• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.91-98
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• 2012

Purpose: The objective of this study is to evaluate the functional outcome and identify prognosis of retear patients in patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear. Materials and Methods: From 1995 September to 2010 March, 147 patients aged 65years or over (40 male, 107 female, with an average age of 69.6) undergoing surgical repair for large to massive full thickness rotator cuff tear (large 67 cases, massive 80 cases). For functional evaluation, preoperative and postoperative 1 year range of motion and muscle power checked. For subjective evaluation, American shoulder and elbow surgeons score and Constant score were checked. For anatomical evaluation, 87 patients were checked shoulder MRI at the time of the postoperative 1 year. Results: ASES score improved from to 50.4 to 88.9, Constant score improved from 47.1 to 75.2. Supraspinatus power improved from 51.1% to 80.8%, external rotator muscle power improved from 64.5% to 83.1%. Forward elevation improved from 117.4 degrees to 153 degrees, external rotation improved from 23.6 degrees to 41.8 degrees. Follow up MRI showed re-tear in 23%, all re-tear patients were from massive tear except one patient. All re-tear patients showed improved clinical outcomes, but supraspinatus and external rotator muscle power were not improved. Conclusions: Patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear showed successful outcomes over 90 percent. Re-tear patients also showed successful clinical outcomes. In elderly patients with large to massive full thickness rotator cuff tear, aggressive surgical repair leads good clinical outcomes.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.109-114
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• 2009

Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.7-12
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• 2010

Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.5 no.1
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• pp.9-14
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• 2012

Purpose: The purpose of the study was to evaluate the accuracy and clinical outcome of ultrasound-guided glenohumeral joint steroid injection on adhesive capsulitis. Materials and Methods: Patients who were diagnosed as adhesive capsulitis by MRI and physical examination and did not improve their symptom with physical therapy and NSAIDS treatment more than 6 months were included in the study. Patients who showed any other shoulder pathology or history if trauma were excluded from the study. 33 patients including 15 males and 18 females were enrolled in the study, the average age being 55.1 (age 42~72). Cocktail of steroid, lidocaine, saline and contrast medium injected inside shoulder glenohumeral joint using novel approach (which we called acromioclavicular approach) under ultrasound guidance. Clinical outcome was measured through passive range of motion and VAS scoring system. Results: Based on radiographic findings, cases were classified according to the leakage of contrast medium; perfect confinement of contrast-medium inside the capsule, partial leakage of the medium and contrast-medium found at outside the joint. Total 25 cases (76%) out of 33 cases showed perfect confinement of contrast-medium inside the glenohumeral joint. Partial leakage was observed in 6 cases (18%), and contrast medium was observed outside of the glenohumeral joint in 2 cases (6%). Perfect-confinement group showed $111^{\circ}$($80{\sim}140^{\circ}$) of forward flexion and $48^{\circ}$($0{\sim}90^{\circ}$) of external rotation before injection, and improved to $134^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($30{\sim}90^{\circ}$) of external rotation after injection (p<0.01). Partial leakage showed $120^{\circ}$($90{\sim}150^{\circ}$) of forward flexion and $70^{\circ}$($10{\sim}90^{\circ}$) of external rotation before injection, and improved to $139^{\circ}$($135{\sim}140^{\circ}$) of forward flexion and $78^{\circ}$($50{\sim}90^{\circ}$) of external rotation after injection (p<0.01). VAS score improved from 7.1 (score 3~9) to 2.6 (score 0~5) (p<0.01) in perfect confinement group, from 7.5 (score 7~9) to 3.3 (score 2~4) (p<0.01) in partial leakage group. Two group showed no significant difference. Conclusion: Accuracy of Acromioclavicular approach was 94% which is better than any other methods published so far. Partial leakage of the injection material did not show inferior result compared to perfect injection.

• Journal of the Korean Arthroscopy Society
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• v.3 no.1
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• pp.17-23
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• 1999

Purpose : We intend to review clinical results after Anterior cruciate ligament(ACL) reconstruction using hamstring tendon arthroscopically. Materials & Methods : Sixty two patients who had underwent arthroscopic ACL reconstruction using hamstring tendon from Mar. 1996 to Mar. 1997 were reviewed. The average follow-up was 16 months and average age at operation was 27 years old. Clinical results were evaluated with physical examination, Lysholm Knee score and instrumented anterior laxity test with Telos Results : The average preoperative Lysholm knee score was 57.0 and postoperative average of that was 91.8. All cases of 62 patients had normal range of motion of knee and were able to walk with no problems at follow-up. On the Lachmann test, there were mild(+) instability in 24 cases, moderate(++) in 24 cases, severe(+++) in 14 cases preoperatively and 48 cases were converted to negative, 14 cases mild postoperatively. On instrumented anterior laxity test with Telos, difference between normal and affected knee on 20 lb which was 13.4mm preoperatively was decreased to 4.7mm at follow-up and anterior stability was regained(P<0.05). Parapatellar complications such as crepitus in 18 cases(29.5%), atrophy of quadriceps in 23 cases(36.5%) were observed. There were 2 cases of inaccuracy of guide pin of semifix screw intraoperatively and 3 cases of malposition of semifix screw postoperatively. Conclusion : ACL reconstruction using hamstring tendon seems to be a effective procedure to establish the stability of knee joint but is technically demanding procedure and leaves some parapatellar complications.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.18-23
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• 2008

