• The Korean Journal of Pain
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• v.24 no.2
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• pp.69-73
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• 2011

Although the incidence of partial-thickness rotator cuff tears (PTRCTs) was reported to be from 13% to 32% in cadaveric studies, the actual incidence is not yet known. The causes of PTRCTs can be explained by either extrinsic or intrinsic theories. Studies suggest that intrinsic degeneration within the rotator cuff is the principal factor in the pathogenesis of rotator cuff tears. Extrinsic causes include subacromial impingement, acute traumatic events, and repetitive microtrauma. However, acromially initiated rotator cuff pathology does not occur and extrinsic impingement does not cause pathology on the articular side of the tendon. An arthroscopic classification system has been developed based on the location and depth of the tear. These include the articular, bursal, and intratendinous areas. Both ultrasound and magnetic resonance image are reported with a high accuracy of 87%. Conservative treatment, such as subacromial or intra-articular injections and suprascapular nerve block with or without block of the articular branches of the circumflex nerve, should be considered prior to operative treatment for PTRCTs.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.120-125
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• 1999

Objectives : To evaluate the effects of arthroscopic acromioplasty and debridement for partial thickness articular side rotator cuff tears, Method: We divided 97 patients into 2 groups according to treatment protocol, with both groups having confirmed intra-articular partial tears of the rotator cuff. In group Ⅰ, we debrided the frayed and fibrotic cuff margin while in group II, we performed subacromial decompression in addition to debridement. After the surgery we checked all the patients with the modified UCLA shoulder rating scale. Results: The follow-up observation 12 months after surgery revealed that 44 patients in group I were rated as excellent in 32 cases, good in 10 cases, fair in 1 case, and poor in one case, while 53 patients in group II, were rated as excellent in 38 cases, good in 17 cases, and fair in 2 cases. Twenty-four month after surgery we observed that patients in group I were rated as excellent in 23 cases, good in 16 cases, fair in 4 cases, and poor in 1 case, while patients in group II were rated as excellent in 34 cases, good in 17 cases, and fair in 6 cases. Conclusion: The use of acromioplasty on partial thickness tears of rotator cuff, even in the cases of intra-articular nature, is preferable to the procedure performed without it.

• Clinics in Shoulder and Elbow
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• v.23 no.3
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• pp.125-130
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• 2020

Background: To determine the prevalence of rotator cuff diseases in a population older than 40 years in or nearby Chuncheon city, Republic of Korea. Methods: Sixty shoulders of 30 people older than 40 years who participated in a health lecture were examined for free by an orthopedic surgeon. Visual analog scale of pain and American Shoulder and Elbow Surgeons scores were assigned, and routine physical examination was performed. Ultrasonography was performed on the shoulder. Results: On ultrasonographic examination, there were one shoulder with full thickness rotator cuff tear, 20 of 60 (33%) with partial thickness rotator cuff tear, five of 60 (8%) with calcific tendinitis, one of 60 (2%) with tear of the long head of the biceps, and five of 60 (8%) with tendinitis of the long head of the biceps. Participants older than 60 years showed significantly high proportions of lesion of the long head of the biceps and rotator cuff diseases (P=0.019 and P=0.015, respectively). Participants who performed physical labor had high proportions of rotator cuff tear and rotator cuff disease (P=0.001 and P<0.001, respectively). Conclusions: Rotator cuff diseases showed a high prevalence in aged persons and resulted in a decrease in shoulder function.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.216-219
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• 2019

Background: Progression of the tear size and erosion of the greater tuberosity (femoralization) in the supraspinatus tear makes it difficult to repair or increases the risk of a re-tear. This study examined the proximal articular surface and greater tuberosity of the humeral head in plain radiography. Methods: Two-hundred forty-seven cases, whose anteroposterior (AP) radiographs were taken correctly, were included from 288 cases, in whom the status of the supraspinatus had been confirmed by surgery. After downloading the plain AP radiograph as DICOM, the radius of the circle apposed at the superior half of the articular surface of the head, and the distance between the circle and the farthest point of the greater tuberosity ('height' of the greater tuberosity) were calculated using the software (TechHime, Korea). MRI checked the number of torn tendons and degree of muscular atrophy. Results: The following were encountered: 93 intact supraspinatus, 50 partial-thickness tears, and 104 full-thickness tears. In the analysis using the 93 intact cases, the average radius of the rotation center was 25.3 mm in male and 22.3 mm in female. The average height of the greater tuberosity from the circle with the same rotation center was 4.3 mm in male and 4.2 mm in female with no statistical significance. The correlation between the reparability of supraspinatus and height of the greater tuberosity, fatty infiltration, and muscular atrophy was confirmed. Conclusions: The height of the greater tuberosity from the circle with the same rotation center was 4.3 mm in male and 4.2 mm in female. This height was strongly correlated with muscular atrophy and fatty infiltration of the supraspinatus tendon.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.257-264
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• 2022

