• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.18-25
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• 2024

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107°(±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.2
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• pp.267-282
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• 1997

This study was to test the relationship between regular physical exercise and physical fitness in nursing students. These subjects were 54 volunteers who agreed with intention of this study and were composed of 24 active group and 30 non-active group. The selected physical fitness tests were grip strength and back strength for measuring muscular strength, sargent jump and standing broad jump for measuring power, push-up, sit-up, and heart rate for measuring total endurance, reaction time and side step test for measuring agility, stick test and stork stand for measuring balance, and trunk flexion and trunk extension for measuring flexibility. The conclusion acquired was as follows : 1) Grip strength had significant difference between active group of $29.5{\pm}5.9kg$ and non-active group $25.4{\pm}7.2kg$(t=2.283, p=.027), and back strength between active group of $54.1{\pm}13.7kg$ and non-active group of $44.7{\pm}15.7kg$(t=2.310, p=.025), 2) Sargent jump was lower with non-active group($44.9{\pm}8.6cm$) than with active group($45.3{\pm}8.8cm$), however, was not significant(t=.182, p=.856). Standing broad jump was significantly lower with non-active group of $161.3{\pm}28.7cm$ than with active group of $191.4{\pm}27.0cm$(t=3.939, p=.000). 3) Push-up showed significant difference between active group of $25.3{\pm}12.3times$ and non-active group of $11.5{\pm}5.1times$(t=5.572, p=.000), and sit-up between active group of $21.8{\pm}7.4times$ and non-active group of $17.1{\pm}5.8times$(t=2.631, p=.011), and heart rate between actvie group of $110.5{\pm}12.8$beats/min and non-active group of $121.5{\pm}9.5$beats/min(t=-3.648, p=.001). 4) Reaction time was significantly higher with non-active group of $.300{\pm}.051sec$ than with active group of $.341{\pm}.041sec$(t=-3.285, p=.002). Side step test was lower with non-active group($8.8{\pm}1.1times$) than with active group($9.2{\pm}1.2times$), however, was not significant (t=1.309, p=.196). 5) Stick test showed not significant difference between active group of $25.8{\pm}14.8sec$ and non-active group of $30.7{\pm}17.9sec$(t=-1.058, p=.295), and stork stand between active group of $4.5{\pm}3.2sec$ and non-active group of $3.7{\pm}3.5sec$(t=.918, p=.363). 6) Trunk flexion came out not significant difference between active group of $14.2{\pm}5.0cm$ and non-active group of $15.8{\pm}7.3cm$(t=-.927, p=.358), and trunk extension between active group of $67.1{\pm}6.5cm$ and non-active group of $67.3{\pm}6.6cm$(t=-.140, p=.889). 7) Power was shown to be significantly related to total endurance(r=.717, p=.000 ; r-.739, p=.000). 8) Total endurance was shown to be significantly related to agility(r=-.752, p=.000 ; r=.684, p=.000 ; r=-.664, p=.000 ; r=.598, p=.002 ; r=.864, p=.000 ; r=-.536, p=.007). These results suggest that regular physical exercise is effective in promoting and maintaining physical fitness. As the further study, it is necessary to reinvestigate the effect with more refined design.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.40-46
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• 2012

Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

• Physical Therapy Korea
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• v.12 no.4
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• Korean Journal of Acupuncture
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• v.25 no.2
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• pp.125-141
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• 2008

