Lee Kwang-Won;Ryu Chang-Soo;Kim Ha-Yong;Kim Byung-Sung;Choy Won-Sik
Journal of the Korean Arthroscopy Society
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v.5
no.1
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pp.27-31
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2001
Purpose : The purpose of this study was to evaluate results of the arthroscopic treatment of calcific tendinitis of the shoulder resistant to conservative treatment. Materials and Methods : From March, 1996 to June, 1998, fourteen patients underwent shoulder arthroscopy to treat resistant calcific tendinitis of the rotator cuff despite conservative treatment for more than 6 months. Calcium deposits were localized to the supraspinatus tendon only in eleven patients, the supraspinatus and infraspinatus tendon in two patients, and to the supraspinatus and subscapularis tendon in one patient. Each shoulder was evaluated with UCLA shoulder rating scale and Constant-Murley score Results : The Constant-Murley pain score improved from average score 3.2 before surgery to average score 8.3 after surgery, and the UCLA functional average score improved from 4.5 preoperatively to 8.3 postoperatively. Preoperative ROM averaged $110^{\circ}$ of flexion, $45^{\circ}$ of external rotation, $90^{\circ}$ of abduction, and internal rotation with the thumb reaching to the spinous process of the third lumbar vertebra, but postoperative range of motion averages improved as follows: $170^{\circ}$ or flexion, $50^{\circ}$ of external rotation, $140^{\circ}$ abduction, and internal rotation with the spinous process of the twelveth thoracic vertebra. Overall 3 patients were rated excellentm 9 were good, 2 were fair. Conclusion : Shoulder arthroscopy is an effective treatment in patients with refractory calcific tendinitis.
Purpose: We try to evaluate the functional outcomes of the ankle with isokinetic plantaflexion torque for acute achilles tendon rupture cases those treated by primary repair with the Krackow suture technique and early rehabilization. Materials and Method: The authors studied retrospectively, 15 patients of acute achilles tendon rupture treated and followed over six months, from July 1997 to May 2001. There were 12 men and 3 women, and mean age was 39.6year. The repair method of ruptured tendon was single or double Krackow suture technique. One week(5days-2weeks) after operation, early ROM with ankle-foot orthosis was started. We used Arner-Lindholm Scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. We analyzed the dorsiflexion peak torque and plantarflexion peak torque of the ankle statistically with strength test with Cybex dynamometer. Result: In clinical results, we had 11 excellent cases(73%) and 3 good cases(20%). In patients satisfaction degree, 11 excellent cases(66.6%), 3 good cases(20%) and 2 fair cases(13.4%). And in strength deficit, 3 none deficit (20%), 9 minimal deficit(60%). We evaluated the isokinetic plantar flexion torque in 3months or 6months after operation. After 3 months, isokinetic test showed the mean functional deficits, 32% and 25% at $30^{\circ}$ and $120^{\circ}/sec$, in 7 cases(46.6%) of 15 cases respectively. After 6 months, the mean deficits were in 21%, 24% at 30. and $120^{\circ}/sec$, respectively. At 3 and 6 months' follow up, absolute value of isokinetic test showed increase of 25. 31bs to 421bs and 19.61bs to 271bs at $30^{\circ}$ and $120^{\circ}/sec$, respectively. Conclusion: We had good result for acute achilles tendon rupture treated by Krakow suture technique and early range of motion exercise of the ankle. After 6 months, strength deficit was 21% in all of cases but were able to return pre-injured state. This study shows Krakow suture technique was recommended method for primary repair and early rehabilization of achilles tendon ruptue.
Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.
