• Clinics in Shoulder and Elbow
• /
• v.6 no.1
• /
• pp.1-7
• /
• 2003

Myofascial pain이나 filbrbomyalgia 등에 의한 만성 견관절통증은 보존적 치료로 치료적인 효과를 기대할 수 있는 질환이며, 수술적 치료가 필요한 다른 질환과의 감별을 요한다. 만성적인 견관절 동통의 치료는 증상의 원인과 악화요인을 확인하고 실질적으로 도움이 될 수 있는 적절한 치료법을, 단계적으로 적용하는 것이 효과적이며. 환자와 teamwork을 형성하여, 환자가 병증에 대해 충분히 이해하고 안심할 수 있도록 도와주는 것이 무엇보다 중요하다.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.134-139
• /
• 2011

Purpose: We wanted to review the arthroscopic Remplissage technique and introduce our experiences with it for treating recurrent shoulder instability with a large Hill-Sachs lesion. Materials and Methods: The arthroscopic Remplissage technique with Bankart repair is performed in patients with no osteoarthritis, no fracture around the shoulder, a history of recurrence more than 10 times, a large Hill-Sachs lesion more than 30 to 40% of the humeral articular surface and glenoid bone loss less than 20%. Results and Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique resulted in a good outcome for the shoulder stability, and good clinical and functional results.

• Clinics in Shoulder and Elbow
• /
• v.16 no.2
• /
• pp.148-152
• /
• 2013

We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.53-58
• /
• 2011

Purpose: We evaluated the minimal 1 year follow-up results (shoulder stability and the clinical and functional results) for the Remplissage technique to fill a Hill-Sachs lesion. Materials and Methods: The subjects were 12 patients who could be followed up for more than 12 months after the "Remplissage" procedures in our hospital from December 2008 to November 2009. Their mean age was 27.9 years old and the mean follow-up was 19 months. The evaluations included the ROM, the ASES score, the KSSI score, the ROWE score and postoperative MRI. Results: On the postoperative functional evaluation after an average of 16 months, the ASES score improved from 50.8 preoperatively to 78.3 postoperatively, the KSSI score improved form 44.5 preoperatively to 81.0 postoperatively and the ROWE score improved from 40.2 preoperatively to 84.3 postoperatively. After an average 14 months for all the cases, the range of movement was nearly in the normal range, which is 178.6${\pm}$18.6 (165~180) degrees for forward flexion and 49.3${\pm}$10 (43~60) degrees for external rotation. Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique has a good outcome after more than 1 year follow-up in terms of the shoulder stability and the clinical and functional results.

• Journal of the Korean Arthroscopy Society
• /
• v.7 no.1
• /
• pp.81-86
• /
• 2003

Purpose : The clinical consequences of arthroscopic Bankart repair using suture anchor with non-absorbable suture as well as various factors, expected to have an effect on the prognosis of disease, have been evaluated and compared through preoperative and postoperative modified Rowe score. Materials and Methods : Twenty-eight cases were evaluated for the subject of this study, which enabled us to follow up at least for more than 18 months from lune, 1997 to May, 2001. Modified Rowe score was used for the evaluation of preoperative and follow-up shoulder function and stability. After setting up 9 factors expected to affect a prognosis, a statistical verification was conducted. Results : The postoperative Rowe score was 87.3, while preoperative Rowe score was 28.4 and the Rowe score was improved significantly(p=0.000). There were 1 case of redislocation and 2 cases of limitation of motion in the shoulder. In prognostic factor analysis through Rowe scoring system. Rowe score of their age at a trauma under 20 years was greater than that of above 20 years and it was significant(p=0.023). Conclusion : It was thought that arthroscopic Bankart repair using suture anchor was one or useful treatment method for recurrent shoulder dislocation patients. It was considered that their age at initial trauma was the factor to affect a prognosis.

