• Title/Summary/Keyword: Partial rotator cuff tear

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Arthroscopic Versus Open ACJJ'omioplasty for Impingement Syndrome and Partial Thickness Rotator Cuff Tear (충돌증후군 및 회전근개부분좌열에서의 관절경적 견봉성형술과 개방적 견봉성형술의 비교 분석)

  • Rhee Yong-Gir;Chang Ki-Seong
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.109-117
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    • 1998
  • We evaluated the results of the surgery for impingement syndromes and partial thickness tears of the rotator cuff with an average follow-up period of 15 months. One group(group I) of 43 patients, 46 cases underwent arthroscopic subacromial decompression. The other comparable group(group Ⅱ) of 10 patients, II cases underwent open acromioplasty. The average age at operation was 48 years, old. Arthroscopic subacromial decompression achieved slightly better pain relief, the range of the acti ve forward flexion, function, strength and the overall score with improvement from the preoperative condition than open acromioplasty. The patient's satisfaction was better in group I as well. Using the UCLA Shoulder Rating Scale, 89% of group I and 82% of group n had good or excellent results. Preservation of the origin of the deltoid during an arthroscopic acromioplasty reduced the postoperative morbidity and made it possible to start rehabilitation sooner and to achieve the better and more predictable results.

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Arthroscopic Capsulolabral Repair Using Absorbable Suture-Anchor for the Traumatic Anterior Instability of Shoulder (흡수성 suture-anchor를 이용한 견관절 전방 불안정성의 재건술)

  • Kim Seung-Ki;Song In-Soo;Seo Hyun Mo;Moon Myung-Sang;Lin Guang
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.65-69
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    • 2004
  • Purpose: The purpose of this study is to evaluate the short-term clinical outcome of the capsulolabral repair using absorbable suture anchor in traumatic anterior instability of shoulder. Materials and Methods: From June 2000 to September 2001, 15 shoulders with recurrent anterior instability were operated with arthroscopic Bankart repair using absorbable suture-anchor 'PANALOK' (Mitek, westwood, MA), and were followed up over 1 year (average; 13 months). The mean age was 23-years. There were fourteen males and one female. The mean duration from the initial symptoms to the operation was 24 months. Associated pathologies were Hill-Sachs defect in 12 cases, SLAP in 6 cases, and partial rotator cuff tear in 2 cases. The results were evaluated by patien's satisfaction, Modified Rowe Score in regard to joint stability, mobility, pain and function in comparison with the preoperative ones, and other complications. Results: At the last follow-up, the total Rowe Score increased from 38 points to 92 points. There were no recurrence and 14 patients among 15 patients gained pre-operative level of sports activity and no other complications. Conclusion: Effective capsulolabral repair could be obtained by the absorbable anchoring without any untoward complications. This procedure is simple and safe one and this system can be a good substitute for the metallic anchor.

Clinical Outcome after Arthroscopic Capsular Release for Adhesive Capsulitis of the Shoulder

  • Yoo, Jae Chul;Koh, Kyoung Hwan;Shon, Min Soo;Bae, Kyu Hwan;Lim, Tae Kang
    • Clinics in Shoulder and Elbow
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    • v.21 no.3
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    • pp.127-133
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    • 2018
  • Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

Results of Arthroscopic Bankart Repair Using Knotless Suture Anchor (Knotless Suture Anchor를 이용한 관절경적 Bankart 봉합술의 결과)

  • Kim Bo-Hyun;Byun Jae-Yong;Hong Chang-Wha;Hwang Chan-Ha;Yoo Ju-Seok;Kim Sang-Bum
    • Clinics in Shoulder and Elbow
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    • v.8 no.1
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    • pp.23-30
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    • 2005
  • Purpose: This paper analyzes the results of arthroscopic bankart repair for anterior recurrent dislocation following a trauma on shoulder. Material and Methods: The subjects were twenty-three (23) cases that were available to follow up for more than eighteen months during the period from November 2001 to June 2003 and were chosen from patients to whom arthroscopic bankart repair was applied using a knotless suture anchor for their traumatic anterior recurrent dislocation on the shoulder. Their average age was 28 (ranging from 15 to 60) with 20 males and 3 females. The injury from sports activities accounted for the most cases with 14 subjects. The average follow-up period was 27 months (ranging from 18 months to 35 months). There were 19 cases of bankart lesions, 4 cases of ALPSA lesions and associated with 5 cases of partial tear in the rotator cuff. The anchors employed were knotless anchor (Mitek) for all the cases. Rowe scoring scale was adopted to judge the results after operations. Patients' subjective satisfaction and range of motion of external rotation were addressed together. Results: Rowe scores showed that 20 cases (87%) reaches the level of 'good' and hinger. The average patients' satisfaction accounted for 90 points out of 100. It was also found that external rotations averagely decreased by 6.5 degree when the range of motion was in at the side. Conclusion: There were satisfactory results of arthroscopic bankart repair using knotless suture anchors as an operative treatment for traumatic anterior recurrent dislocation on shoulder.