The purposes of this study were to compare pelvic tilt. range of motion(ROM) of hip rotation, and leg length difference before and after manipulation and to investigate correlation between changes of each variables after manipulation of sacroiliac pint in 31 low back pain patients(11 males, 20 females) with sacroiliac pint dysfunction. The sacroiliac pint of patients was manipulated on the side of anterior pelvic tilt, using the technique described by Stoddard(1962) and Greenmann (1996). I used this technique because it usually eliminated sacroiliac Pint dysfunction in one treatment session. SPSS for window computer system was used to analyze the data. Also t-test was performed for comparison of the variables before and after manipulation, and Pearson product-moment correlation analysis and regression analysis were performed for changes of each variables after manipulation. The result were as follows: 1. The pelvic tilt after manipulation was significantly decreased(mean=$2.79^{\circ}$) compared with the pelvic tilt before manipulation(p=.001). 2. The PROM of hip internal rotation ipsilateral to anterior pelvic tilt after manipulation significantly decreased (mean = $1.88^{\circ}$) compared with hip internal rotation before manipulation (p=.008). The PROM of hip internal rotation ipsilateral to posterior pelvic tilt after manipulation significantly increased(mean = $1.29^{\circ}$) compared with hip internal rotation before manipulation (p=.029). 3. The PROM of hip external rotation ipsilateral to anterior pelvic tilt after manipulation significantly increased(mean=$2.42^{\circ}$) compared with the hip external rotation before manipulation(p=$2.42^{\circ}$) compared with the hip external rotation ipsilateral to posterior pelvic tilt after manipulation significantly decreased(mean = $1.84^{\circ}$) compared with the hip external rotation before manipulation (p=.008). 4. Leg length difference after manipulation significantly decreased(mean=2.15 mm) compared with leg length difference before manipulation (p=.008). Regression analysis revealed that a fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(p=.009). 5. Pearson product-moment correlation coefficient was used to assess differences of the variables after manipulation. A fair correlation was found between change in leg length difference and change in anterior pelvic tilt after manipulation(r=.462, p<.01). A fair correlation was found between change in anterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.397, p<.05) and between change in anterior pelvic tilt and change in hip external rotation ipsilateral to anterior pelvic tilt(r=.516, p<.01). A fair correlation was found between change in posterior pelvic tilt and changes in hip internal rotation ipsilateral to posterior pelvic tilt (r=.441, p<.05) and between change in posterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.361, p<.05). A fair correlation was found between change in hip internal rotation ipsilateral to anterior pelvic tilt and change in hip external rotation ipsilateral to posterior pelvic tilt(r=.388, p<.05) and between change in hip internal rotation ipsilateral to posterior pelvic tilt and change in hip internal rotation ipsilateral to anterior pelvic tilt(r=.426. p<.05).
Purpose: To describe the impingement of the osteophyte between the olecranon process and olecranon fossa and to understand the effect of removing the lesion on the elbow extension in heavy workers. Materials and Methods: Arthroscopy was performed to elbow of heavy industrial workers who complained painful limitation of elbow extension.6 patients(Teases) with average age of 43 year were selected. The average ROM showed flexion contracture of $17^{\circ}$ and further flexion of $87^{\circ}$. Results: In all cases, after the operation two months follow up, mean flexion contracture improved from $17^{\circ}\;to\;2^{\circ}$ with further flexion from$87^{\circ}\;to\;122^{\circ}$. After the operation 1 year follow up, the mean flexion contracture was $3^{\circ}$ and further flexion was $113^{\circ}$. Pain relief within acquired range of motion was achieved in all cases and there was no complication in this series. Conclusion: Selective removal of the impingement bony spur for treatment of flexion contracture in the patient with chronic cumulative trauma disorder patients appear to be effective method to control pain, recover joint movement and at] ow early rehabilitation.
This study was introduced the short-term effectiveness of Oriental medicine treatment for lumbar disc herniation inpatients. We selected 208 inpatients with a magnetic resonance imaging(MRI)-confirmed lumbar disc herniation since June 2012 until August 2012. Their demographics characterisitics, numeric rating scale(NRS) and Oswestry back-related disability index(ODI) for low or leg pain, lumbar flexion and extension angle were assessed at baseline and when discharged from the hospital. When it measured the straight leg raisingscale(SLR), the low side of the angle was examined. Treatment every patient has received as follow; herbal medicine, bee venom, acupuncture and physical examination, spinal manipulation. NRS of low back pain and leg pain and ODI is $5.6{\pm}2.3$, $4.9{\pm}2.8$ and $45.5{\pm}20.0$, respectively at baseline and $2.8{\pm}1.8$, $2.7{\pm}1.9$ and $27.2{\pm}14.1$, respectively when discharged from the hospital. range of motion(ROM) of lumbar flexion and extension angle and SLR is $70.0{\pm}27.1$, $15.4{\pm}7.2$ and $61.3{\pm}23.0$ respectively at baseline and $80.5{\pm}16.9$, $18.25{\pm}4.1$ and $73.2{\pm}14.0$, respectively when discharged from the hospital. It shows that statistically significant improved(P<0.001). Furthermore, regarding patient satisfaction with the treatment, excellent(33.7%), good(55.4%), normal(10.4%), poor(0.5%), it suggests that most patients(89%) satisfied with the treatment.
