• Clinics in Shoulder and Elbow
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• v.17 no.4
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• pp.194-196
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• 2014

A ganglion is a benign cystic mass, commonly found around a joint or tendon sheath. It frequently occurs at the wrist, foot, ankle, and knee. Intratendinous ganglion has been rarely reported, and intratendinous ganglion of the long head of biceps brachii is extremely rare. According to our literature review, this is the third case of intratendinous ganglion of the long head of biceps brachii, and the first case of arthroscopic treatment. Therefore we report a case of an arthroscopic treatement for an intratendinous ganglion of the long head of biceps brachii.

• Clinics in Shoulder and Elbow
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• v.8 no.2
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• pp.122-126
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• 2005

Purpose: To assess the long-term effect of ulnohumeral arthroplasty and the relationship between radiological recurrence and clinical outcome. Materials and Methods: Eleven elbows with primary osteoarthritis were analyzed at an average of eighty months after ulnohumeral arthroplasty. All patients were male with a mean age of fifty years. The outcomes were assessed using the Mayo Elbow Performance Score(MEPS) and the clinical and radiological results were compared. Results: Four elbows were not painful and six were mildly painful but one was not changed. The mean gain in extension was $15^{\circ}$, in flexion $10^{\circ}$. There were satisfactory results in 8 elbows(73%) and the mean MEPS was 81 points. All of eleven elbows had some degree of recurrent osteoarthritis and there was no correlation between radiological recurrence and clinical endpoints in nine elbows. But in two elbows, it appeared that recurrence of osteophyte at coronoid process was severe and caused fair outcome. Conclusion: Ulnohumeral arthroplasy is one of the effective treatment options for primary osteoarthritis of the elbow. The radiological recurrence did not correlated with the clinical outcome in most cases.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.117-125
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• 2024

While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.141-146
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• 2021

Background: The purpose of the present study was to determine how long superior screws alone or in combination with posterior placement of metaglene screws protruding and penetrating into the scapular spine in reverse total shoulder arthroplasty affect the strength of the scapular spine in a fresh cadaveric scapular model. Methods: Seven fresh cadaver scapulas were allocated to the control group (short posterior and superior screws) and seven scapulars to the study group (spine base fixation with a four long screws, three with both long superior and long posterior screws). Results: The failure load was lower in the spine fixation group (long screw, 869 N vs. short screw, 1,123 N); however, this difference did not reach statistical significance (p>0.05). All outside-in long superior or superior plus posterior screws failed due to scapular spine base fracture; failures in the short screw group were due to acromion fracture. An additional posterior outside-in screw failed to significantly decrease the failure load of the acromion spine. Conclusions: The present study highlights the significance of preventing a cortical breach or an outside-in configuration when a superior or posterior screw is inserted into the scapular spine base.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.366-372
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• 2023

Background: There is minimal literature on the morphology of partial distal biceps tendon (DBT) tears. We sought to investigate tear morphology by retrospectively reviewing 3-Tesla magnetic resonance imaging (3T MRI) scans of elbows with partial DBT tears and to propose a basic classification system. Methods: 3T MRI scans of elbows with partial DBT tears were retrospectively reviewed by two experienced observers. Basic demographic data were collected. Tear morphology was recorded including type, presence of retraction (>5 mm), and presence of discrete long-head and short-head tendons at the DBT insertion. Results: For analysis, 44 3T MRI scans of 44 elbows with partial DBT tears were included. There were 9 isolated long-head tears (20%), 13 isolated short-head tears (30%), 2 complete long-head tears with a partial short-head tear (5%), 5 complete short-head tears with a partial long-head tear (11%), and 15 peel-off tears (34%). Retraction was seen in 5 or 44 partial tears (11%), and 13 of the 44 DBTs were bifid tendons at the insertion (30%). Conclusions: Partial DBT tears can be classified into five sub-types: long-head isolated tears, short-head isolated tears, complete long-head tears with partial short-head involvement, complete short-head tears with partial long-head involvement, and peel-off tears. Classification of tears may have implications for operative and non-operative management. Level of evidence: III.

