• Title/Summary/Keyword: Partial Repair

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Clinical Result of Arthroscopic Partial Repairs in Massive Rotator Cuff Tears (광범위 회전근 개 파열의 관절경하 부분 봉합술의 임상적 결과)

  • Yoo, Jae-Chul;Ko, Kyung-Hwan;Woo, Kyung-Jea
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.150-158
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    • 2009
  • Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.

Do partial glenohumeral degenerative changes in patients undergoing arthroscopic rotator cuff repair influence clinical outcomes?

  • Al-Tawil, Karam;Casey, Joseph;Thayaparan, Prashant;Tavakkolizadeh, Adel;Sinha, Joydeep;Colegate-Stone, Toby
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.112-120
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    • 2022
  • Background: The prognostic factors for patients with full-thickness rotator cuff tears (RCTs) include tear size, muscle atrophy and fatty infiltration. However, the influence of early coexisting degenerative changes on RCT outcomes is unappreciated. The purpose of this study was to calculate the impact that pre-existing partial glenohumeral cartilaginous changes have on patients undergoing arthroscopic RCT repair. Methods: A study of 54 patients undergoing arthroscopic RCT repair was undertaken. The presence of co-existing patches of glenohumeral degenerative cartilaginous changes and RCT size was recorded at surgery. Pre- and postoperative outcomes were assessed using traditional (Oxford Shoulder Score [OSS], 5-level EuroQol-5D [EQ-5D-5L] questionnaire and EuroQol visual analog scale [EQ-VAS]) and patient-centric re-formatted prisms. Outcomes were assessed as an entire dataset, and sub-group analysis was performed according to the grade of co-existing arthritis and tear size. Results: Significant improvements (p<0.05) in clinical outcomes were recognized when assessed using either the traditional or reformatted prisms (average % improvements in OSS, EQ-5D-5L and EQ-VAS were 47%, 33% and 43%, respectively; average improvements in pain, function, and psychological well-being were 48%, 33% and, 29%, respectively). Positive gain was noted in all sub-groups of arthritic grading and tear size. Conclusions: Good clinical outcomes can be achieved following RCT repair even in the presence of local partial degenerative cartilage changes and advancing tear size. These benefits are patient-centered but require RCT repairability.

Avulsion of the Triceps Brachii - 3 cases report - (삼두 근 견열 손상 - 3례 보고-)

  • Rhyou, In-Hyeok;Chung, Chae-Ik;Suh, Bo-Gun;Kim, Kyung-Chul
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.216-221
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    • 2006
  • Avulsion of the triceps brachii is an uncommon injury. The usual mechanism of injury is fall onto an outstretched hand but can occur after direct contact injuries. Diagnosis is critical and dependent on history, physical examination, and radiological findings. Rupture of triceps brachii occurs most frequently at the tendo-osseous insertion and may be complete or partial, and could be associated with radial head fracture. Treatments include surgical repair of the complete rupture and immobilization of partial triceps rupture. We report 3 cases of triceps avulsion fractures treated by open surgical repair with literature reviews.

Partial Thickness Rotator Cuff Tears

  • Shin, Sang-Jin;Seo, Myeong-Jae
    • Clinics in Shoulder and Elbow
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    • v.17 no.2
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    • pp.91-100
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    • 2014
  • Partial-thickness rotator cuff tear (PTRCT) is not single disease entity but one phase of disease spectrum. Symptoms of PTRCT vary from being asymptomatic to severe pain leading to deterioration in quality of life. Pathogenesis of degenerative PTRCT is multifactorial. Whereas articular sided PTRCT is usually caused by internal causes, both internal and external causes have important role in bursal sided PTRCT. A detailed history, clinical examination and magnetic resonance angiography are used in the diagnosis of PTRCT. Treatment of PTRCT is chosen based on age, demands of patients, causes and depth of tear. In most patients, non-operative treatment should be initiated. Whereas debridement can be done for less than 6 mm of articular sided PTRCT and in less than 3 mm of bursal sided PTRCT, repair techniques should be considered for higher grade PTRCT than that. Although the effect of acromioplasty is not clear, acromioplasty may be performed when the extrinsic causes appear to be the cause of tear. Either transtendon repair technique or repair after tear completion provided satisfactory clinical outcomes in treatment of articular sided PTRCT.

Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option?

  • Yang, Hee Seok;Kim, Jeong Woo;Lee, Sung Hyun;Yoo, Byung Min
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.234-239
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    • 2018
  • Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

Microsurgical Replantation of A Partial Ear with Arteriole Anastomosis

  • Ahn, Ho-Beom;Cho, Gue-Seung;Kim, Dae-Young;Lee, Sam-Yoong;Cho, Bek-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.10-14
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    • 1999
  • Ear reconstruction is very difficult to perform and often results in a devastating deformity. The use of microsurgical replantation techniques has allowed very favorable anesthetic results. We report a case of a partial ear replantation without venous repair with the use of medicinal leeches to decompress the acute venous congestion during the postoperative care. The medicinal leech therapy can be very useful in a partial ear replantation in cases with no venous repair.

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Seismic repair of captive-column damage with CFRPs in substandard RC frames

  • Tunaboyu, Onur;Avsar, Ozgur
    • Structural Engineering and Mechanics
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    • v.61 no.1
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    • pp.1-13
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    • 2017
  • The effectiveness of the repair scheme for the damaged captive-columns with CFRPs (Carbon Fiber Reinforced Polymer) was investigated in terms of response quantities such as strength, ductility, dissipated energy and stiffness degradation. Two 1/3 scale, one-story one-bay RC (Reinforced Concrete) frames were designed to represent the substandard RC buildings in Turkish building stock. The first one, which is the reference specimen, is the bare frame without infill wall. Partial infill wall with opening was constructed between the columns of the second frame and this caused captive column defect. Severe damage was observed with the concentration of shear cracks in the second specimen columns. Then, the damaged members were repaired by CFRP wrapping and retested. For the three test series, similar reversed cyclic lateral displacement under combined effect of axial load was applied to the top of the columns. Overall response of the bare frame was dominated by flexural cracks. Brittle type of shear failure in the column top ends was observed in the specimen with partial infill wall. It was observed that former capacity of damaged members of the second frame was recovered by the applied repair scheme. Moreover, ultimate displacement capacity of the damaged frame was improved considerably by CFRP wrapping.

Fundamental Study of Alkali Activated Cement Mortar for Evaluating Applicability of Partial-Depth Repair (도로포장 보수재 활용 가능성 평가를 위한 알칼리 활성 시멘트 모르타르 기초연구)

  • Jeon, Sung Il;An, Ji Hwan;Kwon, Soo Ahn;Yun, Kyung Ku
    • International Journal of Highway Engineering
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    • v.15 no.3
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    • pp.1-8
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    • 2013
  • PURPOSES : This study is to evaluate the feasibility of using the alkali activated cement concrete for application of partial-depth repair in pavement. METHODS : This study analyzes the compressive strength of alkali activated cement mortar based on the changes in the amount/type/composition of binder(portland cement, fly ash, slag) and activator(NaOH, $Na_2SiO_3$, $Na_2CO_3$, $Na_2SO_4$). The mixture design is divided in case I of adding one kind-activator and case II of adding two kind-activators. RESULTS : The results of case I show that $Na_2SO_4$ based mixture has superior the long-term strength when compared to other mixtures, and that $Na_2CO_3$ based mixture has superior the early strength when compared to other mixtures. But the mixtures of case I is difficult to apply in the material for early-opening-to-traffic, because the strength of all mixtures isn't meet the criterion of traffic-opening. The results of case II show that NaOH-$Na_2SiO_3$ based mixtures has superior the early/long-term strength when compared to NaOH-$Na_2SiO_3$ based mixtures. In particular, the NaOH-$Na_2SiO_3$ based some mixtures turned out to pass the reference strength(1-day) of 21MPa as required for traffic-opening. CONCLUSIONS : With these results, it could be concluded that NaOH-$Na_2SiO_3$ based mixtures can be used as the material of pavement repair.

Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft (봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과)

  • Ko, Sang-Hun;Park, Ki-Bong;Park, Gil-Young;Kwon, Sun-Hwan;Kim, Myung-Seo;Park, Sun-Jae
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.135-142
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    • 2020
  • Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.