• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.45-52
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• 2013

Purpose: We wanted to compare the accuracy between the blind anterior approach and ultrasound guided posterior approach, which are preferred in the present clinical practice for the glenohumeral joint injection. Materials and Methods: The consecutive 95 cases were included in that the glenohumeral joint injection was done in the university hospital and the medical record and ultrasonography were available. There were 52 cases which were injected by blind anterior approach (group I) and 43 cases who were injected by ultrasound guided posterior approach (group II). The injection was decided as accurate if the fluid was visualized in the posterior joint under the ultrasound. We evaluated the range of motion before and after 2 weeks of injection. A subjective satisfaction of the patients was interviewed at the 2 weeks after injection. Results: The accuracy of the glenohumeral joint injections of the group I and group II was 80.8% and 90.7%, respectively. The range of motion was improved for the all cases regardless of the approaches. At the 2 weeks after injection, the subjective satisfaction (better than good) was achieved in 73.7%. Conclusion: The accuracy of the blind anterior approach for the glenohumeral joint injection was 80.8%. The accuracy of the ultrasound guided posterior approach was 90.7%. In this comparative study by the one physician, the ultrasound guided posterior approach showed the better accuracy.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2071-2076
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• 2020

Background: Based on the understanding of the muscle activation relationship between the infraspinatus and posterior deltoid muscles to according to the angle of motion during external rotation on glenohumeral joint, effective shoulder joint strengthening exercise for the prevention and rehabilitation of shoulder injury due to muscle strength imbalance can be performed by achieving the ideal muscle activity ratio during exercise. Objectives: To compare and analyze the muscle activation changes and activity ratio of the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle. Design: Quasi-randomized trial. Methods: The study included 48 healthy male and female adults who provided informed consent for participation in the study. All the subjects performed isometric glenohumeral external rotation by setting the angle of motion to 30°, 45°, and 60° using a 5 kg resistance weight pulley. On surface electromyography, the differences in muscle activation and activity ratio between the infraspinatus and posterior deltoid muscles were investigated. Results: A significant difference in muscle activation was found in the comparison between the infraspinatus and posterior deltoid muscles according to the glenohumeral external rotation angle (P<.05). The muscle activation levels of the infraspinatus and posterior deltoid muscles were highest at the external rotation angles of 30° and 60°, respectively. The muscle activity ratio between the infraspinatus and posterior deltoid muscles also showed a significant difference (P<.05) and was highest at the shoulder external rotation angle of 30°. Conclusion: The findings of this study suggest that muscle activity is the highest at the shoulder external rotation angle of 30° in healthy individuals.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.272-278
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• 2021

Anatomical total shoulder arthroplasty (TSA) has been used widely in treatment of glenohumeral osteoarthritis and provides excellent pain relief and functional results. Reverse total shoulder arthroplasty (RSA) was created to treat the complex problem of rotator cuff tear arthropathy. RSA also has been performed for glenohumeral osteoarthritis even in cases where the rotator cuff is preserved and has shown good results comparable with TSA. The indications for RSA are expanding to include tumors of the proximal humerus, revision of hemiarthroplasty to RSA, and revision of failed TSA to RSA. The purposes of this article were to describe comprehensively the conditions under which RSA should be considered in glenohumeral osteoarthritis, to explain its theoretical background, and to review the literature.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.3
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• pp.33-40
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• 2022

Background: The cross-body and the sleeper stretches have been used to improve posterior shoulder tightness (PST). However, such stretching techniques may not always help achieve scapular stability and may even aggravate patient's symptoms. Therefore, a new stretching technique (passive glenohumeral internal rotation with bridging) was developed as a more effective method that may allow for greater scapular stability without aggravating the symptoms. Thus, this study aimed to examine and compare this novel stretching technique to determine its effect on the range of motion (ROM) and acromio-humeral distance (AHD) in patients with glenohumeral internal rotation deficits (GIRD) with posterior shoulder tightness. Methods: A total of 30 symptomatic patients with asymmetrical GIRD were randomly assigned to two groups: the novel stretching group (n=15) and the joint mobilization group (n=15). The intervention was conducted twice a week for a total of four weeks. The ROM of shoulder internal rotation was measured by a goniometer and the AHD was evaluated by an X-ray before and after the intervention. Results: Both the treatments improved ROM and AHD in patients with GIRD (p<.05). However, the improvements in internal rotation ROM and AHD in the novel stretching group were significantly greater than that of the subjects in the mobilization group. There was a significant difference between the two groups (p<.05). Conclusion: These results show that both novel stretching and joint mobilization improved ROM and AHD in patients with GIRD with PST. However, novel stretching was more effective than joint mobilization.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.179-185
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• 2016

Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2004.11a
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• pp.117-121
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• 2004

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.11a
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• pp.87-93
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• 2006

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.11a
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• pp.101-109
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• 2006

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.3-4
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• 2006

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.120-127
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• 2015

Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.