• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.18-23
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• 2008

Purpose: The purpose of this study is to evaluate the clinical results of the function and stability of ACL reconstruction using the flexible reamer. Materials and Methods: We reviewed 98 patients who taken ACL reconstruction using the flexible reamer from March, 1999 to May, 2004. And the follow-up period was more than 12 months in all cases. We used the subjective tests including Lysholm knee score and 2000 International Knee Documentation Committee(IKDC) subjective knee score, and the objective tests such as anterior drawer test, Lachman test, pivot shift test, and KT-2000 arthrometer to evaluate the clinical results. Results: In the range of motion of the affected knee, the extension deficit more than 5 degree was 8 cases preoperatively and 1 case postoperatively. The flexion deficit more than 5 degree was 12 cases preoperatively and 2 cases postoperatively. The mean Lysholm knee score was 61.3 point(${\pm}3.5$ SD) preoperatively and 87.7 point(${\pm}2.0$ SD) postoperatively. The mean 2000 International Knee Documentation Committee(IKDC) subjective knee score was 49 point(${\pm}3.3$ SD) preoperatively and 84 point (${\pm}2.2$ SD) postoperatively. 93 cases were more than grade II in Lachman test preoperatively and 5 cases postoperatively. 71 cases were more than grade II in pivot shift test preoperatively but 89 cases were negative postoperatively. The mean maximal manual difference by KT-2000 arthrometer was 6.8 mm(${\pm}1.9$ SD) preoperatively and 1.8 mm(${\pm}0.8$ SD) postoperatively. Conclusion: ACL reconstruction using the flexible reamer achieved the ideal isometric point of femur and anatomic graft placement, so we could obtain good results, especially in rotational stability.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.67-72
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• 2011

Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.180-188
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• 2009

Purpose: We evaluate the short-term clinical outcome of arthroscopic rotator cuff tendon repair with suture-bridge technique in patients with full thickness rotator cuff tear. Materials and Methods: 29 (male:17, female:12) consecutive shoulders treated with this index procedure and early rehabilitation were enrolled. Mean age was 56.4 years (range, 34~73 years) and mean follow-up period was 13 months (range, 12-15 months). Clinical outcomes were evaluated by using the University of California Los Angeles (UCLA) score, the Korean Shoulder Scoring System (KSS) and Visual Analogue Scale (VAS). Postoperative cuff integrity was evaluated through magnetic resonance imaging (MRI) and categorized by Sugaya classification. Results: Postoperative UCLA scores improved from 16.4 to 31.6 (p< 0.05) and KSS scores showed 88 at 6 months and 92 at last follow up. Preoperative VAS score was 8.6, which was decreased to 2.1 at 3 months and 1.4 at 6 months postoperatively. 28 patients (96.5%) had increase in range of motion. The follow up MRI was taken in 15 shoulders and the cuff integrity was type I in 6 cases, type II in 7, type III in 1 and type V in 1 by Sugaya classification. Conclusion: Arthroscopic suture-bridge technique resulted in good or excellent clinical outcome in 96.5% of the cases, so we think this technique is one of the reliable procedure for full-thicknes rotator cuff tear.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.61-67
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• 2021

Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.

• Journal of the Korean Arthroscopy Society
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• v.7 no.2
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• pp.160-168
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• 2003

Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.1-6
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• 2014

Purpose: In order to know the effectiveness of ultrasonographic examination in diagnosis and follow-up evaluation for the frozen shoulder, we compared those with contralateral side in initial and after steroid injection. Materials and Methods: For the 20 unilateral frozen shoulder from July 2012 to July 2013, ultrasonographic examination was tried using reference line 1 (CBT: distance from coracoid process to LHB tendon) and line 2 (CBG: distance from coracoid process to bicipital groove). We tried 1 time steroid injection and compared the improvement in gross motion and reference line with 2 month, 4 month, and 6 month's serial ultrasonographic examination. Results: The differences on CBT line between lesion side and normal side were -5.6 mm, -5.0 mm, and -4.3 mm in neutral (Neut), external rotation (ER) and internal rotation (IR), respectively. The differences on CBG line were -6.1 mm, -4.7 mm, and -5.0 mm respectively (p<0.05). The changes in the reference line after steroid injection were evaluated at 2 month (CBT: -4.8 mm, -3.5 mm, -2.6 mm / CBG: -4.7 mm, -4.0 mm, -3.6 mm), 4 month (CBT: -4.7 mm, -3.2 mm, -1.7 mm / CBG: -4.3 mm, -3.7 mm, -1.2 mm), and 6 month (CBT: -1.1 mm, -2.9 mm, -0.5 mm / CBG: -1.2 mm, -0.7 mm, -0.9 mm). The gross motion was improved at 4 month after injection, from elevation $108^{\circ}$, ER $32^{\circ}$, IR L5 in initial to $133^{\circ}$, $42^{\circ}$, L3 respectively (p<0.05). Pain improved from 7.5 in initial to 3.0 at 2 month on visual analog scale (VAS). Conclusion: The serial examination after steroid injection revealed that the delayed improvement on reference line (6 month) compared with pain (2 month) or gross motion (4 month). Dynamic ultrasonogram was useful in diagnosis and follow-up evaluation of frozen shoulder.

