• Title/Summary/Keyword: 재파열

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Usefulness of Serial Ultrasonography of the Rotator Cuff Repair (회전근 개 파열의 수술적 치료시 초음파 연속 검사의 유용성)

  • Park, Jae-Hyun;Choi, Won-Ki;Choi, Chang-Hyuk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.78-85
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    • 2008
  • Purpose: The findings of preoperative magnetic resonance imaging (MRI) and ultrasonography (US) examination in the diagnosis of rotator cuff tear were then compared with the findings of arthroscopic examination, and to evaluate the postoperative integrity of rotator cuff using serial US examination. Methods: Between February and May 2008, 29 patients with rotator cuff tear had undergone preoperative US and MRI examination and subsequent arthroscopic examination. And the results of MRI and US were compared with intra-operative results of the arthroscopic examination. We observed the postoperative integrity of rotator cuff using serial (postoperative 2 weeks, 6 weeks, 3 months) US examination. Results: The sensitivity of US and MRI for identifying rotator cuff tear were 100% and 100%. The sensitivity of US and MRI were 95% and 82% in full thickness tear, and 50%, 33% in partial thickness tear, respectively. Overall accuracy of US and MRI were 86%, 69%. Among 22 patients were operated for full thickness tear, intra-operative gap formation was identified in 11 patients (50%, small to medium 2 cases, large to massive 9 cases) which were identified at 2 weeks postoperative US. We could find 5 re-tears (23%, small to medium 1 case, large to massive 4 cases) on 6 weeks postoperative US after passive range of motion (ROM) exercise, and could also find 7 re-tears (32%, small to medium 2 cases, large to massive 5 cases)on 3 months postoperative US after active ROM exercise. Conclusion: Serial US after arthroscopic rotator cuff repair was useful to differentiate intra-operative gap formation from postoperative re-tear. We found 5 retears (23%) at 6 weeks and 7 retears (32%) at 3 months postoperative US, it was useful to make treatment plan during postoperative rehabilitation.

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Revisional Rotator Cuff Repair (회전근 개 재파열 후 봉합술)

  • Kim, Kyungil;Jeong, Jinyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.91-99
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    • 2019
  • Most patients experience pain relief and functional improvement after arthroscopic rotator cuff repair. In some patients, however, symptoms still remain after surgery. Failed rotator cuff repair is a complex outcome of biological, technical, and traumatic factors. Moreover, re-tears might or might not be the main cause for patients with persistent pain after rotator cuff repair. Therefore, a thorough understanding of the patient's history, physical examination, and appropriate imaging studies will be needed to evaluate and manage these patients. The patient's age, functional requirement, quality of the rotator cuff, preoperative range of motion, quality of the deltoid, and glenohumeral arthritis are factors to consider before performing revisional rotator cuff repair. Preoperative patient education is as important as the surgical technique for successful revisional rotator cuff repair.

Revision Rotator Cuff Repair (회전근 개 봉합술 후 재수술)

  • Kim, Young-Kyu;Kim, Dong-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.119-125
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    • 2009
  • The primary purposes of revision repair for a failed rotator cuff repair are a relief of pain and functional improvement. Therefore, revision repair is most proper in patients with the functional deficit accompanied with the shoulder weakness as well as the persistent pain. The important factor that is considered in revision repair is a quality of torn cuff. Especially, Care must be taken to ensure that the revision repair is possible, considering the size of tendon defect, atrophy of the muscle, fatty infiltration and extent of the retraction of tendon. Revision repair of a failed rotator cuff repair is more difficult, and the functional results are less satisfactory than those of primary repair, because excessive bursal scarring and tendon retraction may be exhibited, a large or massive tear is often detected, tear has usually been present for a long time, and a quality of muscle-tendon may be poor. So, we discuss our experiences related to revision repair after a failed cuff repair that has been recently introduced through the articles.

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The Prediction of Structural Behavior for Composite Pressure Vessel with Changed Dome Shape (돔 형상 변화에 따른 복합재 압력용기의 구조 거동 예측)

  • Hwang, Tae-Kyung;Park, Jae-Byum;Kim, Hyung-Kun;Doh, Young-Dae
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2008.11a
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    • pp.288-292
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    • 2008
  • Dome shape design method of filament wound (FW) composite pressure vessel, which can create various dome shape with fixed boss opening, was suggested. And, the performance indices (PV/W) for composite pressure vessel with same boss opening but different dome shape were investigated by finite element analysis (FEA) and hydro-test. The FEA showed good agreement with test results for burst pressure. Generally, as the dome shape of pressure vessel was changed to flat dome, the inner volume is increased and the burst pressure is decreased. In the case of above ${\rho}_o$=0.54, the performance index showed decreased value due to the low burst pressure. However, at ${\rho}_o$=0.35, the dome shape change brings not significant reduction of burst pressure and performance index.

