• Title/Summary/Keyword: Partial-thickness tear

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What are Valuable Positive Signs of Supraspinatus Test for Diagnosis of Torn Rotator Cuff? - Comparison of Pain and Weakness in "Empty Can Test" and "Full Can Test" - (회전근 개 파열의 진단을 위한 극상근 검사에서 유용한 양성 징후는 무엇인가? - "Empty can test"와 full can test"에서 통증과 근력 약화의 비교 -)

  • Shin, Hun-Kyu;Kim, Eu-Gene;Jeong, Hwa-Jae;Kim, Jong-Min;Choi, Jae-Yol;Lee, Yong-Taek
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.27-32
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    • 2007
  • Purpose: To investigate the validity of positive signs of supraspinatus test. Materials and Methods: The empty can test and full can test were performed on 200 shoulders which were diagnosed with magnetic resonance imaging or surgical findings as full thickness tear, partial thickness tear and no tear. Presence of pain, weakness, pain or weakness, and both pain and weakness were recorded as positive signs separately. The two tests with positive signs were compared and analyzed. Results: Pain and weakness were severity-dependent, and the empty-can test had a higher incidence of pain. The sensitivities of the two supraspinatus tests in all positive signs were higher when including partial-thickness tears in the tear group; however, their specificities were higher when excluding partial-thickness tears. The sensitivities of an empty-can test in 'pain', 'pain or weakness', 'both pain and weakness' were higher than those of the full-can test, otherwise, the specificity of the full-can test for 'pain' and 'pain or weakness' were higher. Concordance rate between 'pain or weakness' and 'pain' was the highest in all categorization. Conclusion: Both empty can and full can test were valuable for detecting torn rotator cuff.

Orthopaedic Rehabilitation in Chronic Shoulder Pain (만성 견관절통에 대한 정형외과적 재활치료)

  • Tae, Suk-Kee;Lee, Kee-Hyun
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.99-107
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    • 2003
  • Disorders of the shoulder in which conservative management is indicated as a primary treatment include idiopathic frozen shoulder, atraumatic instability. acute calcific tendinitis , subacromial impingement syndrome, partial thickness or small full thickness tear of the rotator cuff, and chronic rotator cuff tear in elderly population. Aside from medication and various physical modalities used for relief of pain, the mainstay of orthopaedic rehabilitation consists of stretching of the tendons and capsulologamentous complex, and strengtnening of rotator cuff muscles as well as surrounding muscles. However, orthopaedic rehabilitation in chronically painful conditions of the shoulder differs in detail according to the specific diseases or injuries, And it is important to make the rehabilitation program that can be undertaken by the patients rather than adhering to a fixed schedule. Also the program should be changed as the condition of the patient improves or deteriorates. Nevertheless there are basic rules of stretching and strengthening , which should always be observed in applying orthopaedic rehabilitation treatment.

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.

Arthroscopic Treatment of Symptomatic Shoulders with Minimally Displaced Greater Thberosity Fracture (상완골 대결절의 미세전위골절의 관절경적치료)

  • Kim Seung-Ho;Ha Kwon-Ick
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.178-186
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    • 1999
  • Twenty-three patients with chronic shoulder pain beyond 6 months after the fracture of the greater tuberosity underwent arthroscopic treatment and were retrospectively assessed after an average of 29 months(range, 22 to 40 months). There were 18 men and 5 women with the average age of 39 years(range, 24 to 61 years). Fourteen were isolated fractures and nine were related to acute anterior instability episode. The average displacement of the fracture was 2.3mm(range, 0 to 4mm) on the anteroposterior view of the plane radiographs. At the time of arthroscopy, all patients had partial thickness rotator cuff tears in the articular surface. The cuff tears were located on the tuberosity fracture area and were an Ellman's grade I to n in depth. With the arthroscopic debridement or repair of the tear depending on the condition of the tear itself, as well as the subacromial decompression, the UCLA score revealed good to excellent results in 20 and fair in 3 patients. Nineteen of the patients had returned to the previous level of activities. The patient with a higher activity demand revealed a lower level of activity return(p=0.034). The partial thickness rotator cuff tear should be considered in patients with chronic shoulder pain after the minimally displaced fracture of the greater tuberosity, and arthroscopic debridement or repair is an appropriate procedure.

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Arthroscopic Decompression of Subacromial Impingement Syndrome (관절경적 감압술에 의한 견봉하 충돌증후군의 치료)

  • Kim Seong Jae;Kim Beom Su;Choe Nam Hong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1995.05a
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    • pp.13-13
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    • 1995
  • The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

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Evaluation of Tear Film Lipid Layer Thickness Measurements Obtained Using an Ocular Surface Interferometer in Nasolacrimal Duct Obstruction Patients

