Aim: There have been increasingly publications about the complicated disease of patello-femoral joints after total knee arthroplasty (TKA). We have treated soft tissue impingement under the patella after TKA by arthroscopic surgery and investigated the findings and efficacy of the treatment.

Materials and Methods: 6 patients and 8 knees which showed soft tissue impingement of patello-femoral joints after TKA. Surgical arthroscopy was performed and impinging soft tissues were classified and the efficacy of arthroscopic treatment were evaluated.

Results: We classified the patients with soft tissue impingement under the patella into three groups: (I) patellar clunk syndrome; the isolated fibrous nodule located suprapatellar lesion, without the other fibrous tissues causing the impingement, (II) impinging hypertrophic synovitis; generalized hypertrophic synovitis, no fibrous nodule, and (III) the combined type of (I)+(II), the suprapatellar fibrous nodule with generalized hypertrophic synovitis. Therapeutic efficacy was that in the category of type I two were good-excellent, in type II three were fair and one was poor, and in type III two were fair.

Conclusions: Better results were obtained in type I (a patellar clunk syndrome) than type II (impingement synovitis).

Introduction: Carpal tunnel syndrome (CTS) occurs as one of clinical features of Dialysis Related Amyloidosis (DRA). Recently, it has been suggested that advanced glycation endproducts (AGEs) and bate 2 microglobulin (b2m) modified with AGEs are related to DRA. In our previous cross-sectional study, the fact that serum pentosidine, which is an AGE, was higher in DRA than in non-DRA indicates that it has potential as an indicator for the occurrence of DRA in HD patients.

Aim: In this prospective study we examined to elucidate whether serum levels of pentosidine relate to the occurrence of CTS in patients with HD in 4 years longitudinal follow up.

Material and Methods: The subjects are 106 end-stage renal failure patients undergoing HD, who had never operated for CTS. Serum pentosidine was measured by the HPLC method with column switching. b2m and intact PTH were also measured. During follow up period we operated 15 patients for CTS.

Results: Pentosidine levels were significantly elevated in the operated group than the non-operated group, whereas there were not significant differences in b2m and intact-PTH.

Conclusion: These results indicate that serum pentosidine has the potential as an indicator for the occurrence of CTS in long-term hemodialysis patients.