• Clinics in Shoulder and Elbow
• /
• v.2 no.2
• /
• pp.157-169
• /
• 1999

Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.12 no.1
• /
• pp.29-36
• /
• 2013

Purpose: Proprioceptive function has been known to be important to shoulder stability. However, the function in rotator cuff tear patients is rarely investigated. The purpose of current study is to report the proprioceptive function in rotator cuff tear patients and to analyze the proprioceptive function regarding the tear size and the presence of subscapularis tear. Materials and Methods: Between 2011 and 2012, total 76 patients (male 28 and female 48) were recruited and average age was 61.7 years old (range, 38~76). Preoperatively, joint position senses in internal and external rotation were measured for proprioceptive function testing by method of active re-positioning technique. The absolute difference from set point was measured. Proprioceptive function was further analyzed according to tear size of rotator cuff, the presence of subscapularis tear, visual analogue scale of pain, shoulder functional score (American society of elbow and shoulder score), and ranges of motion in shoulder. Results: The absolute difference for external rotation was $4.9^{\circ}{\pm}2.9^{\circ}$, in normal joint and $4.9^{\circ}{\pm}3.0^{\circ}$for involved joint in rotator cuff tear patients. This difference was not significant statistically (p=0.87). The absolute difference for internal rotation was $4.0^{\circ}{\pm}2.7^{\circ}$in normal joint whereas $4.8^{\circ}{\pm}3.7^{\circ}$ for involved joint showing statistically significant difference (p=0.043). There was some trend that the proprioceptive function of internal rotation was more impaired in the bigger tear size group (more than medium tear) compared to the smaller tear size group (partial thickness and small tear, 5.0 vs. 4.0, p=0.061). The impairment of internal rotation proprioception was also accentuated in patients with subscapularis tear (4.8 vs. 4.0, p=0.065). The proprioceptive function of internal rotation was decreased when the pain visual analogue scale was increased (5.2 vs. 4.0 p=0.04), shoulder functional score was decreased (6.1 vs. 4.2, p=0.005), or range of motion in shoulder joint was restricted (5.3 vs. 3.7, p=0.041). Conclusion: The deficit of proprioceptive function was observed in rotator cuff tear patients. Proprioception for internal rotation was impaired in patients with the bigger tear size and subscapularis tear. Pain, shoulder function score, and range of motion were also shown to be related with the deficit in proprioceptive function.

• The Korean Journal of Nuclear Medicine
• /
• v.38 no.4
• /
• pp.288-293
• /
• 2004

Purpose: increased uptake of wrist and hand joints in three phase bone scintigraphy (TPBS) have been used in the detection of reflex sympathetic dystrophy syndrome (RSDS). TPBS frequently shows increased shoulder uptake in the hemiplegic RSDS patients. We investigated the significance of the shoulder uptake in the detection of these patients. Materials and Methods: Twenty three patients who had hemiplegia due to brain stroke and diagnosed as RSD were enrolled in this study (M:F=16:7, R:L=11:12). The mean age was $63{\pm}10$ yrs. Ter normal volunteer (mean age: $60{\pm}5$, M:F=1:9) data was used as control group. TPBS was performed $59{\pm}32$ days after stoke (acute stage). We obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in three phase images and compared to the count ratios of shoulders in the delayed image. Hand ROI included an ipsilateral wrist. Sensitivity of detecting the affected limb was defined using the right/left count ratio of normal control. Results: Sensitivities using count ratios of hand blood flow, blood pool and delayed image were 45%, 76% and 78%, respectively. Sensitivity of shoulder count ratio was 74%. Log of right/left counts of hand delayed image and that of shoulder delayed image were correlated well with statistical significance (Spearman's R=0.824, p<0.001). Conclusion: Shoulder uptake showed good correlation with hand uptake in the delayed image of TPBS. Shoulder uptake maybe helpful in the diagnosis of reflex sympathetic dystrophy syndrome in patients with hemiplegia.

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 1999.03a
• /
• pp.8-8
• /
• 1999

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2008.03a
• /
• pp.13-13
• /
• 2008