• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.153-162
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• 2013

The arthroscopic bony procedures during rotator cuff repair include acromioplasty, distal clavicle resection, footprint preparation and coracoplasty. The indication of each bony procedure is based on the theoretical reasons, and various types of surgical techniques are available. The purpose of this review article is to review the backgrounds of the indication and surgical techniques in the arthroscopic bony procedures during rotator cuff repair.

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.4-7
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• 2011

Rotator cuff disease is one of the most common shoulder problems. When dealing with patients suffering from rotator cuff disease, whether to perform surgery or not is the most common difficulty faced by the outpatient clinic. Choosing the adequate operation time as well as the method of operation is important when deciding to perform surgery. Selecting the type of non-surgical treatment is an important issue when opting not to perform surgery. This review article will focus on the decision-making process involved in the treatment of rotator cuff disease.

• Clinics in Shoulder and Elbow
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• v.22 no.2
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• pp.100-105
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• 2019

Suture anchors are commonly used in shoulder surgeries, especially for rotator cuff tears. Peri-anchor cyst formation, however, is sometimes detected on follow-up radiologic image after surgery. The purpose of this report is to discuss the case of a patient who presented with regression of extensive peri-anchor cyst on postoperative 4-year follow-up magnetic resonance imaging and had good clinical outcome despite peri-anchor cyst formation after arthroscopic rotator cuff repair.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.269-278
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• 2022

Objective: The aim of this study was to evaluate the effects on pain and function of patients with rotator cuff tendinopathy when applying trigger point of infraspinatus and teres minor to myofascial trigger point release (MFR) plus mobility exercise and MFR. Design: A randomized controlled trial. Methods: The total participants were 30patients and were separated to MFR plus mobility exercise group(n=15) and MFR group (n=15) according to the randomized treatment method. The MFR was performed at two infraspinatus tampon points and one teres minor tampon point for twice a week for 4 weeks and the treatment time was 6 minutes 20 seconds in each position. The MFR group also carried out the myofascial trigger point release in the same way as the MFR plus mobility exercise group. Results: The MFR plus mobility exercise group significantly reduced objective and subjective pain (p<0.05). The range of motion of the shoulder joint flexion and external rotation, Quick-Disability of the Arm, shoulder and Hand, and Shoulder Pain and Disability Index were significantly improved in the group to which MFR plus mobility exercise was applied (p<0.05). Conclusions: These results confirmed that MRF plus mobility exercise is more effective in relieving shoulder pain and improving function in rotator cuff tendinopathy.

• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.173-181
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• 2022

Background: Healing of the tendon itself is not always related to successful clinical outcomes after rotator cuff repair. It was hypothesized that certain radiologic factors affecting clinical outcomes could exist in case of the retear after arthroscopic rotator cuff repair (ARCR) and the radiologic factors could help predict clinical process. The purpose of this study was to identify the radiologic factors associated with clinical outcomes of the retear after ARCR. Methods: Between January 2012 and December 2019, among patients with sufficient footprint coverage for ARCR, 96 patients with Sugaya classification 4 or higher retear on follow-up magnetic resonance imaging were included. The association between clinical outcomes such as American Shoulder and Elbow Surgeons (ASES) score, Constant score and range of motion and radiologic variables such as initial tear dimension, retear dimension, variance of tear dimension, critical shoulder angle, acromial index, and acromiohumeral distance was analyzed. Results: Preoperatively, the ASES and Constant scores were 59.81±17.02 and 64.30±15.27, respectively. And at the last follow-up, they improved to 81.56±16.29 and 78.62±14.16, respectively (p<0.01 and p<0.01). In multiple linear regression analysis, the variance of the mediolateral dimension of tear had statistically significant association with the ASES and Constant scores (p<0.01 and p=0.01). Conclusions: In patients with the retear after ARCR, the variance in the mediolateral dimension of tear had significantly negative association with the clinical outcomes. This could be considered to be reference as relative criteria and needed more sample and mechanical study.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.39-43
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• 2023

Nasotracheal intubation is commonly performed under general anesthesia in oral and maxillofacial surgery. For the convenience of surgery, nasal Ring-Adair-Elwyn (RAE) tubes are mainly used. Because the nasal RAE tubes were bent in an "L" shape, the insertion depth was limited. Particularly, it is necessary to accurately determine the appropriate depth of the RAE tubes in children. Several types of nasal RAE tubes are used in the medical market, which vary in material and length. We performed endotracheal intubation using a nasal RAE tube for double-jaw surgery, but air leakage persisted even when the air pressure in the cuff was increased. When checked with a laryngoscope, it was confirmed that the tube was pushed out, and the cuff was caught on the vocal cords, causing air leakage. Since inserting the tube deeply did not solve the problem, replacing it with a nasal RAE tube (Polar^TM, Preformed Tracheal Tube, Smith Medical, Inc., USA) did not cause air leakage; thus, we reported this case.

