• Clinics in Shoulder and Elbow
• /
• 제22권3호
• /
• pp.159-170
• /
• 2019

Delaminated rotator cuff tear pertains to the horizontal split of the tendon substance. As reported previously, the presence of a delaminated tear and incidence of delaminated rotator cuff tear ranges from 38% to 92%. The different strain intensities applied across the rotator cuff tendon, and the shear stress between the bursal and articular layers seem to play a role in its pathogenesis. In a delaminated rotator cuff tear, the degree and direction of retraction between two layers differ, with accompanying intrasubstance cleavage. A surgeon therefore needs to consider and carefully evaluate the tear characteristics when repairing delaminated rotator cuff tear. Delaminated rotator cuff tear is considered to be a poor prognostic factor after rotator cuff repair, but numerous surgical repair techniques have been introduced and applied to resolve this problem. Recent literature has reported good clinical outcomes after delaminated rotator cuff repair.

• Clinics in Shoulder and Elbow
• /
• 제5권1호
• /
• pp.55-62
• /
• 2002

Purpose : To compare and analyze the results of arthroscopic subacromial decompression and rotator cuff repair between partial rotator cuff tear and complete rotator cuff tear. Material and Methods : The authors studied 42 patients of rotator cuff tear with operation and followed over one year at Dankook university hospital from September, 1998 to March, 2001 The patient average age is 53 years and follow up period is 23 months (12-42mon1hs). We obtained 22 cases in the partial rotator cuff tear group and 20 cases in the complete rotator cuff tear group. In all cases, we used ASES methods to evaluated pain scale and function. Result : In the last follow up patients, the pain scale is decreased from 7.2 to 0.9 (ASES method : 34 to 91) in the partial rotator cuff tear group and from 7.6 to 1.2 (ASES method . 29 to 88) in the complete rotator cuff tear group, but there was no evidence of statistical difference between two groups (P>0.05). The range of motion after operation were increased in two groups. Excellent to good results were obtained 93％ and 95％ patients had pain relief and satisfied function. Conclusion : Arthroscopic subacromial decompression and arthroscopic rotator cuff repair showed good results for both of (ult-thickness and partial thickness rotator cuff tear patients in pain relief and improving the function.

• Clinics in Shoulder and Elbow
• /
• 제22권3호
• /
• pp.121-127
• /
• 2019

Background: Posterior decentering is not an uncommon finding on rotator cuff tear patients' shoulder magnetic resonance imaging. No previous study has reported on the relationship between posterior decentering and rotator cuff tear. Methods: We assessed patients' rotator cuff tear humeral head positions based on humeral-scapular alignment (HSA). Subjects were classified into centering and decentering groups based on a <2 mm or >2 mm HSA value, respectively. Differences in rotator cuff tear size, degree of tear, and fatty degeneration between the two groups were evaluated. Results: One hundred seventy-five patients (80 males, 95 females; mean age: $59.7{\pm}6.5$ years old) were selected as subjects (casecontrol study; level of evidence: 3). Tear size, degree of subscapularis tendon tear, and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis muscles were significantly different between the two groups (p<0.001, p<0.001, p<0.001). Conclusions: The occurrence of decentering was related to rotator cuff tear size, degree of subscapularis tendon tear, and fatty degeneration of the rotator cuff muscles.

• 대한관절경학회지
• /
• 제16권1호
• /
• pp.98-103
• /
• 2012

회전근 개 파열의 봉합술은 최근 들어 괄목할만한 발전을 보여주고 있다. 회전근 개 파열의 자연사를 관찰하면 대부분의 경우에서 시간이 지남에 따라 크기가 증가하는 양상이 관찰되었다. 회전근 개 파열의 후기에 오는 지방 침윤 및 광범위 회전근 개 파열 후 발생하는 회전근 개 파열 관절증은 회전근 개 파열의 봉합술에서 예후를 예측하거나 수술 시기를 결정하는데 중요한 요소라 할 수 있다. 회전근 개 파열시 증상 발생 후 3년 뒤에 중등도의 지방 침윤이 발생하는 것으로 관찰되어 그 이전에 회전근 개 파열의 봉합술을 시행하는 것이 추천되고 있으며, 또한 회전근 개 파열 관절증에서도 견봉상완골 간격이 감소하기 전에 봉합술을 하는 것이 권장되고 있다. 회전근 개 파열의 관절경하 봉합술은 크게 일열 봉합술 및 이열 봉합술로 나눌 수 있으며, 시간과 비용 면에서는 전자가 장점이 있으나, 생역학적이 관점에서는 후자가 더 우수하다. 이열 봉합술의 생역학적인 장점을 유지하면서 보다 적은 시간에 회전근 개의 봉합을 가능하게 한 교량형 봉합술이 개발되어 최근 널리 사용되고 있으며, 교량형 봉합술 내에서도 파열의 특성에 따라 몇 가지 다른 술식이 개발되어 사용되고 있다.