Kim, Choong-Sup;Heo, Su-Young;Kim, Min-Su;Kim, Nam-Soo;Lee, Hae-Beom
Journal of Veterinary Clinics
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v.31
no.6
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pp.483-489
/
2014
This study describes a surgical technique and evaluates the clinical outcomes in small breed dogs with cranial cruciate ligament rupture (CCLR) treated with tibial plateau leveling osteotomy (TPLO). Seven skeletally mature dogs weighing less than 15 kg underwent unilateral TPLO to stabilize the stifle joint with CCLR. Clinical evaluation was performed via visual lameness score, range of motion (ROM), and thigh girth circumference (TC). Postoperative complications were recorded. All patients reached a grade 1 score at 1 week and grade 0 at 8 weeks postoperatively. The mean operated limb extension angle was 98.11%, 99.07%, and 98.73% of the mean extension angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean operated limb flexion angle was 98.07%, 95.88%, and 96.35% of the mean flexion angle of the contralateral limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. The mean TC of the operated limb was 92.95%, 93.68%, and 95.44% of the mean TC of the normal limb at 4 weeks, 8 weeks, and 12 weeks postoperatively, respectively. Our outcomes for TPLO in small breed dogs are not worse than those previously reported for large breed dogs. Based on the result in the present study, CCLR in small dogs can be successfully managed with TPLO, as done in large breed dogs.
Purpose: The purpose of this study was to analyze the clinical result and the gait patterns for patients who had undergone the arthroscopic posterior cruciate ligament (PCL) reconstruction using Achilles allograft. Materials and Methods: Among the patient who had undergone the arthroscopic PCL reconstruction using fresh-frozen Achilles allograft between March 2004 to March 2005, we selected 12 patients who compliance to our rehabilitation program. Clinical result and gait analysis were carried out at 36 months postoperatively. There were measured by using range of motion (ROM), Lysholm knee score, Tegner activity score, IKDC score, posterior stress test, and posterior translation measured by using Telos stress arthrometer. Kinematic gait analysis was carried out using 3-dimensional gait analysis system. Results: The PCL reconstruction surgery yielded statistacally significant results in all of clinical evaluation. In gait analysis, the average knee flexion angle increased during stance phase and decreased during the swing phase, but was not statistically significant and there were no significant difference between both sides of their knees overall. Conclusion: Since there was no statistically significant difference between the injured and uninjured sides as a result of the gait evaluation of the patients who had arthroscopic reconstruction surgery on their PCL injured knee and conformed to the rehabilitation program, systemic and strict rehabilitation ought to be important in the reconstruction surgery.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.12
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pp.5867-5874
/
2012
The aim of this study was to find on muscle architectural and tissue compliance of biceps brachii in stroke patient based on elbow joint angle. The subjects of this study were twelve hemiplegic adults after stroke with passive range of motion in the elbow from $10^{\circ}$ to $90^{\circ}$ and Modified Ashworth Scale score 1 to 3 were recruited. Ultrasonography and Myotonometer was used to measure biceps brachii muscle pennation angle, fascicle length, and tissue compliance at the rest condition and pennation angle, fascicle length, and tissue compliance of the biceps brachii muscle were measured in the affected and unaffected sides of people after stroke at 9 different elbow angles ranging from $10^{\circ}$ to $90^{\circ}$ at the rest condition. The results of this study, comparisons found that the pennation angles of the affected biceps brachii muscle were significantly larger(p<.05) than the unaffected muscle in the most extended positions($<40^{\circ}$), whereas the affected fascicle lengths were significantly shorter(p<.05) than the unaffected muscle in most flexed positions($>20^{\circ}$), and the affected tissue compliance were significantly lower(p<.05) than the unaffected muscle in most extended positions($<50^{\circ}$) Therefore, pennation angles, fascicle lengths, and tissue compliance were found to be joint-angle-dependent in both the affected and unaffected sides at the rest condition. Suggest that, the results data can be used as a muscle architectural changes and clinical treatment research in stroke patients.
Purpose: To evaluate the efficacy of ultrasound guided injection of prolotherapy and steroid mixture injection in patients with adhesive capsulitis. Materials and Methods: 53 patients with adhesive capsulitis were included in the study and in all the patients a mixture of steroid and prolotherapy agent was injected into the coracohumeral ligament under the sonographic guidance. The patients were evaluated using the VAS and ROM of the shoulder before the injection and at 8 weeks and at 1 year after the injection. Results: Forward flexion was 93.4 degrees before the injection and was 142, 153 degrees at 8weeks and 1 year after injection. Abduction was 79.2 degrees before the injection and was 125.4, 152.6 degrees at 8 weeks and 1 year after the injection. The VAS score was 6.7 before the injection and was 3.5, 3.7 at 8 weeks and 1 year after the injection. Conclusion: The ultrasound guided injection of prolotherapy and steroid mixture into the coracohumeral ligament in patients with adhesive capsulitis is allowing both tissue distension and inflammatory process controlling procedure. It is effective in improving the range of shoulder motion significantly and is also effective in decreasing the pain.
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