• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.145-150
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• 2014

In the patients of retracted massive rotator cuff tears, there are much of difficulty to functional recovery and pain relief. Nevertheless the development of treatment, there are still debates of the best treatments in the massive rotator cuff tears. Recenlty various of treatments are introduced; these are acromioplasty with debridement, biceps tenotomy, great tuberoplasty with biceps tenotomy, partial repair, mini-open rotator cuff repair, arthroscopic rotator cuff repair, soft tissue augmentation, tendon transfer, flap, hemiarthroplasty, and reverse total shoulder arthroplasty. That there is no difference of result for reverse total shoulder arthroplasty between patients who have massive rotator cuff tear without arthritis and patients who have cuff tear arthropathy. Reverse total shoulder arthroplasty is one of reliable and successful treatment options for massive rotator cuff tear. Especially it is more effective for patients who have a pseudoparalysis.

• 대한관절경학회지
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• 제2권2호
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• pp.141-146
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• 1998

Recent studies suggest that most meniscal cysts can be treated surgically by arthroscopic management of the meniscal tear and arthroscopic cyst evacuation. But arthroscopic cyst decompression may sacrifice a substantial amount of meniscal tissue that is not torn in order to expose the "stalk" of the cyst. Nowadays, the trend is changing as preserving the involved meniscus to prevent from inevitable degenerative changes after meniscectomy. The purpose of this report is to describe a new surgical technique that minimizes loss of meniscal tissue in hopes of maximizing residual meniscal function. We experienced 10 patients with meniscal cysts that were consisted of four lateral cysts and six medial cysts. Menisci were torn in all cases. Arthroscopic partial meniscectomy and decompression of cysts were performed in 9 cases, and arthroscopic partial meniscectomy and open cystectomy in 1 case. The procedures were consisted of injection of the methylene blue into the cyst, partial meniscectomy of the meniscal tear until the dye was seen in orifice of the cyst, and decompression of cyst through cystic opening. This article serves to confirm the relationship between torn menisci and cysts, to re-evaluate the occurrence ratio of the meniscal cyst on the medial to lateral meniscus, and to assess the efficacy of arthroscopic partial meniscectomy and decompression of cyst as a potentially meniscal sparing procedure.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.72-79
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• 2003

Purpose: To compare the results of arthroscopic rotator cuff repair and subacromial decompression in partial thickness rotator cuff tear (PTRCT) with those in full thickness rotator cuff tear (FTRCT). Subjects and method: Of the 46 patients who were rested of the rotator cuff tear based on the operational findings, 42 patients who were able to receive a serial follow-up for 2 years were selected as the study subjects. The average age of the patients at the time of the operation was 55 years, and the mean duration of the follow-up was 34 months. The subjects included 22 cases of PTRCT and 20 cases of FTRCT. In terms of rotator cuff repair, the average number of tendon to tendon repair (TTR) was 1 in both PTRCT and FTRCT, and that of tendon to bone repair (TBR) was 1 and 3 in PTRCT and FTRCT, respectively. The average number of use of suture anchor was 1 and 2 in PTRCT and FTRCT, respectively. The level of shoulder pain and function of the subjects were measured using shoulder functional evaluation score of American shoulder and elbow society (ASES score) at before and 2 years following the operation. Results: At the final follow-up following the operation, PTRCT group showed changes in scores from 7.2 to 0.9 on average pain score and 34 to 91 on ASES score, whereas FTRCT group showed changes in scores from 7.6 to 1.2 on pain score and 29 to 88 on ASES score. There were no significant differences between the two groups (P > 0.05). The average range of motion of shoulder significantly increased in both groups at the final follow-up in comparison with the pre-operative time point. The evaluation at the final follow-up showed that 93% of the total subjects showed good or excellent results, and 95％ showed satisfactory results from the procedure with regard to pain reduction and functional outcomes. Two cases of the 3 fair results were caused by acromioclavicular arthritis. Conclusion: It may be anticipated that arthroscopic rotator cuff repair and subacromial decompression may bring satisfactory post-operative outcomes in both PTRCT and FTRCT on pain relief and functional recovery. However, careful preoperative examination of the acromioclavicular joint is critical to avoid failures of these procedures.