Objective : The aim of this study is to investigate the curative effect of Bee Venom Acupuncture Therapy for pain and limited R.O.M (range of motion) of shoulder in stroke patients. Methods : The subjects of this study were 6 patients with shoulder pain in stroke sequelae. Routine Oriental Medical programs (Acupunture, moxibustion, herbal medicine and physical therapy) were maintained for each subject throughout this study. Single subject ABABAB design was adopted. Each period was 4 days as a rule. Only during the treatment period, Bee Venom Acupuncture Therapy was provided as intervention at the acupoints of LI15(Gyeonu),　TE14(Gyeollyo), GB21(Gyeonjeong), LI14(Bino). The change of pain was measured with a Visual Analogue Scale(VAS). The pain threshold was measured using pressure algometer at the same acupoints where Bee Venom Acupuncture Therapy was provided. And the R.O.M of shoulder joint (flexion, extension, abduction, adduction, external rotation, internal rotation) was measured as well. Analysis was performed by Bayesian analysis using WinBUGS for the comparison of treatment(Bee Venom Acupuncture Therapy) and non-treatment. Results : The median overall improvement for difference in VAS was -2.219(-3.213, -1.175), for difference in external rotation of shoulder R.O.M was 9.992(-2.298, 18.49), for difference in tenderness score of LI14(Bino) by pressure algometer was 5.05(0.6283, 7.762). 95% credibility intervals being shown in brackets. However, the median overall improvement for difference in the other measurements was not significant. Conclusion : This study suggests that Bee Venom Therapy may be applicable to decrease pain and improve R.O.M of shoulder in hemiplegia patients with stroke. Further elaborated single subject designs need to be accumulated to confirm the effects of Bee Venom Acupunture Therapy on shoulder pain in patients with stroke sequelae.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.47-52
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• 2010

Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.311-316
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• 2007

Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

• Journal of Acupuncture Research
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• v.24 no.4
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• pp.143-155
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• 2007

Objectives: To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Methods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group, n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. All three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significantly(p<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.2
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• pp.123-132
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• 2016

Objectives The aim of this study done as pilot study is to analyze the current state of patients who have low back pain through registry. Methods This study is done under approval of Gil Oriental Medical Hospital of Gachon University, Oriental Medical Hospital of Sangji University, Jecheon Oriental Medical Hospital of Se-Myung University IRB. Among subjects who signed the consent form by their own will, we decided whom to register as subjects of this study by the standard of selection and exception. We collected the sociological investigation, character of low pack pain, degree of symptom which they felt before and after the hospitalization from registered subjects. Results 1. The number of the subjects is 16. The average age is 41.0. 9 of them are female, 7 of them are male. Most of the subjects have history illness which has connection with low pack pain. 2. According to the patient's free description of the back pain, 6 of them suffered throbbing pain. And 8 of the patients have chronic pain, 6 of them have intermittent pain of back pain analysing the character of the low back pain. They answered the pain lasted for 47.6 minutes on average. 3. About the change on the average R.O.M. of L-spine, R.O.M. of Lateral bending, Extension, Flexion, Rotation has increased after leaving the hospital compared with before hospitalization. 4. The amount of discomfort or strength of pain, which was checked by VAS on the day of leaving the hospital, has decreased than they were before the hospitalization. And there was the improvement on the dysfunction score and EQ-5D. Conclusions Through this study, we specifically analyzed the symptoms of the low back pain by accumulating the analysis about the symptoms using several indicators and description which is freely spoken by patients about their symptoms. Further research is expected to complete multi-center registry by building registry and by using it, to get various epidemiologic informations about low back pain.

• PNF and Movement
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• v.4 no.1
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• pp.45-50
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• 2006

Purpose : This study shows the movements of the ankle and the foot in walking stages, and helps to diagnose and treat the problems of the ankle and the foot. The foot in human is a mean of the transportation, body support, and shock absorber. However, the slightest changes in the anatomical position can cause a significant increase of the stress and force in the ankle and the foot. The regular compressive force in the ankle of the normal person is generated by the contraction of the gastrocnemius and popliteus muscles, and transmitted to the achilles tendon. The plantar flexion about 10 degrees occurs immediately after the heel strike, getting ready for the weight acceptance. The shear force about 80 % of the body weight is generated immediately after the heel off of the mid stance phase. In those who have a problem in the ankle, the compression force at the ankle decreased to 1/3 of the body weight, and the shear force decreased, and the compressive force was reached at their maximum level earlier than the normal people. Conclusion : Analysis of the movements at the ankle and the foot in walking phase can make the effort to diagnose and treat the ankle and foot with the problems. However, the further study is necessary.