arthroplasty (THA), large numbers of patients demonstrated mechanical failure due to loosening. The two main initial concerns were infection and wear. With the recent advances in antibiotics and aseptic techniques and with improvement in surgical technique, the incidence of infection has decreased tremendously. Subsequently, the issues of wear and osteolysis have become the main concern. Initially attributing these problems to so-called "cement disease," clinicians sought out alternative methods of fixation; hence arose cementless femoral stem fixation. This article provides an overview of our modern understanding of cementless femoral stem fixation, focusing on design issues and outcomes. Particular attention is paid to three areas of continuing controversy with regard to the uncemented femoral stem: geometric design, material composition, and type and extent of porous coating.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
The treatment of ankle fractures in the presence of diabetes mellitus can be difficult because of a higher complication rate with this subset of the population. When peripheral neuropathy is present at the time of trauma, there is an... more
The treatment of ankle fractures in the presence of diabetes mellitus can be difficult because of a higher complication rate with this subset of the population. When peripheral neuropathy is present at the time of trauma, there is an increased risk of developing Charcot arthropathy, a limb-threatening complication that often creates breakdown, instability, and chronic ulceration of the limb. The authors present a case report of a diabetic patient who sustained an unstable ankle fracture with subsequent neuroarthropathic event that required multiple surgical procedures for salvage of the limb.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
... Articles. Late Reconstruction for Sequelae of Compartment Syndrome. Yoon, Patrick MD. ... The author declares that he has nothing to disclose. Address correspondence and reprint requests to Patrick Yoon, MD, Hennepin County Medical... more
... Articles. Late Reconstruction for Sequelae of Compartment Syndrome. Yoon, Patrick MD. ... The author declares that he has nothing to disclose. Address correspondence and reprint requests to Patrick Yoon, MD, Hennepin County Medical Center, Minneapolis, MN 55415. ...
Revision total knee arthroplasty (TKA) is considered by some to be the most difficult procedure in the field of orthopaedic surgery. Good results can be consistently obtained if a meticulous and methodic approach is taken by the provider.... more
Revision total knee arthroplasty (TKA) is considered by some to be the most difficult procedure in the field of orthopaedic surgery. Good results can be consistently obtained if a meticulous and methodic approach is taken by the provider. Keeping the goals of treatment in mind ...
Problems with the patellofemoral joint comprise the most common complication in primary and revision total knee arthroplasty (TKA). The difficulties can range from instability and anterior knee pain at one end of spectrum of severity, to... more
Problems with the patellofemoral joint comprise the most common complication in primary and revision total knee arthroplasty (TKA). The difficulties can range from instability and anterior knee pain at one end of spectrum of severity, to fracture and extensor mechanism disruption at ...
Research Interests:
One of the primary steps in revision hip arthroplasty is the extraction of retained components before surgical reconstruction. In revision arthroplasty, the removal of well-fixed components and cement can be extremely demanding, time... more
One of the primary steps in revision hip arthroplasty is the extraction of retained components before surgical reconstruction. In revision arthroplasty, the removal of well-fixed components and cement can be extremely demanding, time consuming, and damaging to the remaining host bone. The aims of the current study were to examine the numerous operative techniques used during extraction of acetabular and femoral components and review the results of revision hip arthroplasty after cementless component removal. A review of 157 acetabular components and 113 femoral components removed from 219 patients during hip revision arthroplasty between 1985 and 2000 was done. The average age of the patients was 64.3 years. The average followup was 5 years (range, 0.7-12.5 years). An extended proximal femoral osteotomy was done in 37 (33%) of the femoral revisions. There were 14 (5%) acetabular failures for which the patients required reoperation. There were no femoral rerevisions. Complications included dislocation (6% after acetabular revision and 9% after femoral revision), infection (6%), femoral fracture (6%), hematoma (3.5%), acetabular fixation failure (2.5%), and femoral osteolysis (1%). The removal of cemented and well-fixed porous-coated implants can be done with adequate preoperative planning and a thorough knowledge of numerous implant removal techniques.