• Journal of Korean Orthopaedic Sports Medicine
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• v.12 no.1
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• pp.37-41
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• 2013

Purpose: We investigated the short term results of medial deltoid ligament repair after diagnosis of chronic medial ankle instability. Materials and Methods: 262 military patients with ankle instability symptom were evaluated between May 2007 and December 2009. We diagnosed 29 chronic medial ankle instability cases with medial drive through sign under arthroscopy, radiologic findings and physical exam, treated with deltoid talo-navicular band repair using anchor suture. We used the American orthopedic foot and ankle society ankle-hindfoot score (AOFAS), visual analog scale (VAS) and ankle functional satisfactory scores were carried out. Results: 29 patients (11.1%) has chronic medial ankle instability, mean AFOAS score, VAS was improved from 65.4(range; 43-83), 6.0(range; 4-10) to 82.0(range; 60-100), 3.2(range; 1-7). Patients satisfaction were excellent 13(44.8%), good 11(37.9%) and poor 5(17.2%). Two cases was recurred and revised with allo-tendinous reconstruction. Conclusion: We underwent surgery to repair the talo-navicular ligament for chronic medial ankle instability, and about 83% of satisfactory results were obtained.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.194-201
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• 2010

Purpose: We evaluated clinical and radiological results for open reduction and internal fixation of acromioclavicular dislocation without coracoclavicular ligament repair after removal of implants. Materials and methods: Clinical and radiological results were obtained for 53 patients who underwent open reduction and internal fixation of an acromioclavicular joint dislocation between 1998 and 2007. A total of 21 patients were treated with a modified-Phemister method and 32 patients were treated with a Hook plate method. All subjects were surveyed after removal of their implants. The Constant scoring system was administered postoperatively to evaluate clinical results. Radiologic outcomes were evaluated by both coracoclavicular intervals on plain films. Results: Constant scores were $87.59{\pm}7.8$ in the Phemister group and $89.35{\pm}5.3$ in the Hook plate group. For both groups, the mean coracoclavicular interval at preoperative radiography was 15.9 mm at the injured site and 8.0 mm at the opposite site. After metal removal, the mean difference between coracoclavicular distances between normal and injured sites were 1.0 mm for the Hook plate group and 1.2 mm for the modified Phemister method group (p>0.05). Conclusion: Open reduction and internal fixation of an acromioclavicular joint without coracoclavicular ligament repair shows good long-term clinical and radiological results.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.160-166
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• 2007

Purpose: The current study assessed the factors affecting outcomes of primary repair procedures in tears of multiple rotator cuff tendons. Materials and Methods: Among the cases of rotator cuff tears involving two or more tendons receiving operations between 1997 and 2003, The clinical results of 19 cases with more than 2 years follow-up were evaluated by the UCLA score. We evaluated the correlation of trauma, active motion, acromiohumeral distance, tear size, and surface area with the UCLA score using Pearson's linear correlation coefficient (PLCC). Results: UCLA scores increased significantly in all cases, from 9 to 26.1 on average. However, the results were good in 53%, and poor in 47% according to Ellman's criteria. Trauma, active elevation, acromiohumeral distance, and tear size did not correlate with the UCLA score, but the tear surface area was inversely correlated with the score (PLCC=-0.696). Cases with degeneration of the infraspinatus muscle above Goutallier grade III on MRI showed worse results than cases with less degeneration. Conclusion: The clinical results of primary repair of rotator cuff tears involving multiple tendons were satisfactory in 53% of patients. Large tear surface area and severe degeneration of the infraspinatus were poor prognostic factors.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1042-1052
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• 2018

Objective: To determine the utility of computed tomography (CT) ventricular volumes and morphometric parameters for deciding the treatment strategy in children with a hypoplastic left ventricle (LV). Materials and Methods: Ninety-four consecutive children were included in this study and divided into small LV single ventricle repair (SVR) (n = 28), small LV biventricular repair (BVR) (n = 6), disease-matched control (n = 19), and control (n = 41) groups. The CT-based indexed LV volumes, LV-to-right-ventricular (LV/RV) volume ratio, left-to-right atrioventricular valve (AVV) area ratio, left-to-right AVV diameter ratio, and LV/RV long dimension ratio were compared between groups. Proportions of preferred SVR in the small LV SVR group suggested by the parameters were evaluated. Results: Indexed LV end-systolic (ES) and end-diastolic (ED) volumes in the small LV SVR group ($6.3{\pm}4.0mL/m^2$ and $14.4{\pm}10.2mL/m^2$, respectively) were significantly smaller than those in the disease-matched control group ($16.0{\pm}4.7mL/m^2$ and $37.7{\pm}12.0mL/m^2$, respectively; p < 0.001) and the control group ($16.0{\pm}5.5mL/m^2$ and $46.3{\pm}10.8mL/m^2$, respectively; p < 0.001). These volumes were $8.3{\pm}2.4mL/m^2$ and $21.4{\pm}5.3mL/m^2$, respectively, in the small LV BVR group. ES and ED indexed LV volumes of < $7mL/m^2$ and < $17mL/m^2$, LV/RV volume ratios of < 0.22 and < 0.25, AVV area ratios of < 0.33 and < 0.24, and AVV diameter ratios of < 0.52 and < 0.46, respectively, enabled the differentiation of a subset of patients in the small LV SVR group from those in the two control groups. One patient in the small LV biventricular group died after BVR, indicating that this patient might not have been a good candidate based on the suggested cut-off values. Conclusion: CT-based ventricular volumes and morphometric parameters can suggest cut-off values for SVR in children with a hypoplastic LV.

• Journal of the Korean Wood Science and Technology
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• v.27 no.3
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• pp.82-90
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• 1999

The buddhistic painting of Song-Kwang temple in Seungjoo-gun, Chonnam, Korea is not known in chronicle, but it could be estimated to works in the early 19th century through it's remaining records and qualities of materials. And it was analysed the qualities of materials consisting of pigment layer, silken-ground layer and support layer in order to preserve buddhistic painting, made back-adherent paper of the support layer proper to it, tested its compatibility, and then concluded as follows. 1. The section structures of buddhistic painting is consisted of the pigment layer, silken-ground layer of silk and the support layer of Korean hand made paper, it could be recognized that buddhistic painting in 19th century was basically composed of the pigment layer, the silken-ground layer and the support layer. Moreover the pigment layer and the silken-ground layer got adhered with glue, and sheets of support layers got back adhered with paste. 2. The support layer of buddhistic painting consisted of 5 layers and two kinds of paper were used for them. The first and second layers were composed of Korean hand made paper made of pure paper mulberry bast fibers, and the rest of them of paper that paper mulberry bast fibers were mixed into recycled hemp fibers. Though it is difficult to assert without the security of more data, finding out the then situation through the qualities of materials, it was presumed that the society in 19th century was suffered from economical difficulties and the operation of the paper industry of temples was rather difficult and so low-qualitative recycled hemp fibers might used for back-adherent paper. 3. Considering tension between silken-ground layers and support layers of this materials, newly made back-adherent paper was used for repair, and then I could conform that it was proper to back-adherent paper for repair.

• 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.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.229-235
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• 2011

Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.135-142
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• 2020

Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.