  • Lee, Sang Min;Chung, Sok Joong;Lew, Helen
    • Korean Journal of Ophthalmology
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    • v.32 no.6
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    • pp.445-450
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    • 2018
  • Purpose: To compare the tear film lipid layer thickness (LLT) between patients with incomplete nasolacrimal duct obstruction (NLDO) and normal controls and to analyze the changes in tear film LLT and blinking pattern after silicone tube intubation in NLDO patients. Methods: We reviewed the medical records of 68 eyes in 52 incomplete NLDO patients who underwent silicone tube intubation from January 2017 to July 2017. The LLT, blinking pattern, and Meibomian gland image were measured with the LipiView II ocular surface interferometer. The Meibomian gland drop-out ratio was measured using the polygon selection tool in the Image J program. Tear meniscus height, which is the other lacrimal indicator, was assessed with spectral-domain optical coherence tomography. Results: Tear meniscus height was significantly decreased after silicone tube intubation (p < 0.01). Preoperative minimum, maximum, and average LLT values were $62.4{\pm}24.0$, $86.7{\pm}17.9$, and $71.7{\pm}23.3nm$, respectively. Significant changes in the minimum, maximum, and average LLT ($74.8{\pm}23.6$, $98.8{\pm}11.0$, and $91.6{\pm}16.1nm$, respectively) were observed after silicone tube intubation (p < 0.001, p = 0.001, and p < 0.001). The partial blinking/total blinking ratio in 20 seconds and the Meibomian gland drop-out ratio showed no significant change after silicone tube intubation. Conclusions: Overall, the LLT was increased after silicone tube intubation. Silicone tube intubation may be helpful in maintaining LLT with a normalized of amount of tears.

Arthroscopic Repair of Full Thickness Tear of The Supraspinatus; Evaluation of the Clinical Outcome and the Postoperative Rotator Cuff Integrity (견관절 극상건 전층 파열의 관절경적 복원술; 임상적 결과 및 술후 회전근개 상태의 평가)

  • Noh, Kyu-Cheol;Chung, Kook-Jin;Kim, Sung-Woo;Yoo, Jung-Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.50-57
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    • 2006
  • Purpose: The purpose of this study was to evaluate the tendon healing of arthroscopic repair in full-thickness supraspinatus tears. We evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement. Materials and Methods: Thirty consecutive full-thickness supraspinatus tears were repaired arthroscopically in 19 patients with a one row of anchor and 11 patients with two rows of anchors. Patients ranged in age from 51 to 79 years (average 63 years). Average follow-up was 16 month (range, 12 to 28 months). To evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement, we calculate the Constant, ASES, UCLA scores. The 30 patients had either an MR Arthrogram (25 cases) or an MRI (5 cases), performed between 5 months and 20 months (mean 10 months) after surgery. Results: The cuff was healed in 21/30 cases (70%) and partially torn in 3 cases (10%) after the arthroscopic repair of full-thickness supraspinatus tear. Although the supraspinatus tendon was totally torn to the tuberosity in 6 cases(20%) after the arthroscopic repair, the size of the tear was smaller than the initial in 5 cases. The Constant score improved from an average of $55.7{\pm}7.1$ points preoperatively to $77.7{\pm}9.7$ points at the last follow-up (p<0.001), and the average ASES score improved from $39.2{\pm}7.4\;to\;72.4{\pm}12.6$ (p<0.001), and the average UCLA score improved from $17.9{\pm}2.2\;to\;26.8{\pm}5.0$ (p<0.001). Strength of elevation was significantly better $(7.1kgs{\pm}2.4)$ in the shoulders with a healed tendon that in those with an total or partial re-tear tendon $(4.5kgs{\pm}1.0)$ (p<0.05). Factors adversely affecting tendon healing were increasing age, Only 41.7% of the repairs completely healed in patients over 65 years (p<0.05). Conclusion: Arthroscopic repair of isolated full-thickness tear of the supraspinatus leads to completely healing in 70% of the cases. Total or partial re-tear of the repaired rotator cuff is associated with a decreased strength. Older patients had significantly lower healing rates.

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Oxygen Diffusion According to the Fitting Conditions of Contact Lens (콘택트렌즈의 피팅조건에 따른 산소확산)

  • Kim, Dae Soo
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.35-43
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    • 2008
  • Purpose: This review article was written to investigate how the various factors, such as lacrimal thickness, CL's thickness and Dk, affects the influx of $O_2$ diffusion into the cornea. Methods: A mathematical model was proposed to analyze the oxygen diffusion reaching the cornea through the tear layers and contact lens based on Fick's law and the principle of continuity of the diffusion flux through the each layers. Results: The model predicts how the parameters such as the thickness of tear layer on the cornea, both the Dk and thickness of contact lenses etc., affect the oxygen tension at cornea and oxygen flux entering the cornea. Conclusions: It is found that either too flat or too tightly fitted contact lenses can cause the oxygen deficiency at/inside the periphery of the cornea because of the reduction of oxygen flux resulted from too thickened tear layer.

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Detection of Tendon Tears by Degree of Linear Polarization Imaging

  • Kim, Ji-Hoon;Oh, Jung-Hwan;Kang, Hyun-Wook;Lee, Ho;Kim, Jee-Hyun
    • Journal of the Optical Society of Korea
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    • v.13 no.4
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    • pp.472-477
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    • 2009
  • A Stokes polarimetry imaging (SPI) system was developed and utilized to detect tendon tears by constructing the degree of linear polarization (DOLP) image maps after linearly polarized light illumination. The micro and partial-thickness tears of turkey tendons were made and imaged by the SPI system at different incident polarization angles (IPA) with different mechanical loads on the tendon. The micro and partial-thickness tendon tears were detected by the DOLP images due to weak birefringence around the tears. The tendon tears were detected by a highest DOLP contrast at longest visible wavelength (Red, 650 ${\pm}$ 50 nm). All polarized images showed modulated DOLP as the incident polarization angle (IPA) was varied. The varying DOLP allowed the optimal detection of the micro and partial-thickness tendon tears at a certain IPA. The SPI system with variable IPA and spectral information can improve the detection of the tendon tears by higher visibility of fiber orientations, and thereby improve diagnosis and treatment of the tendon related injuries.