• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.175-179
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• 2010

Purpose: Rotator cuff disease is the most common shoulder disease. Rotator cuff tear, which is related to cuff tendon degeneration, is commonly encountered in clinical practice. Materials and Methods: Knowledge about the biology of the normal rotator cuff is fundamental to understanding the pathophysiology of and degenerative processes in rotator cuff tendon tears. Furthermore, such basic knowledge provides a rationale for and facilitates the development of treatment modalities. Results and Conclusion: Therefore, we reviewed the biology of the normal rotator cuff tendon, theories to explain the pathophysiology of rotator cuff tendon tear, and current research on apoptosis of rotator cuff tenofibroblasts.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.98-103
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• 2012

The repair technique of rotator cuff tear has been markedly developed in recent years. When the natural history of rotator cuff tear was followed, the size of rotator cuff tear increased with time. The fatty infiltration which would come at the later period of rotator cuff tear and the rotator cuff tear arthropathy which would be occurred after massive rotator cuff tear may be the important factors in predicting the prognosis of rotator cuff tear or determining the timing of surgery. Because moderate supraspinatus fatty infiltration appeared an average of 3 years after onset of symptoms, the repair of rotator cuff tear was recommended to be performed before that. And if there was massive rotator cuff tear with cuff tear arthropathy, it was recommended that the rotator cuff repair should be performed before the occurrence of the narrowing of acromiohumeral interval. The techniques of arthroscopic rotator cuff repair were mainly the single row repair and the double row repair. The former is good in view of time consuming and cost, but the latter is superior in view of biomechanics. To maintain the benefit in biomechanics of double row technique and reduce the time of surgery, the suture-bridge technique was invented and widely used recently. There are several modified techniques in arthroscopic suture-bridge technique according to the characteristics of rotator cuff tear.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.14-22
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• 2009

회전근 개 부분 파열은 노화의 과정 중 생기는 무증상의 병변 또는 견관절 기능 장애의 잠재적인 원인으로 생각되었다. 발병 원인은 해부학적인 원인에 의한 충돌 또는 반복적 미세 외상 등이 원인으로 이해되고 있으며 병리생태에 관한 이해가 깊어지고 진단 기구, 즉 초음파나 자기공명영상, 관절경 등의 발달로 발생률이 과거에 비해 증가하고 있다. 그러나 회전근 개부분 파열은 질환 자체보다 전층 파열로 진행하는 일종의 질환 스펙트럼(disease spectrum)의 개념으로 전층 파열에 비해 현재까지 발표된 연구 자료가 많지 않다. 즉 회전근 개 부종, 견봉과의 마찰로 생긴 염증성 건병증, 회전근 개 섬유화 및 부분 또는 전층 파열로 진행되는 회전근 개 병변의 스펙트럼의 일부로 간주되는 경우가 많다. 본 종설은 회전근 개 부분 파열의 진단, 파열 분류, 수술의 적응증 및 수술 방법과 그 결과에 대해 논하고자 한다.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.8-12
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• 2006

회전근 개 파열이 왜 통증을 일으키며 어떤 경우 통증을 일으키는가에 대해 아직도 모르는 부분이 많다. 그러나 생 역학적으로 회전근 개 질환을 이해하고 접근하면 순리적으로 풀어져 나가는 부분도 많다. 회전근 개가 파열되었어도 통증이 미약하다면 수술보다는 적극적인 보존적 치료가 원칙이다. 만약 수술을 하는 경우 고식적인 방법으로 충분한 경험을 쌓은 후 관절경술을 시도하여야 한다. 물론 최근 관절경술로 파열된 회전근 개를 봉합하여 주는 것이 선호되고 있으며 치료 결과 역시 관절경술이 더 좋을 수는 있으나 불안정성과 마찬가지로 전례에서 가능한 것도 아니고 만족한 결과를 모든 정형외과 의사가 공히 얻는 것은 아니다. 특히 회전근 개 봉합술은 고도의 관절경술 수기가 요구되는 것이므로 충분한 연마가 요구된다.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.71-76
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• 2008

The pathophysiology of rotator cuff tears and the progression of asymptomatic tears to symptomatic tears are yet unclear and much controversy. It is likely to involve a number of factors such as a genetic predisposition, extrinsic impingement from structures surrounding the cuff and intrinsic degeneration from changes within the tendon itself. Degenerative changes in the rotator cuff with aging seem to be related to the anatomic and mechanical environment of the rotator cuff. The histopathologic appearance of rotator cuff tendon rupture specimens demonstrates a consequence of degenerative changes at the site of tendon insertion into bone. It weakens the tensile strength of the tendon. Is the process of degeneration intrinsic or extrinsic in nature? I suggest that degeneration is intrinsic and not caused by extrinsic factors. Even though, rotator cuff tear may be secondary to multiple factors, I believe that primary cause of rotator cuff tears is preexisting degenerative change.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.167-174
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• 2010

Purpose: Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. Materials and Methods: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan. Results: Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up. Conclusion: Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.92-97
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• 2012

Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.131-131
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• 2008

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.138-139
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• 2009