The Clinical Outcomes of Arthroscopic Repair of Isolated type II SLAP Lesion in Non-athletes (비 운동선수에 있어 단독 제 2형 SLAP 병변의 관절경적 봉합수술의 임상적 결과)

  • Yoo, Jae-Chul;Ahn, Jin-Hwan;Koh, Kyoung-Hwan;Kim, Seung-Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.185-190
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    • 2008
  • Purpose: The purpose of this study is to provide the clinical outcomes of arthroscopic type II SLAP repair in non-athletes, and to compare the clinical outcomes between those who had isolated type II SLAP lesion and those who had combined partial thickness supraspinatus tear that did not required a combined repair. Materials and Methods: From July 2005 to January 2007, 142 consecutive type II SLAP lesions were treated with arthroscopic surgery. The inclusion criteria for the study were; (1) younger than 50 years old; and (2) non-athletes. Exclusion criteria were; (1) prior surgery, fracture or combined recurrent dislocation history on the affected shoulder; (2) combined full thickness rotator cuff tear or PTST (>50% thickness) patient that needed repair; and (3) combined infection, arthritis or inflammatory disease. Remaining 19 patients meet the criteria. Among them, 13 had combined PTRCT that did not require repair (Group I), and 6 had isolated type II SLAP lesion without combined supraspinatus tear (Group II). The mean age was 36.7 years (29~49 years), mean symptom duration was 39.1 months (3~216 months) and mean follow-up was 19.0 months (12~27 months). In all patients, the range of motion of affected shoulder, pain and function visual analogue scale (PVAS, FVAS), the Constant score and UCLA score were evaluated preoperatively and postoperatively. Results: In group I, external rotation at side was decreased significantly (p=0.003),but there were no statistical significant change at the remains(p>0.05). And there were no differences between groups (p>0.05). At the final follow-up, all clinical outcome measurements improved after surgery with statistical significance (p<0.05): UCLA score, $22.8{\pm}5.2$ to $32.8{\pm}2.1$; Constant score, $79.4{\pm}8.6$ to $94.9{\pm}4.3$; PVAS $5.4{\pm}2.7$ to $1.1{\pm}1.4$; FVAS $63.2{\pm}15.3$ to $93.4{\pm}7.3$. But, in group comparison of the mean UCLA score and Constant score, there were no statistical significant differences between two groups. Conclusion: Arthroscopic repair of type II SLAP lesion provided good clinical outcomes in nonathletic population. Combined partial thickness supraspinatus tear does not seem to hamper the final outcome at minimal 1 year follow-up.

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Arthroscopic Bankart Repair: At Least 5 Years Follow-up (관절경적 Bankart 병변 봉합술: 5년 이상 추시 결과)

  • Heo, Mu-Jung;Kim, Kyung-Taek;Kim, Chul-Hong;Kang, Min-Soo;Kim, Hyeon-Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.83-88
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    • 2009
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using metal suture anchors for treatment of chronic traumatic anterior instability of shoulder joint. Materials and Methods: 85 patients (80 male and 5 female) were included in this study. The average age was 26 (15~52) years old and the period from the first injury to operation was average 20 (6~38) months. All cases had Bankart lesion and 44 cases had Hill-Sachs lesion. The SLAP lesion was associated in 10 cases and 7 cases had partial rotator cuff tear. The average follow-up period was 89 (68~108) months. Results: Preoperative Rowe score was average 29.3 (25~50) and Rowe score improved to 86.8 (40~100), excellent in 28 cases (32.9%) and good in 46 cases (54.1%) at last follow up period and 70 cases (82.4%) had full range of motion of the shoulder. The arthroscopic revision surgery of the shoulder was performed in 3 cases (3.5%) because of postoperative re-dislocation. Conclusion: We concluded that arthroscopic Bankart repair with metal suture anchors is one of the reliable and effective method for recurrent anterior shoulder dislocation with Bankart lesion.

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Accompanying Lesions and Clinical Results in the Greater Tuberosity Fracture of the Humerus with Anterior Shoulder Dislocation Under the Age of Forty (40세 이하에서 견관절 전방 탈구가 동반된 상완골 대결절 골절에서 관절내 병변 및 임상 결과)

  • Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Kyu;Park, Hyeun-Kook;Park, Jang-Hee;Shin, John
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.20-26
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    • 2011
  • Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.