• Clinics in Shoulder and Elbow
• /
• v.26 no.1
• /
• pp.3-9
• /
• 2023

Background: Modifications of the medialized design of Grammont-type reverse shoulder arthroplasty (RSA) using a bony increased offset (BIO-RSA) has shown better clinical results and fewer complications. The aim of this study is to compare the clinical results, complications, and radiological outcomes between patients undergoing standard RSA and BIO-RSA. Methods: A retrospective review was performed of 42 RSA procedures (22 standard RSA and 20 BIO-RSA). With a minimum of 1 year of follow-up, range of motion (ROM), Constant shoulder score (CSS), visual analog scale (VAS), and subjective shoulder score (SSS) were compared. Radiographs and computed tomography (CT) scan were examined for scapular notching, glenoid and humeral fixation, and graft healing. Results: At a mean follow-up of 27.6 months (range, 12-48 months), a significant difference was found for active-internal rotation (P=0.038) and for passive-external rotation (P=0.013), with better results in BIO-RSA. No other differences were found in ROM, CSS (P=0.884), VAS score, and SSS. Graft healing and viability were verified in all patients with CT scan (n=34). The notching rate was 28% in the standard RSA group and 33% in the BIO-RSA group, but the standard RSA had more severe notching (grade 2) than BIO-RSA (P=0.039). No other significative differences were found in glenoid and humeral fixation. Conclusions: Bone-graft lateralization is associated with better internal and external rotation and with less severe scapular notching compared to the standard RSA. Integration of the bone graft occurs effectively, with no relevant changes observed on radiographic evaluation. Level of evidence: III.

• Journal of Veterinary Clinics
• /
• v.37 no.3
• /
• pp.135-140
• /
• 2020

The purpose of this study was to determine the outcome of distal femoral osteotomy for distal femoral varus and medial patellar luxation (MPL) grade 4 in small-breed dogs. Radiographs and medical records were reviewed to collect data and plan the surgery in small-breed dogs with MPL grade 4. Computed tomography (CT) imaging was also performed in cases of severe bone deformities. Signalment, weight, medial patellar luxation and lameness grade, radiographic bone union, complications, pre- and postoperative femoral varus angle, passive range of motion, static weight bearing distribution and visual analogue scale scores were recorded. Thirteen corrective distal femoral osteotomies were performed with ancillary and additional procedures in 9 dogs; 4 dogs had staged bilateral procedures; and four stifles were suspected to have partial or complete rupture of the cranial cruciate ligament. One stifle underwent patellar groove replacement. The mean ± SD pre- and postoperative femoral varus angles were 109.15°± 3.71° and 96.30°± 2.97°, respectively. Significant improvements in passive range of motion, thigh circumference and visual analogue scale (VAS) scores were observed. There was no reluxation of the patella. This study suggests that distal femoral osteotomy with traditional and additional procedures provided satisfactory outcomes in patient healing and functional recovery in small-breed dogs with excessive femoral varus angles.

• Archives of Reconstructive Microsurgery
• /
• v.10 no.2
• /
• pp.93-98
• /
• 2001

Purpose : This describes our experience with a tenocutaneous free flap from the dorsum of the foot or radial forearm to reconstruct the dorsal skin and extensor tendons of the hand. Material and Methods : Between february 1987 and July 1998, we treated 9 patients with composite tissue loss on the dorsal hand caused by crushing injury. Nine men had an average age of 26.4 years(range, $19{\sim}47$). We treated 5 patients with the free dorsalis pedis flap including the extensor tendons and the superficial peroneal nerve and 4 patients with reverse forearm flap including the brachioradialis tendon and/or superficial radial nerve. Flap size was average 4.4(3,2cm. Evaluation of the results was based on the survived flap rate, the recovery rates for range of motion of the metacarpophalageal joints in the operated fingers. two-point discrimination. Results : All flaps were well vascularized and survived completely. Recovery rates for range of motion of the metacarpophalageal joints in operated fingers range from $78%{\sim}99%$(average, 90%). Two-point discrimination of the transferred flaps in 5 patients average $20{\pm}3.5mm$. Conclusion : The advantages of this procedure are mass action reconstruction with tendon, one-stage operation, faster healing with less adhesion formation, and early mobilization.

• Clinics in Shoulder and Elbow
• /
• v.24 no.3
• /
• pp.166-171
• /
• 2021

Background: This study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after arthroscopic rotator cuff repair (ACRC). Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography. Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.