Purpose: The purpose of this study is to evaluate the clinical results of the function and stability of ACL reconstruction using the flexible reamer. Materials and Methods: We reviewed 98 patients who taken ACL reconstruction using the flexible reamer from March, 1999 to May, 2004. And the follow-up period was more than 12 months in all cases. We used the subjective tests including Lysholm knee score and 2000 International Knee Documentation Committee(IKDC) subjective knee score, and the objective tests such as anterior drawer test, Lachman test, pivot shift test, and KT-2000 arthrometer to evaluate the clinical results. Results: In the range of motion of the affected knee, the extension deficit more than 5 degree was 8 cases preoperatively and 1 case postoperatively. The flexion deficit more than 5 degree was 12 cases preoperatively and 2 cases postoperatively. The mean Lysholm knee score was 61.3 point(${\pm}3.5$ SD) preoperatively and 87.7 point(${\pm}2.0$ SD) postoperatively. The mean 2000 International Knee Documentation Committee(IKDC) subjective knee score was 49 point(${\pm}3.3$ SD) preoperatively and 84 point (${\pm}2.2$ SD) postoperatively. 93 cases were more than grade II in Lachman test preoperatively and 5 cases postoperatively. 71 cases were more than grade II in pivot shift test preoperatively but 89 cases were negative postoperatively. The mean maximal manual difference by KT-2000 arthrometer was 6.8 mm(${\pm}1.9$ SD) preoperatively and 1.8 mm(${\pm}0.8$ SD) postoperatively. Conclusion: ACL reconstruction using the flexible reamer achieved the ideal isometric point of femur and anatomic graft placement, so we could obtain good results, especially in rotational stability.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.50-55
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• 2013

Purpose: The purpose of this study was to compare the clinical results of absorbable knot-tying and absorbable knotless suture anchors in arthroscopic Bankart repair. Materials and Methods: This study compared the patients who underwent arthroscopic Bankart repairs using absorbable knottying suture anchors (59 patients: KT Group), and absorbable knotless suture anchors (52 patients: KL Group). Preoperative and postoperative evaluations were performed by Rowe scores, patient satisfaction score, visual analogue scale (VAS), American shoulder and elbow surgeons (ASES) score, range of motion (ROM), and re-dislocation rate. Results: Postoperative VAS, Rowe scores, ASES score were significantly not different between the 2 groups (VAS: p=0.250, Rowe score: p=0.412, ASES: p=0.052). Mean postoperative VAS was 0.5 in KT Group and 0.8 in KL Group (p=0.250), and limited ROM was noted only in one patient in KL Group. Mean Rowe score was 94.3 in KT Group and 96.3 in KL Group (p=0.412), and mean ASES score was 97.3 in KT Group and 94.0 in KL Group (p=0.052). Re-dislocation rate were no different between the 2 groups. Conclusion: There were no differences in clinical outcomes and re-dislocation rate between Knot-Tying and Knotless repairs.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.2
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• pp.51-58
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• 2001

Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

• Journal of the Korean earth science society
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• v.22 no.6
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• pp.469-479
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• 2001

This study investigated the trends in the number of applicants and mean score and applicants’ responses on the test items of Earth Science in the College Scholastic Ability Test (CSAT) implemented for 3 years (1999-2001). The percentage of applicants of science track were 43.14% in 1995, but reduced through 29.5% in 2001 to 26.92% in 2002 CSAT For elective subject, about 22% of science track students applied to Earth Science II which ranked third to Biology II and Chemistry II. In 1999, test items were developed to have the expected difficulty 40 ${\sim}$ 59% (6 items) to 60 ${\sim}$ 79% (10 items). But in 2001 every 16 items were developed to have difficulty 60 ${\sim}$ 79%, which was caused by the policy of so called ‘easy CSAT’. Thus the mean score of ‘Earth Science II’ was increased from 50.26 in 1999 through 64.47 in 2000, to 67.58 in 2001. Applicants were generally very good at solving test items focusing on process skills only and familar items but poor at solving test items related to the motion of the earth and planets and sea wave, especially items calling two or more concepts. Thus special measures to cope with the decrease in applicants of science track should be provided. And it is recommended to develop test items with wider range of difficulty and to reduce test items calling process skills only. And special consideration should be given to teaching the content area with poor achievement and high actual difficulty compared to the expected.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.7-10
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• 2013

Purpose : This study evaluated the effects of breathing protocols on matching results of PET and CT images using two breathing protocols such as free breathing and acquisition in holding the breathing after the normal expiration in acquiring CT images. Materials and Methods: Whole body FDG PET and CT images of 200 patients (mean age: 58 (range 20~84), 103 males and 97 females) using Discovery VCT (GE Healthcare, Milwaukee, USA). When taking CT images, subjects were asked to breathe freely (free breathing, n=100) or hold the breathing after the normal expiration (Hold, n=100). In the whole body image coronal section where PET and CT were matched, the matched error of the boundary between diaphragm and liver was measured in length. The matched errors were compared according to breathing protocol by age, sex and disease. The verification of statistical significance was made by SPSS 15.0 (SPSS Inc., Chicago, IL, USA) via one way ANOVA. Results: The matched error in all was 0.87 mm. According to breathing protocol, there was no significant difference in matched error as1.01 mm in free breathing and as 0.73 mm in hold breathing (p=.688). The matched error according to sex did not show significant difference as 1.08 mm of males, and 0.93 mm of females in free breathing (p=.517). In hold breathing, there was no significant difference as 0.79 mm of males and 0.66 mm of females (p=.738). There was no significant difference in matched error by age between free breathing and hold breathing (free breathing (p=.728), hold (p=.465). There was no significant difference in matched error by disease between free breathing and hold breathing (free breathing (p=.197), hold (p=.518) Conclusion: The difference in matched error between free breathing and hold breathing was less than 5 mm at 99%. There was no statistically significant difference in matched error by breathing protocol, age and disease. It was proved that there was no difference in matched error between PET and CT images according to breathing protocol during PET/CT scan.