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

• 대한약침학회지
• /
• 제14권4호
• /
• pp.53-58
• /
• 2011

Objectives: There is no report on treatment of acute traumatic rotator cuff tear in Traditional Korean Medicine. We reported Traditional Korean Treatment for pain relief and better movement of acute traumatic rotator cuff tear. Methods: Shoulder MRI was used to confirm the diagnosis of tear of rotator cuff. The patient was treated with Traditional Korean Methods (Acupuncture, Herbal medicine, Pharmacopuncture) for 6 months. We evaluated the patient through VAS (Visual Analogue Scale), UCLA shoulder scale, ROM (Range of motion) and Shoulder MRI. Results: After 6 months of treatment, the patient's VAS was decreased whereas UCLA score and Shoulder ROM were increased. Rotator cuff tear was repaired on Shoulder MRI images. Conclusions: In acute traumatic rotator cuff tear, Korean Traditional Treatment is good method for pain relief and better movement.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2009년도 제17차 학술대회
• /
• pp.210-210
• /
• 2009

For a bursal-side retracted laminated rotator cuff tear, simple repair of the retracted bursal-side rotator cuff might be insufficient because the repaired tendon could remain as an intratendinous tear of the rotator cuff. We present a repair method for intratendinous rotator cuff tears using the suture-bridge technique. We believe that this method helps to preserve the remnant rotator cuff tendon without tissue damage and restores the normal rotator cuff footprint in bursal-side delaminated rotator cuff tears.

• Clinics in Shoulder and Elbow
• /
• 제9권2호
• /
• pp.222-226
• /
• 2006

Full-thickness rotator cuff tears are relatively uncommon in the young adults. One of the pathogenesis of such tear is thought to be closely related to the specific trauma event. Favorable outcome is expected in young patient rotator cuff tears when it is diagnosed early following prompt surgical repair. However, early detection is sometimes difficult when the acute rotator cuff tear is combined with other injuries especially around the shoulder joints such as ipsilateral humerus fractures. Authors report an uncommon case of acute traumatic rotator cuff tear accompanied by the midhumerus shaft fracture in young adult.

• Clinics in Shoulder and Elbow
• /
• 제7권1호
• /
• pp.23-29
• /
• 2004

It has been reported that rotator cuff tear have good response to arthroscopic or open repair even if the range being so wide. However, the majority of this literature regarding the diagnosis and treatment of tear focused on lesion of the supraspinatus and infraspinatus tendons. But involvement of the subscapularis tendon with rotator cuff tear should be thought to be less common and poorer to open operative repair. Furthermore, some europian author have stated that the rotator cuff tear including the subscapularis tendon are sufficiently distinct in their clinical presentation and prognosis as to merit separate consideration of their diagnosis and treatment. The purpose of this study is to evaluate result of arthroscopic or open repair in patient with rotator cuff tear that include the subscapularis tendon. Of the 128 rotator cuff repairs performed from 1998 through 2003, 12 had a tear that include the subscapularis tendon in combination with the supraspinatus (8 cases) and infraspinatus (4 cases). Mean duration of symptoms before surgical treatment was 6 months (range 3 to 12 months). All 12 patient demonstrated a positive lift off sign. Shoulder function was assessed using the Constant- Murley score, which ranges from 30 to 58. Pain was assessed using a linear visual analogue scale range from 0 to 10. Postoperative Constant score range from 40 to 64 (average 47.8). Pain score improved from 5.5 to 8.5, but there are postoperative pain improvement on nothing in 5 patient. The overall result for 12 patient were satisfy in 2, fair in 5 and dissatisfy in 5: Therefore satisfactory result were noted only in 16 % of this overall group. In conclusion, we have failed to make good result in patient with rotator cuff tear that included the subscapularis tendon. At the result, outcome after surgical repair of this type of rotator tear is comparatively inferior to the result of operative repair of rotator cuff not involved the subscapularis tendon.

• Clinics in Shoulder and Elbow
• /
• 제17권1호
• /
• pp.44-47
• /
• 2014

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.