• Journal of Korean Physical Therapy Science
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• v.15 no.4
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• pp.27-34
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• 2008

Background: This study was designed to analyze Repetitive dorsiflexion exercises in ankles have effects on the active range of flexion and extension motion through lumbar, cervical spine and ankle, wrist joints. Methods: 30 female college students in their twenties who frequently wear high heels participated the number of the experimental group was 15 persons and the number of the control group was 15 persons. They did exercise at the physical therapy room in M college, from the 8th of March to the 11th of April 2007. The experimental group had used the model of dorsiflexion repetitive exercise three times per week, for 4 weeks, but the control group did not exercise at all. In the sagittal plane active ROM of the these spine and joints were measured before and after the experiment using a digital goniometer. The results of two groups were compared and analyzed using paired T-test. Results: The active range of flexion and extension motion of the vertebra(especially lumbar flexion) and distal joints were significantly different in exercise group(p<.05). Conclusion: The model of repetitive dorsiflexion exercise of the ankle joint had positive effects on improving the active range of flexion and extension motion of the lumbar vertebra and distal joints of limbs. The results suggest that the repetitive dorsiflexion exercise is useful and also effective therapy for improving motion in women usually wearing high-heel.

• Journal of the Computational Structural Engineering Institute of Korea
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• v.33 no.3
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• pp.145-152
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• 2020

In this study, we evaluated spinal stability based on the change in the thoracolumbar fixation segment using finite element analysis (FEA). To accomplish this, a finite element (FE) model of a normal thoracolumbar spine (T10-L4), including intervertebral discs (IVD), ligaments, and facet joints, was constructed, and the material properties reported in previous studies were implemented. However, L1 was assumed as the lesion site, and three types of posterior fixation, namely, L1-L2, T12-L2, and T12-L1-L2, were implemented in the thoracolumbar FE model. In addition, the loading conditions for flexion, extension, lateral bending, and axial rotation were adopted. Through the series FEA, the deformation, equivalent stress, range of motion, and moment on the pedicle screws, vertebrae, and IVD were calculated, and the spinal stability was evaluated based on the FEA results.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.18 no.1
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• pp.83-86
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• 2012

Background: The research examined the effect of a scapular stabilizing exercise on shoulder pain, active range of motion (AROM) and changes in the position of the shoulder blade of patients with frozen shoulder. Methods: General physical therapy and a scapular stabilizing exercise were applied to a 53-year-old female patient with frozen shoulder three times a week for four weeks. Before and after the therapy, measurements were made on the visual analog scale (VAS) and of the AROM, and a lateral scapular slide test was conducted. Results: Following the therapy, VAS fell from 7 to 3. Before therapy, flexion, abduction, internal rotation, and external rotation recorded $133^{\circ}$, $102^{\circ}$, $45^{\circ}$, and $53^{\circ}$ respectively; after the therapy they increased to $150^{\circ}$, $123^{\circ}$, $55^{\circ}$, and $65^{\circ}$ respectively. The lateral scapular slide test showed sliding distances before therapy of 8.5cm at $0^{\circ}$, 9.2cm at $45^{\circ}$, and 11.3cm at $90^{\circ}$; after therapy, the distances decreased to 6.8 cm at $0^{\circ}$, 8.2 cm at $45^{\circ}$, and 9cm at $90^{\circ}$. Conclusion: The scapular stabilizing exercise was effective in alleviating shoulder pain, increasing AROM, and reducing changes in the position of the shoulder blade of frozen shoulder patients.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.655-666
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• 2013

PURPOSE: The main objective of this study is observing the effects of the functional postural trunk exercise (FPTE) on deep cranio-cervical flexor (CCF) muscle endurance applied on neck pain patients suffering from the acute whiplash-association disorder (WAD). METHODS: The study was tested with 47 patients with neck pain. All patients were equally treated with the ordinary therapy, only experimental group (n=23) was treated with FPTE: assumption of an upright lumbo-pelvic and spinal postural position, adding a neck lengthening manoeuvre in addition. Patients attended physical therapy for 3 times a week, for 4 weeks. Visual analogue scale (VAS) for pain, neck disability index (NDI), range of motion (ROM), were recorded both before and after the intervention. Also muscle activity in the CCF test was employed to analyze the changes between before and after. RESULT: After 4 weeks of training intervention, a remarkable increase in muscle endurance, rotation, extension ROM (p<.05) and decrease in pain and NDI (p<.05) in both groups. Further, the differences between groups were muscle endurance (F=60.350, p<.01), pain, and the left rotation ROM (p<.05). CONCLUSION: From the results, the experimental group had significant the increase in muscle endurance, and the significant decrease in pain. Whilst further research in this category is necessary, these observations suggest that applying exercise in early diagnosis can be of help to treat the neck pain patients suffering from the WAD.