• Clinics in Shoulder and Elbow
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• 제25권2호
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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.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2004년도 학술대회
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• pp.59-66
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• 2004

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2004년도 학술대회
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• pp.77-82
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• 2004

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2002년도 아시아견관절학술대회
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• pp.79-83
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• 2002

• 대한관절경학회지
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• 제2권1호
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• pp.21-24
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• 1998

후방십자인대 신선 파열 중 근위 및 중 1/3 실질 부위의 파열에 대한 관절경하 일차수복술 시행의 이론적 배경과 술기를 기술하였다.

• 대한정형외과스포츠의학회지
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• 제5권2호
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• pp.155-160
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• 2006

목적: 경골과 골절과 동반된 외측 반월상 연골 손상에서 봉합술 및 부분 절제술 후 치료 결과를 분석 하고자 하였다. 대상 및 방법: 1953년 2월부터 2004년 8월까지 경골과 골절로 치료 한 23명, 24예의 외측 반월상 연골 파열을 대상으로 하였다. 파열의 형태는 반월상 연골-관절낭 경계부의 종 파열 (14예, 66.7%)이 가장 많았다. 모든 골절은 관절경과 영상 증폭기의 감시하에 정복을 하였으며 반월상 연골 종 파열은 관절경하 수직 봉합술을, 나머지는 부분 절제술로 치료 하였다. 임상적 결과를 Ikeuchi의 평가 기준에 따라 분류하고 수술 전과 후의 Lysholm 점수를 비교 하였다(paired t-test). 결과: Ikeuchi 평가 기준에 따른 결과는 봉합술을 시행한 14예중 우수 12예 (85.7%), 양호 12예 (7.1%), 보통1예 (7.1%)였으며, 부분 절제술을 시행한 6예 중 우수는 4예 (66.7%), 양호는 2예(33.3%)를 보였다. Lysholm 점수는 수술 전 평균 56.6점에서 수술 후 92.3점으로 증가 하였다(p<0.0001, paired t-test). 결론: 경골과 골절은 외측 반월상 연골의 봉합술이나 부분 제거술의 결과에 나쁜 영향을 끼치지 않는 것으로 사료된다.

• 한방재활의학과학회지
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• 제24권1호
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• pp.77-82
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• 2014

Objectives Adhesive capsulitis (AC) is a restricted shoulder range of motion. Rotator cuff disease (RCD) has been believed to be a major etiologic factor of AC, however, how soon is the development time from RCD to AC (DTRA) has not been elucidated. The purpose of our study was to evaluate the correlation between the ultrasonographic characteristics of RCD and the DTRA. Methods Total 40 patients who were diagnosed as AC were recruited. The clinical characteristics of RCD were diagnosed by ultrasonography and classified with the Southern California Orthopedic Institute for Rotator Cuff Classification. The correlation was analyzed with Mann-Whitney U test and one-way analysis of variance. Results 60% of full thickness tear and 40% of partial thickness tear patients (10 male and 30 female, mean age of $54.0{\pm}8.4$ years) and 38% of bursitis and 21% of neovascularization were observed. The mean value of DTRA was $74.8{\pm}131.3$ days. There were no correlation between DTRA and gender (p=0.63), location of the partial tear (p=0.63), the severity of the partial thickness tear (p=0.63), full thickness tear (p=0.66) and completeness of the tear (p=0.16). The presence of bursitis or neovascularization was not associated with DTRA (p=0.60, p=0.61). Conclusions Although RCD is a major etiologic factor of AC, the severity, the type of RCD and the presence of bursitis and neovascularization were not statistically correlated with the DTRA in our study. Comprehensive consideration about etiologic factor analysis of AC will be needed with prospective study design for future study.