• Korean Journal of Applied Biomechanics
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• v.30 no.1
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• pp.103-109
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• 2020

Objective: The purpose of this study is to compare the muscle activity by electrode location in the biceps brachii during the arm curl isometric exercise and to provide the basic data needed to develop the proper electrode location of the biceps brachii based on the study results comparing the muscle activity by the angle of the elbow joint. Method: 17 adult males (Age: 21.50±4.63 yrs, height: 175.29±5.97 cm, weight: 63.79±15.31 kg, upper-arm length: 30.10±1.22 cm) participated in the study. In the arm curls isometric exercise, the experiment was divided into 1st and 2nd steps to compare muscle activity according to electrode location in the biceps brachii and muscle activity according to elbow angle change. In the first experiment, the surface electrode was attached at one-third point on the line from medial acromion to cubital fossa, according to the measurement method indicated by SENIAM. The elbow angle was set to 90°. In the second experiment, according to the proposed method of this study, the electrodes were separated at one finger's width in the left and right direction at one-third point on the line from medial acromion to cubital fossa, attached at the long head and short head. From the long head electrode, in about a width of two fingers in proximal direction, a total of three electrodes were attached at the myotendinal junction of the long head. The elbow angles were set as 70°, 90°, and 110°, and the isometric exercise (100% MVC) for 5 seconds was maintained with keeping the forearm and the rope to be 90° for the first and second experiments. Results: During the arm curl isometric exercise, there was no significant difference in SH and SENIAM proposition location proposed by this researcher. LH was shown to be lower than the muscle activity of the location proposed by SENIAM and there were significant (p<.01) differences. MJ appeared lower than the muscle activity of the location proposed by SENIAM and there were significant (p<.001) differences. The muscle activity by the elbow joint angle of SH in the biceps brachii was shown in large order of 70°<90°<110°, but there was no significant difference. The muscle activity by the elbow joint angle of LH was shown in large order of 90°<70°<110°, but there was no significant difference. The muscle activity by the elbow joint angle of MJ was shown in large order of 110°<90°<70°, but there was no significant difference. Conclusion: During the arm curl isometric exercise of the biceps brachii, it is judged appropriate to attach surface electrodes to the location proposed by SENIAM.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.31 no.5
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• pp.586-593
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• 2007

This paper proposes closed-form plastic limit load solutions for elbow with local wall thinning at extrados under internal pressure. This work was performed using 3-dimensional, small strain FE analyses based on elastic-perfectly plastic materials. The wide range of elbow and local wall thinning geometries are considered. For systematic analyses for effect of axial thinning extent on limit loads, two limiting cases are considered; a sufficiently long thinning, and the circumferential part-through surface crack. Then, the closed-form plastic limit load solutions for intermediate thinning are obtained by using result of two limiting cases. The effect of axial thinning extent for elbow on plastic limit load is highlighted by comparing with that for straight pipes. Although the proposed limit load solutions are developed for the case when local wall thinning exist in the center of elbow, it is also shown that they can be applied to the case when local wall thinning exists anywhere within elbow.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.37-39
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• 2019

Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.127-133
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• 2014

Heterotopic ossification (HO) within the substance of the subscapularis tendon is a rare lesion which remains a poorly described condition with little known of the exact mechanisms involved. Furthermore, its clinical importance remains still unclear. To our knowledge, there are no studies present to data regarding HO within the substance of the subscapularis tendon, even with resultant isolated complete tear of the subscapularis tendon. Here we present a case of huge HO associated with unusual isolated complete tear of subscapularis tendon concomitant with tear of biceps long head tendon. After arthroscopic debridement for the complete tear site of biceps long head tendon, mini-open excision of the ossification and subscapularis repair with suture anchor fixation were performed. The patient showed complete recovery of strength and function of the subscapularis at subsequent 24 months follow up.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.162-162
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• 2008

Many anomalous origins of the long head of the biceps tendon (LHBT) have been reported. However, developmental anomalies of the LHBT are rarely encountered in daily practice. We report a patient with an anomalous LHBT that was adherent to and confluent with the rotator cuff throughout its intra-articular course and present the clinical, magnetic resonance arthrography, and arthroscopic findings.