• Journal of Biomedical Engineering Research
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• v.37 no.1
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• pp.39-45
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• 2016

A pressure measurement system was developed to verify magnitude and position of transferred pressure on the body surface during the intermittent pneumatic compression (IPC) which is one of the most well-known methods for the prevention of deep vein thrombosis (DVT). Eighty force sensing resistors (FSR) were arranged on a mannequin leg and a hardware controller sensed, digitized, and transferred pressure data every second while IPC was being applied. Finally, sensed pressure data were color coded and visualized on the 3D model with lab-developed software. The pressure data were also saved to files for further analysis. Using this measurement system, the changing pattern of pressure was measured on the mannequin leg by changing both chamber pressure and cuff tightness. As a result, net pressure transferred onto the body surface is dependent on chamber pressure and cuff tightness. Under the same chamber pressure, the tighter a cuff was worn, the wider compressed area was and the shorter compression cycle was. Also transferred pressure was proportional to both chamber pressure and cuff tightness.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.197-205
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• 2015

Background: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration ($2{\times}2$ anchor with $4{\times}4$ suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using $2{\times}2$ anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medial-row stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. Results: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. Conclusions: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.206-210
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• 2015

Background: Assessment of the clinical outcomes after rotator cuff repair is essential for their effectiveness on treatment. The Korean Shoulder and Elbow Society devised the Korean Shoulder Scoring System (KSS) for patients with rotator cuff disorder. The purpose of this study was to evaluate the availability of the KSS for assessment of clinical outcomes in patients after arthroscopic rotator cuff repair, and for comparison with other appraisal scoring systems. Methods: A total of 130 patients with partial-thickness or full-thickness rotator cuff tear who underwent arthroscopic repair using a single row or double row suture bridge technique were enrolled. The average follow-up period was 25.9 months. All patients were classified according to various factors. Comparison within corresponding categories was performed, and the correlation between the KSS and other shoulder assessment methods including University of California Los Angeles (UCLA), Constant and American Shoulder and Elbow Surgeons (ASES) score was analyzed. Results: Total score of the KSS response had increased from 59.6 preoperatively to 88.96 at last follow-up. All KSS domains, including function, pain, satisfaction, range of motion, and muscle power had improved up to 24 months postoperatively. Statistical significance was observed mainly in preoperative measurements with number and size of torn tendons, and greater than or equal to grade 3 of fatty infiltration. The KSS was best correlated with the UCLA scoring system in both preoperative (r=0.785) and postoperative (r=0.951) measurements. Conclusions: The KSS was highly reliable and valid as a discriminative instrument, and it showed strong correlation with ASES and UCLA scoring systems.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.485-492
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• 2014

PURPOSE: This study aimed to examine the pain, range of motion (ROM), upper extremity task performance, and functional levels of patients after rotator cuff repair according to the timing of a closed chain exercise thereby presenting basic data for an effective rehabilitation program. METHODS: The intervention was applied three times per week, one hour per day, for four weeks to 40 participants, 78 of whom had undergone rotator cuff repair. The participants were divided into four groups and assigned to usual general physical therapy and an open chain exercise. Group I consisted of the open chain exercise only. The closed chain exercise was applied to group II after the 4 times, group III after the 7 times, group IV after the 10 times. Measurement were used ROM, visual analogue scale (VAS), box and block test (BBT), and shoulder pain and disability index (SPADI). A one-way analysis of variance was conducted to test differences. RESULTS: There were significant differences in the internal/external rotation between group I and group II. The VAS significantly differed between group II and group I, group III, and group IV. The BBT results of group II and group I were significantly different compared to those of group IV. The SPADI significantly differed between group II and group I and between group II and group IV. CONCLUSION: The closed chain exercise was effective for patients following rotator cuff repair from the second week after active exercise was prescribed, verifying its applicability in rehabilitation programs.