• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.89-95
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• 2006

Purpose: Arthroscopic repair of rotator cuff tears are many techniques that have been developed to improve the initial postoperative strength of the repair. There was a doubt that current arthroscopic cuff repairs using a single row of suture anchors reproduce insufficient area of the anatomic cuff insertion, and concerns about failure of fixation often lead surgeons to limit early motion. Newer technique of double-row repair in arthroscopic treatment may provide initial stronger fixation and more contact with bone at the repair site than single-row repair did. We studied the comparison between clinical outcomes of arthroscopic single- and double-row repair in cuff tears at 1year postoperatively. Materials and methods: We retrospectively analyzed 40 shoulders with single-row repair and 38 shoulders with double-row repair of full-thickness rotator cuff tears between May 2002 and October 2004. Out of total 78 shoulders, 42 (54%) were male patients and 36 (46%) were female patients and the mean age at surgery was 56 years. All patients were diagnosed by physical examination and MRI. At 1year' follow-up after operation, we evaluated with the ASES and the Constant scoring system, and measured muscle power of abduction, internal and external rotation of the affected shoulder then compared with each other. Results: Mean ASES scores and Constant scores in double-row repair group improved more than single-row repair group significantly at 1year postoperatively. Muscle power of abduction and internal rotation, especially abduction power, improved more significantly in double-row repair group than in single-row repair. Conclusion: Arthroscopic double-row repair for the full thickness rotator cuff tear may be a superior technique, which showed better clinical outcomes and restoration of muscle power compared with single-row repair at relatively short period of postoperative follow-up. Restoration of footprint close to normal anatomy by double-row repair seems to play an important role in the recovery of muscle strength.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.201-207
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• 2017

Background: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a $70^{\circ}$ arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. Methods: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a $30^{\circ}$ arthroscope in the conventional group, but two portals and a $70^{\circ}$ arthroscope as well as the $30^{\circ}$ one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. Results: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the $70^{\circ}$ arthroscope. Conclusions: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a $70^{\circ}$ arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.73-77
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• 2007

Purpose: This study reports the clinical results of the arthroscopic repair of type II SLAP lesion with bio-knotless anchor. Materials and Methods: 25 cases of 25 patients (20 male, 5 female) were included in this study. The average age was 44.5 years old. Preoperative ASES score was average 44. Arthroscopic SLAP repair with 1 or 2 bio-knotless anchors were performed in all cases. The average follow up period was 15 months. Results: The ASES score improved to average 92.7 at last follow up period and 23 cases had full range of motion of the shoulder. 2 case had mild limited range of motion of the shoulder without any problem in normal activity. Conclusion: Arthroscopic repair with bio-knotless anchor in type II SLAP lesion is one of the good methods because of the good clinical results.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.23-30
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• 2005

Purpose: This paper analyzes the results of arthroscopic bankart repair for anterior recurrent dislocation following a trauma on shoulder. Material and Methods: The subjects were twenty-three (23) cases that were available to follow up for more than eighteen months during the period from November 2001 to June 2003 and were chosen from patients to whom arthroscopic bankart repair was applied using a knotless suture anchor for their traumatic anterior recurrent dislocation on the shoulder. Their average age was 28 (ranging from 15 to 60) with 20 males and 3 females. The injury from sports activities accounted for the most cases with 14 subjects. The average follow-up period was 27 months (ranging from 18 months to 35 months). There were 19 cases of bankart lesions, 4 cases of ALPSA lesions and associated with 5 cases of partial tear in the rotator cuff. The anchors employed were knotless anchor (Mitek) for all the cases. Rowe scoring scale was adopted to judge the results after operations. Patients' subjective satisfaction and range of motion of external rotation were addressed together. Results: Rowe scores showed that 20 cases (87%) reaches the level of 'good' and hinger. The average patients' satisfaction accounted for 90 points out of 100. It was also found that external rotations averagely decreased by 6.5 degree when the range of motion was in at the side. Conclusion: There were satisfactory results of arthroscopic bankart repair using knotless suture anchors as an operative treatment for traumatic anterior recurrent dislocation on shoulder.

• Clinics in Shoulder and Elbow
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• v.21 no.4
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• pp.234-239
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• 2018

Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.11-19
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• 2020

Background: The purpose of this study was to evaluate and compare deltoid origin status following large rotator cuff repair carried out using either an open or an arthroscopic method with a propensity score matching technique. Methods: A retrospective review of 112 patients treated for full-thickness, large rotator cuff tear via either a classic open repair (open group) or an arthroscopic repair (arthroscopic group) was conducted. All patients included in the study had undergone postoperative magnetic resonance imaging (MRI) and clinical follow-up for at least 12 and 18 months after surgery, respectively. Propensity score matching was used to select controls matched for age, sex, body mass index, and affected site. There were 56 patients in each group, with a mean age of 63.3 years (range, 50-77 years). The postoperative functional and radiologic outcomes for both groups were compared. Radiologic evaluation for postoperative rotator cuff integrity and deltoid origin status was performed with 3-Tesla MRI. Results: The deltoid origin thickness was significantly greater in the arthroscopic group when measured at the anterior acromion (P=0.006), anterior third (P=0.005), and middle third of the lateral border of the acromion level (P=0.005). The deltoid origin thickness at the posterior third of the lateral acromion was not significantly different between the arthroscopic and open groups. The arthroscopic group had significantly higher intact deltoid integrity with less scarring (P=0.04). There were no full-thickness deltoid tears in either the open or arthroscopic group. Conclusions: Open rotator cuff repair resulted in a thinner deltoid origin, especially from the anterior acromion to the middle third of the lateral border of the acromion, at the 1-year postoperative MRI evaluation. Meticulous reattachment of the deltoid origin is as essential as rotator cuff repair when an open approach is selected.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.9-13
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• 2005

An isolated tear of the subscapularis is uncommon, and there are a few literatures regarding the treatment of this problem. But, the incidence has increased with development of the arthroscopic techniques. An all-arthroscopic rotator cuff repair is a challenging procedure that can be effectively performed for treatment of subscapularis tendon tears. Often, tears of the subscapularis tendon do not involve entire tendon, and retraction of the torn edge is within to 2 cm of its attachment site. Occasionally, the entire tendon is torn and retracted medially to the glenoid. This article outlines the examination, preoperative planning and details the steps necessary to perform this procedure on upper third of subscapularis tears.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.66-71
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• 2012

The posterior root of medial meniscus maintains normal meniscal function by circumferential hoop tension and prevents extrusion of meniscus and progression of osteoarthritis. A complete tear of posterior root of medial meniscus leads to loss of hoop tension, it is important to repair it and preserve the function of the medial meniscus. Recently, a variety of arthroscopic assisted reduction and repair techniques have been used. We create an arthroscopic all-inside suture technique using a 18 gauge spinal needle and suture anchor that is easier and more convenient compared with the previous techniques. So we report this technique with a review of current literatures.

• Journal of Korean Foot and Ankle Society
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• v.25 no.1
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• pp.25-31
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• 2021

The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.183-188
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• 2017

Background: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon. Methods: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography. Results: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively). Conclusions: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.