Rhee pioneers advanced shoulder surgery in Korea
Rhee Yong-girl
Professor in Department of Orthopaedic Surgery, Kyunghee University School of Medicine
Rhee Yong-girl is one of the most noted and prolific Korean orthopedic surgeons to specialize in treating injuries of the shoulder. Every year, he treats about 10,000 patients. He was the first Korean to become a board member of the International Congress of Shoulder and Elbow Surgery (2008).
The shoulder is considered the most complicated and unstable joint in the human body. Composed of bones, ligaments, muscles and tendons, it is the only joint capable of moving in every direction. Despite the shoulder’s unique characteristics, however, the field of shoulder surgery was not yet recognized in Korea 25 years ago. Orthopedic surgeons, who were largely trained for knee joint problems, took care of all orthopedic patients. Studying the relatively unexplored area was a major decision for orthopedist Rhee Yong-girl, who had never doubted his future as a knee specialist until 1991. Looking back, however, the 61-year-old now clearly sees how important the decision was for his career and the country. At first, few of his colleagues took his decision seriously. Many thought he had no reason to choose a struggle over a straight and easy road. Under the mentorship of Yoo Myung-chul, one of the nation’s best orthopedic surgeons at that time, Rhee seemed to be on the right track at Kyung Hee University Hospital in Seoul. But he was dead serious. As soon as he made up his mind, he wrote a long letter to Hiroaki Fukuda, a renowned shoulder surgeon who was living in Japan. “In the letter, I said, ‘I will become a surgeon as great as you are someday,” Rhee, now chief orthopedic surgeon at Kyung Hee University Hospital, said in an interview. “We actually met three years later at the inaugural Asian Shoulder Society Meeting in Taipei. When I introduced myself, Fukuda recognized my name. This is one of those unforgettable moments in my life.” Meeting Fukuda was also a turning point of his career. Thanks to the Japanese scholar, Rhee was able to grow not only as a surgeon but also as a researcher. “Fukuda knew how to publish competitive papers in global medical journals despite limited research resources in his country.
Facing similar challenges as a Korean scholar, I wanted to gain his know-how,” he said. “He helped me greatly and treated me like a brother.” A deep knowledge of the engineering of the human musculoskeletal system is indispensible in orthopedic surgery. For shoulder surgeons, who deal with the complex structure made up of three bones and various related muscles, ligaments and tendons, having the eyes of an engineer can be especially useful. During Rhee’s training at the University of Washington in Seattle from 1992 to 1993, he met the right teacher, Frederick A. Matsen, to gain the expertise. “Matsen was a unique orthopedic surgeon who had extensive knowledge about biomechanics thanks to his previous experience as a physician and neurosurgeon,” Rhee said. “While working with him, I learned a lot about the biomechanics of the shoulder and surgical techniques.” All these mentors and experiences have helped Rhee grow as a versatile doctor who is capable of doing both high-level research and surgery. Today, he is one of the best and most prolific orthopedic surgeons for the shoulder in Korea. Every year, he treats about 10,000 patients who suffer from various injuries such as rotator cuff tears and frozen shoulder. Rhee has earned many honors on the international stage. He became the first Korean board member of the International Congress of Shoulder and Elbow Surgery in 2008. In 2016, he successfully hosted the 13th International Congress of Shoulder and Elbow Surgery for the first time in Jeju Island as congress president — the first major international conference of his field to be held in Korea. In 2014, he became a founding member of the Asian Shoulder Elbow Group, which aims to promote cooperation among doctors in the field in Asia.
‘I want to be the bridge to the future’
Over the past 10 years, Rhee has educated Asian orthopedic surgeons in countries such as Thailand, India and Indonesia. Through live cadaver demonstration workshops, he teaches about shoulder instability surgery, rotator cuff tear repair, reverse total shoulder arthroplasty and elbow arthroplasty. In addition, Rhee has successfully hosted the annual ConMed Linvatec Asia Arthroscopy Symposium to share his know-how of shoulder arthroscopy, a surgery that uses a tiny camera called an arthroscope to repair the tissues inside or around the shoulder joint. “Learning from Yoo, Fukuda and Matsen was a blessing for me, and now I want to give back what I received to others in need. As one of the first Korean orthopedists who tried to pioneer the field of advanced shoulder surgery, I understand the difficulties they face well,” he said. The biggest thing Rhee did for aspiring Korean orthopedists was writing the textbook, “The Shoulder: Diagnosis and Treatment,” which became a best seller upon its release in 2002. “For me, one of the most difficult parts of learning was the lack of proper textbooks written in Korean. Many were riddled with errors and omissions,” he said. “After returning to Korea in 1993, I had almost no patients. So I began write down useful things while waiting. This habit eventually created an entire book.” He believes Korea has reached the point where it has to set its own medical agenda in order to join the leaders’ pack. “When it comes to surgical techniques, Korean shoulder surgeons are surely among the best in the world. The number of papers they publish is also the second highest only after the Americans. Given the short history of the field in Korea, these are amazing achievements,” he said.
Fast-growing number of orthopedic patients
The two most common shoulder disorders are the rotator cuff tear and adhesive capsulitis, also known as frozen shoulder. A rotator cuff tear refers to a tear of one or more tendons of the four rotator cuff muscles in the shoulder, while adhesive capsulitis refers to a condition characterized by stiffness and pain in the shoulder joint for unclear reasons. According to the Health Insurance Review and Assessment Service, the number of patients with a rotator cuff tear increased to 570,000 in 2014 from 360,000 in 2010. Meanwhile, the number of frozen shoulder patients jumped to more than 2 million from 1.71 million. Such large numbers were unimaginable in the early 1990s, when Rhee started to treat shoulder joint patients in Korea. “When the country was poor, medical services focused more on saving lives, and sometimes on that only,” he said. “Now the focus is shifting to the quality of life. This explains why the numbers are increasing quickly.” Also, the country is living through the era of the baby boomers, that is, 40 to 60 year olds who were born after the Korean War (1950-53) and who today are still very active in outdoor activities such as running, hiking, skiing and playing tennis. Consequently, the demand for treating shoulder joint issues is expected to continue to grow for a while.