• Clinics in Shoulder and Elbow
• /
• v.26 no.4
• /
• pp.373-379
• /
• 2023

Background: The purpose of this study was to determine the association between smoking and clinical outcomes of hook plate fixation for acute acromioclavicular (AC) joint injuries. Methods: This study retrospectively investigated 82 patients who underwent hook plate fixation for acute AC joint dislocation between March 2014 to June 2022. The patients were grouped by smoking status, with 49 in group N (nonsmokers) and 33 in group S (smokers). Functional scores and active range of motion were compared among the groups at the 1-year follow-up. Coracoclavicular distance (CCD) was measured, and difference with the uninjured side was compared at initial injury and 6 months after implant removal. Results: No significant differences were observed between the two groups in demographic factors such as age and sex, as well as parameters related to initial injury status, which included time from injury to surgery, the preoperative CCD difference value, and the Rockwood classification. However, the postoperative CCD difference was significantly higher in group S (3.1±2.6 mm) compared to group N (1.7±2.4 mm). Multivariate regression analysis indicated that smoking and the preoperative CCD difference independently contributed to an increase in the postoperative CCD difference. Despite the radiographic differences, the postoperative clinical outcome scores and active range of motion measurements were comparable between the groups. Conclusions: Smoking had a detrimental impact on ligament healing after hook plate fixation for acute AC joint dislocations. This finding emphasizes the importance of smoking cessation to optimize reduction maintenance after AC joint injury. Level of evidence: III.

• Journal of the Korean Arthroscopy Society
• /
• v.12 no.2
• /
• pp.82-86
• /
• 2008

Many rotator cuff tears are operatively treated in recent years. Postoperative rehabilitation of rotator cuff repair is as important as diagnosis of disease or surgery itself. And it is a crucial factor on the prognosis of the surgery. For appropriate rehabilitation, surgeon should have knowledge about the anatomy and biomechanics of shoulder. The purposes of postoperative rehabilitation are to avoid additional injury, to decrease inflammation, to help healing process of collagen, to strengthen weak muscle, to recover decreased range of motion, to increase endurance of muscle and to protect the repair site and deltoid. These protocols must be individualized according to the condition of the patients.

• Journal of Veterinary Clinics
• /
• v.20 no.1
• /
• pp.104-109
• /
• 2003

This study was performed to evaluate the postoperative heating process according to lameness degree, swelling, and muscle atrophy after femoral head and neck ostectomy on Retriever dogs with hip dysplasia and hindleg lameness. Femoral head and neck ostectomy (FHO) was performed for the repair of hip dysplasia in 4 Retriever dogs (5 hips) referred in veterinary medical teaching hospital of college of veterinary medicine, Konkuk University. Age (Mean $\pm$ SD) of patients was 10.3 $\pm$ 3.0 months (range,7 to 16 months) and body weight (Mean $\pm$ SD) was 28.2 $\pm$ 3.4 kg (range, 25 to 34 kg). After FHO, all cases are treated with carprofen (2.2 mg/kg, PO bid, tapering at interval 1-2 weeks) and physical therapy including passive range-of-motion exercises. In all cases, lameness degree was showed V at the next day after surgery, IV at 5 to 7 days, II-III at 30 to 35 days, II at 60 days, and I at 105 to 114 days. These results suggested that femoral head and neck ostectomy was able to be performed on large breed dogs with hip dysplasia and hindleg lameness.

• Journal of the Korean Academy of Clinical Electrophysiology
• /
• v.11 no.1
• /
• pp.39-44
• /
• 2013

Purpose : The purpose of present study is to evaluate the joint angles of legs in the standing posture for six patients with unilateral knee osteoarthritis. Methods : The participants underwent unilateral total knee replacement. A motion analysis was used to measure the joint angles of the hip, knee, and ankle. The measurements were taken before the surgery, one week and two weeks after the surgery. Both sides of the legs were evaluated. Results : This result showed that after a certain healing period, both hip joint angles showed a significant difference while there was no significant difference in the knee and ankle joint angles. After surgery, the angle of ankle dorsiflexion was smaller on the operated side than the opposite side compared to the pre-surgery measurements. Conclusion : After surgery, the asymmetry in a standing position left unchanged due to contracture of the knee joint and tightness in the hamstring muscle. Therefore, when physiotherapists plan an initial exercise programs for TKR patients, it is essential to apply adequate exercises which consider the contracture of the leg joints.

• Korean Journal of Veterinary Research
• /
• v.62 no.2
• /
• pp.1.1-1.8
• /
• 2022

Rehabilitation treatments after orthopedic surgery promote postoperative healing in humans. In veterinary medicine, there is increased interest in rehabilitation treatments because they are potentially beneficial to animals in the post-operation period. This study examined the effectiveness of rehabilitation treatment in dogs that underwent orthopedic surgeries, including femoral head & neck ostectomy (FHNO) and medial patellar luxation treatment (MPLT). The group that received the rehabilitation treatment after FHNO (1.88 weeks) showed a significantly shorter recovery length of 6.62 weeks compared to those that did not receive the treatment (8.50 weeks). The other group that received the rehabilitation treatment after MPLT (4.38 weeks) showed a significantly shorter recovery length of 5.01 weeks compared to those that did not receive the treatment (9.39 weeks). For the qualitative evaluation, the types and frequencies of rehabilitation treatments were monitored. The rehabilitation programs used frequently were heat therapy, laser therapy, passive range of motion, exercise therapy, and aquatic therapy. A standard rehabilitation program after hindlimb surgery was suggested based on the quantitative and qualitative investigation. The results add additional evidence that showed the beneficial effects of rehabilitation treatments in dogs.

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