Background: Chronic subscapularis tendon tear (SBT) is a degenerative disease and a common pathologic cause of shoulder pain. Several potential risk factors for chronic SBT have been reported. Although metabolic abnormalities are common risk factors for degenerative disease, their potential etiological roles in chronic SBT remains unclear. The purpose of this study was to investigate potential risk factors for chronic SBT, with particular attention to metabolic factors. Methods: This study evaluated single shoulders of 939 rural residents. Each subject undertook a questionnaire, physical examinations, blood tests, and simple radiographs and magnetic resonance imaging (MRI) evaluations of bilateral shoulders. Subscapularis tendon integrity was determined by MRI findings based on the thickness of the involved tendons. The association strengths of demographic, physical, social, and radiologic factors, comorbidities, severity of rotator cuff tear (RCT), and serologic parameters for SBT were evaluated using logistic regression analyses. The significance of those analyses was set at p<0.05. Results: The prevalence of SBT was 32.2% (302/939). The prevalence of partial- and full-thickness tears was 23.5% (221/939) and 8.6% (81/939), respectively. The prevalence of isolated SBT was 20.2% (190/939), SBT combined with supraspinatus or infraspinatus tendon tear was 11.9% (112/939). In multivariable logistic regression analysis, dominant side involvement (p<0.001), manual labor (p=0.002), diabetes (p<0.001), metabolic syndrome (p<0.001), retraction degree of Patte tendon (p<0.001), posterosuperior RCT (p=0.010), and biceps tendon injury (p<0.001) were significantly associated with SBT. Conclusions: Metabolic syndrome is a potential risk factor for SBT, as are these factors: overuse activity, diabetes, posterosuperior RCT, increased retraction of posterosuperior rotator cuff tendon, and biceps tendon injury.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.38-43
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• 2009

Purpose: The purpose of this study was to assess the efficacy of MR arthrography to detect partial thickness rotator cuff tears. Materials and Methods: One hundred and seventy seven patients with a high suspicion for rotator cuff disease were studied by performing MR-arthrography and subsequent arthroscopy. The ability of MR-arthrography to detect partial thickness tears was evaluated according to the location of the tears. We determined the correspondence between the measurements of the articular side partial tears on MR arthrography and those on the arthroscopic findings. Results: The arthroscopic diagnosis of partial thickness rotator cuff tears was divided into 3 groups according to their location. There were 63 cases on the articular side, 41 cases on the bursal side and 20 cases on both sides. The sensitivity of MR-arthrography was 82% for the articular side tears and 11% for the bursal tears. The specificity was 88% for the articular side tears and 100% for the bursal tears. MR-arthrographic measurement correctly predicted 72% in 28 repaired cases of 56 articular side partial thickness tears. Conclusions: MR-arthrography may be a reliable tool for diagnosing articular side partial thickness rotator cuff tears, but it has limitations for bursal side tears.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.2
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• pp.93-97
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• 2004

Continued research needs to be devoted to understanding the natural history of rotator cuff tears. Recent studies have shown progression of tear, symptomatic flare-ups and irreversible change in rotator cuffs managed nonsurgically. These data allow the grouping of patients with rotator cuff tears into three categories based on risk-benefit ratios. Nonsurgical care should be maximized for patients with impingement symptoms only, with partial-thickness tears, with chronic tears, and for the elderly patients. The proper selection of candidates for nonsurgical management should lead to the high success rate quoted by multiple authors. Even though conservative treatment is necessary, early surgery should be considered for tears that are acute, small or medium, associated with shoulder loss of function, or occur in a younger patient. Prolonged nonsurgical care in these patients risks tear propagation and irreversible changes to the cuff, which may complicate rotator cuff repair.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.124-131
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• 2004

Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2001.03a
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• pp.91-92
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• 2001

1. Partial cuff tears are common and incapacitate active people in the 5th to 6th decades. 2. The pathogenesis appears multifactorial. 3. The pain is proportional to the degree of concomitant subacromial bursitis, not to the size of the cuff tear. 4. The diagnosis is made by several imagings, arthroscopy and/or trial tenotomy. 5. The spontaneous healing is unlikely and progression to complete tears is frequent. 6. The intratendinous extension poses therapeutic problem but satisfactory results are obtained by open surgery in approximately $90\% of cases.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.68-72
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• 2006

Purpose: To demonstrate arthroscopically the presence of bilateral shoulder "mirror lesions" due to overhead work. Materials and Methods: A cross-sectional study was performed in a historical cohort of 10 male tire plant workers who underwent MRI studies of both shoulders. Bilateral intraarticular shoulder pathology was diagnosed by magnetic resonance imaging and confirmed by arthroscopy. "Mirror lesions" were defined as similar pathology between an individual patient's two shoulders. Results: We report on ten patients who had bilateral "mirror lesions." The most common mirror lesions were tears of the rotator cuff. Most patients (7 of 10) had more than one mirror lesion in their shoulders. There were two bilateral full thickness tears involving the supraspinatus and infraspinatus, four bilateral partial thickness supraspinatus tears, six bilateral partial or upper corner lesion complete subscapularis tears, and one bilateral complete supraspinatus tear. Conclusion: Occupational overhead work with simultaneous use of both arms is associated with bilateral shoulder lesions verified by arthroscopy. By demonstrating the work-related bilateral shoulder involvement, this study suggests an etiopathogenesis for these lesions and provides rational for developing worksite prevention strategies.