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Ultrasonographic Assessment for Rotator Cuff Repair According to the Tear Sizes and the Repair Method (회전근 개 파열의 크기 및 봉합 방법에 따른 초음파를 이용한 추적검사의 유용성)

  • Choi, Chang-Hyuk;Park, Jae-Hyun;Shin, Dong-Young;Lee, Jae-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.53-61
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    • 2009
  • Purpose: This study was designed to evaluate the clinical usefulness of serial ultrasonography (USG) after arthroscopic rotator cuff repair and to assess the re-tear rate and the re-tear time according to the tear sizes and the repair method. Materials and Methods: Between January 2008 and June 2008, 52 patients were treated with arthroscopic rotator cuff repair, Of the 52 patients, 29 patients that had undergone more than six months follow-up underwent preoperative USG examinations and subsequent arthroscopic examinations. MRI and USG findings were compared with intraoperative results of arthroscopic examinations. The postoperative integrity of the rotator cuff was observed using serial USG examination performed postoperatively at two weeks, six weeks, three months, and six months. Results: Small to medium rotator cuff tear were identified in 10 patients where the double pulley suture bridge (DPSB) technique was performed; the re-tear rate was 20%. For 19 patients with large to massive rotator cuff tears, the re-tear rates was 100% for six patients who had undergone tendon to tendon (TT) repair, the re-tear rate was 50% for two patients who had undergone tendon to tendon and bone to tendon (TTBT) repair and the re-tear rate was 55% for11 patients where the DPSB technique was performed. Re-tear rates according to follow-up periods were 7% from two to six weeks, 66% from six weeks to three months and 27% from three to six months postoperatively. Conclusion: Serial USG examinations after arthroscopic rotator cuff repair were useful to assess the re-tear rate and the re-tear time. In addition, USG examination were useful for treatment planning during postoperative rehabilitation.

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The Structural Integrity Evaluation of Composite Pressure Vessel Using Acoustic Emission (음향방출을 이용한 복합재 압력용기의 건전성 평가)

  • 이상호;최용규
    • Journal of the Korean Society of Propulsion Engineers
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    • v.1 no.2
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    • pp.1-11
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    • 1997
  • During hydroproof test of composite pressure vessel, acoustic emission signal was measured and analyzed to evaluate structural integrity of composite motor case. When pressure was held for 1 min. at constant pressure from low pressure level to high pressure level, the pattern of hit rate of good composite pressure vessel is increased with higher value than that of bad composite pressure vessel. This report also presents detection possibility of burst location approximately in the range of 25∼36% of burst pressure using energy rate. In case that it is difficult to detect burst location of composite motor case, it is possible to detect burst location, i.e. structurally weak location of composite pressure vessel with applying same pressure lower than maximum expected operating pressure(MEOP) repeatedly.

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Risk Factor for Poor Clinical Outcome in Patients with Retear after Repair of the Rotator Cuff (회전근 개 파열 봉합술 후 재파열 환자에서 불량한 임상 결과의 원인 인자)

  • Lee, Hee Jae;Joo, Il Han;Hur, Jeong Min;Oh, Hyun Keun;Lee, Bong Gun
    • 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.

The Radiologic and Clinical Changes after Open Complete Repair of Massive Rotator Cuff Tears (개방적 완전 봉합술로 치료한 광범위 회전근 개 파열 환자에서 치료 전후의 방사선학적 및 임상적 소견의 변화)

  • Moon, Eun-Sun;Choi, Min-Sun;Kim, Myung-Sun;Kong, Il-Kyu;Kim, Byoung-Jin
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.109-114
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    • 2009
  • Purpose: This study evaluated the preoperative and postoperative radiologic findings of patients with complete repairs after massive rotator cuff tears along with the incidence of re-tear and the clinical outcomes. Materials and methods: This study evaluated 33 cases who had open complete repairs for massive rotator cuff tears and these patients were followed up for more than 24 months. The clinical evaluation was performed according to the shoulder joint function test of the American Shoulder and Elbow Surgeons (ASES), and the degree of arthritis related to the massive rotator cuff tears was evaluated using the Hamada classification. Results: The ASES scores improved from 37.6 preoperatively to 85.6 postoperatively. The mean preoperative acromio-humeral interval (AHI) score was 6.5 mm, which increased to 9.3 mm immediately after surgery, and there was a decreased to 6.5 mm noted at the last follow up. The lower radiology stages of arthritis according to the classification showed better preoperative and postoperative results. Conclusion: An open complete repair as the surgical treatment for a massive rotator cuff tear showed satisfactory results for pain relief and an improvement in the shoulder joint function though re-tear after surgery.

A Bucket Handle Tear after Revisional Meniscal Allograft Transplantation in Lateral Meniscus - A Case Report - (외측 반월상 연골 재이식술 후 발생한 양동이형 파열 - 증례 보고 -)

  • Yang, Jae-Hyuk;Kim, Taik-Sun;Park, Sung-Bum;Yoon, Jung-Ro
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.56-59
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    • 2012
  • Meniscal allograft transplantation (MAT) is an accepted treatment for the symptomatic postmeniscectomized knee in younger patients. However, the likelihood of a successful outcome is reduced by various complications. One of the complications after MAT is manifested as grafted meniscal tear. However, a bucket handle meniscal tear (BHMT) following MAT is an uncommon complication and furthermore a BHMT after revisional MAT (RMAT) is a extremely rare complication. We encountered a case of BHMT after RMAT in a lateral meniscus. Retrospectively reviewing the case, we could assume the cause, which would be helpful to prevent the complication in further MAT procedures.

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Correlation of Clinical Outcome and Cuff Integrity after Open Repair in Large and Massive Rotator Cuff Tears (대형 및 광범위 회전근 개 파열의 개방적 봉합술 후 임상적 결과와 회전근 개 연속성(integrity)의 상관 관계)

  • Noh, Haeng-Kee;Wang, Joon-Ho;Kim, Dong-Hwee;Park, Jong-Woong;Kim, Jae-Gyoon;Park, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.65-72
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    • 2007
  • Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.