• Clinics in Shoulder and Elbow
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• 제22권4호
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• pp.183-189
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• 2019

Background: Since the establishment of biological augmentation to improve the treatment of rotator cuff tears, it is imperative to explore newer techniques to reduce the retear rate and improve long-term shoulder function after rotator cuff repair. This study was undertaken to determine the consequences of a gel-type atelocollagen injection during arthroscopic rotator cuff repair on clinical outcomes, and evaluate its effect on structural integrity. Methods: Between January 2014 and June 2015, 121 patients with full thickness rotator cuff tears underwent arthroscopic rotator cuff repair. Of these, 61 patients were subjected to arthroscopic rotator cuff repair in combination with an atelocollagen injection (group I), and 60 patients underwent arthroscopic rotator cuff repair alone (group II). The visual analogue scale (VAS) for pain and the Korean Shoulder Society (KSS) scores were evaluated preoperatively and postoperatively. Magnetic resonance imaging (MRI) was performed at 6 months postoperatively, to assess the integrity of the repair. Results: VAS scores were significantly lower in group I than in group II at 3, 7, and 14 days after surgery. KSS scores showed no significant difference between groups in the 24 months period of follow-up. No significant difference was obtained in the healing rate of the rotator cuff tear at 6 months postoperatively (p=0.529). Conclusions: Although a gel-type atelocollagen injection results in reduced pain in patients at 2 weeks after surgery, our study does not substantiate the administration of atelocollagen during rotator cuff repair to improve the clinical outcomes and healing of the rotator cuff.

• 대한정형외과학회지
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• 제54권2호
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• pp.91-99
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• 2019

대부분의 환자는 관절경적 회전근 개 봉합술 후 통증이 완화되고 기능적 호전을 보이지만 일부 환자는 수술 후에도 증상이 지속된다. 재파열은 생물학적, 기술적, 외상적 요인이 복합적으로 작용하여 발생한다. 회전근 개 봉합술 후 재파열이 지속되는 통증의 원인일 수도 원인이 아닐 수도 있다. 따라서 이런 환자들의 평가 및 치료는 난해하여 철저한 문진, 이학적 검사, 적절한 영상 검사를 통해서 통증의 원인에 대한 분석이 이루어져야 한다. 재봉합술의 시행 여부는 환자의 나이, 기능적 요구도 회전근 개의 상태, 수술 전 관절 운동 범위, 삼각근의 상태, 관절과 상완 관절의 관절염의 유무에 따라 결정되어야 한다. 성공적인 재봉합술은 술기뿐만 아니라 수술 전 환자 교육 또한 중요하다.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.115-119
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• 1999

Purpose: We reviewed the SLAP lesions and associated injuries, also evaluated a hypothesis that the type II posterior SLAP lesion is related with posterior rotator cuff tear and gives rise to the postero-superior instability. Materials and Methods: The patient recording papers, MRI, video and operation sheets were reviewed with the 28 SLAP lesions confirmed by the arthroscopy among 242 cases. Among these SLAP lesions, type II was 22 cases and classified to the anterior, posterior(16 cases), combined subtype(6 cases) based on the main anatomic location. There were 14 cases of the type II accompanying rotator cuff tear. The average follow-up(13 months) results were evaluated with the ASES and Rowe rating score after repair or debridement of the SLAP lesions. Results: In the type II lesions accompanying the rotator cuff tears(14 cases), the posterior(l0 cases) and combined type(4 cases), cuff lesions were all existed posteriorly. Also We could confirm the drive-through sign in the eleven cases, though did not check the disappearance of this sign after repair because of retrospective study. We could followed up the 22 cases, 18 cases(77%) were excellent or good, fair 3 cases(14%) and poor 1 case(4%). Also, type II lesions with the rotator cuff tear(14 cases) were showed better results in the repair(8 cases) than the debridement(6 cases) of the unstable type II with the cuff repair. Conclusion: The type II lesions were frequently associated with the cuff tear in the specific location. We could presume the possibility of postero-superior instability in the SLAP lesion with the cuff injuries. Also, satisfactory results could be experienced when the unstable SLAP lesions with the cuff tear were repaired at the same time.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1995년도 Symposium and Workshop
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• pp.46-46
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• 1995

We investigated the reliablity of the ultrasonography for diagnosis of rotatar cuff taers. We prepared histological sections of forty shoulder joints In match the ultrasound planes, and conducted a comparative study of tke two sets of images. hi cases of rotator cuff tear, hyperechogenic and cartilaginfication of the tear site were detected as hyperechogenic foci. On the countrary, the regions in which tendon fibers were decreased or absent showed sonolucent areas. We caluculated the echo level of rotator cuff objectively. The area of abnormal echo level and the other regions located in the same depth of the rotator cuff were defined by ultrasonic equipment. The mein difference in these two echo levels was calculated. The mean difference in patients with rotator cuff tears was larger than that in normal cases. These results indicate that ultrasonography is a useful procedure in many patients with rotator cuff lesions.

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.44-47
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• 2014

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

• Journal of Chest Surgery
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• 제51권6호
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• pp.423-426
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• 2018

This study determined the feasibility of the cuff technique for small-caliber vascular grafts in a rat model. A graft was implanted with the cuff technique or suture technique in a 1-cm segment of the abdominal aorta in 12 rats. The mean aortic clamp time was 29 minutes with the cuff technique and 44 minutes with the suture technique; the cuff technique was significantly shorter. Abdominal angiography at 1 week after implantation showed no significant stenosis in 9 rats, focal stenosis of the mid-portion of the graft in 1 rat with each technique, and total occlusion of the graft in 1 rat with the suture technique. We have successfully used the cuff technique for anastomosis for small-caliber vascular grafts in an animal model.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.157-158
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• 2009

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.50-54
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• 2003

Object: To evaluate the efficiencies of the arthroscopic rotator cuff surgery which is Performed without the traction system in the lateral decubitus position. Methods: Twenty-nine cases of the arthroscopic rotator cuff surgery performed without the traction system in the lateral decubitus position were studied from February, 2002 to January, 2005. We performed a repair using the arthroscopic debridement and the arthroscopic rotator cuff repair, or using the mini-open incision technique after the confirmation of rotator cuff tear, then, the arthroscopic subacromial decompression was performed after the confirmation of subacromial lesions Results: We could easily find the subscapularis tear which was often overlooked in the arthroscopic rotator cuff surgery performed with the traction surgery by the relaxation of the subscapularis, as the arm position was internally rotate about 45 to 70 degrees from abducted position. We found that the operation time was reduced 14 minutes shorter than the operation time of the controlled group which had the surgery with the traction system on the average. We also found that there were no neurovascular complications from all cases. Conclusions: The arthroscopic rotator cuff surgery without traction system in the lateral decubitus position provided the better visual field, easy manipulation of the joint and reducing operation time.

• Clinics in Shoulder and Elbow
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• 제18권1호
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• pp.47-51
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• 2015

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.

• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.51-58
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• 2016

The arthroscopic rotator cuff repair is now considered a mainstream technique with highly satisfactory clinical results. However, concerns remain regarding healing failures for large and massive tears and high revision rate. In recent decades, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. The focus of biomechanical test in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. Recent studies have shown that a transosseous tunnel technique provides improved contact area and pressure between rotator cuff tendon and insertion footprint, and the technique of using double rows of suture anchors to recreate the native footprint attachment has been recently described. The transosseous equivalent suture bridge technique has the highest contact pressure and fixation force. In this review, the biomechanical tests about repair techniques of rotator cuff tear will be reviewed and discussed.