• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.35-40
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• 2010

Purpose: To compare the outcome of patients who underwent rotator cuff repair using all-arthroscopic mini-open repair techniques. Materials and Methods: We retrospectively reviewed 44 patients who underwent either arthroscopic (group I) or mini-open (group II) rotator cuff repair. 23 patients underwent an arthroscopic repair and 21 patients had a mini-open repair. The mean age was 50.4 years in the arthroscopic group and 56.7 years in the mini-open group. The outcomes for the 2 groups were evaluated using ROM, VAS, ASES, UCLA scale. Statistical analysis was performed using correlations, T-test, Paired T-test. The mean follow-up period in the arthroscopic and mini-open groups were 24.1months and 26.1months, respectively. Results: The group I (arthroscopic group) had 2 small-sized tears, 10 medium sized tears, and 11 large sized tears (3~5 cm). The group II (mini-open group) had 1 small sized tears, 8 medium sized tears, and 12 large sized tears. The mean cuff tear size of the group I and Group II were 3.8 cm and 4.2 cm, respectively. At last follow-up periods, ROM and functional scores were improved. In the group I and group II, there were no significant difference in ROM, VAS, ASES, UCLA score. Conclusion: The size of the tear did not produce different results at arthroscopic repair group but larger tear size was associated with a worse outcome in mini-open group. There were no significant clinical results between the arthroscopic and mini-open group.

• The Korean Journal of Pain
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• v.33 no.4
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• pp.344-351
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• 2020

Background: The effects of far-infrared radiation (FIR) on the treatment of rotator cuff diseases remains unknown. We evaluated the safety and efficacy of FIR after arthroscopic rotator cuff repair with regard to postoperative pain and healing. Methods: This prospective randomized comparative study included 38 patients who underwent arthroscopic rotator cuff repair due to a medium-sized tear. Patients were randomly divided into the FIR or control group (n = 19 per group). In the FIR group, FIR with an FIR radiator started 1 week postoperatively for 30 minutes per session twice daily. It lasted until abduction brace weaning at 5 weeks postoperatively. We assessed pain using a pain visual analogue scale (pVAS) and measured the range of motion (ROM) of the shoulder at 5 weeks, and 3 and 6 months, postoperatively. The anatomical outcome was evaluated using magnetic resonance imaging at 6 months postoperatively. Results: At 5 weeks postoperatively, the average pVAS score was lower in the FIR group than in the control group (1.5 ± 0.8 vs. 2.7 ± 1.7; P = 0.019). At 3 months postoperatively, the average forward flexion was higher in the FIR group (151.6° ± 15.3° vs. 132.9° ± 27.8°; P = 0.045), but there was no significant difference at 6 months postoperatively. There was no significant difference in healing failure between the groups (P = 0.999). Conclusions: FIR after arthroscopic rotator cuff repair could be an effective and safe procedure to reduce postoperative pain, thereby facilitating rehabilitation and better ROM in the early postoperative period.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.132-140
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• 2010

Purpose: Surgical treatment of massive rotator cuff tear is challenging and there are various surgical options. The purpose of this article is to describe arthroplasty for the treatment of massive rotator cuff tear. Materials and Methods: We reviewed all publications that focused on and/or mentioned arthroplasty as a treatment option for massive rotator cuff tear. Results: Arthroplasty can be used as primary treatment and represents a salvage option for irreparable rotator cuff tear. Hemi-arthroplasty can provide satisfactory results by Neer's limited goals criteria in patients with intact coracoacromial arch. In addition, reverse total shoulder arthroplasty can be a salvage option for pain relief and restoration of active flexion in elderly patients with pseudoparalysis. Conclusion: In patients with massive rotator cuff tear, proper selection of arthroplasty can provide pain relief and restoration of functional range of motion in shoulder joints.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.10-19
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• 2023

Background: Tendon degeneration contributes to rotator cuff tears; however, its role in postoperative structural integrity is poorly understood. The purpose of this study was to investigate the factors associated with postoperative structural integrity after rotator cuff repair, particularly focusing on the histology of tendons harvested intraoperatively. Methods: A total of 56 patients who underwent primary arthroscopic rotator cuff repair between 2009 and 2011 were analyzed. A 3-mm-diameter sample of supraspinatus tendons was harvested en bloc from each patient after minimal debridement of the torn ends. Tendon degeneration was assessed using seven histological parameters on a semi-quantitative grading scale, and the total degeneration score was calculated. One-year postoperative magnetic resonance imaging was used to classify the patients based on retear. Results: The total degeneration scores in the healed and retear groups were 13.93±2.03 and 14.08±2.23 (P=0.960), respectively. Arthroscopically measured anteroposterior (AP) tear sizes in the healed and retear groups were 24.30±12.35 mm and 36.42±25.23 mm (P=0.026), respectively. Preoperative visual analog scale pain scores at rest in the healed and retear groups were 3.54±2.37 and 5.16±2.16 (P=0.046), respectively. Retraction sizes in the healed and retear groups were 16.02±7.587 mm and 22.33±13.364 mm (P=0.037), respectively. The odds of retear rose by 4.2% for every 1-mm increase in AP tear size (P=0.032). Conclusions: The postoperative structural integrity of the rotator cuff tendon was not affected by tendon degeneration, whereas the arthroscopically measured AP tear size of the rotator cuff tendon was an independent predictor of retear. Level of evidence: III.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.11-19
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• 2020

Background: The purpose of this study was to evaluate and compare deltoid origin status following large rotator cuff repair carried out using either an open or an arthroscopic method with a propensity score matching technique. Methods: A retrospective review of 112 patients treated for full-thickness, large rotator cuff tear via either a classic open repair (open group) or an arthroscopic repair (arthroscopic group) was conducted. All patients included in the study had undergone postoperative magnetic resonance imaging (MRI) and clinical follow-up for at least 12 and 18 months after surgery, respectively. Propensity score matching was used to select controls matched for age, sex, body mass index, and affected site. There were 56 patients in each group, with a mean age of 63.3 years (range, 50-77 years). The postoperative functional and radiologic outcomes for both groups were compared. Radiologic evaluation for postoperative rotator cuff integrity and deltoid origin status was performed with 3-Tesla MRI. Results: The deltoid origin thickness was significantly greater in the arthroscopic group when measured at the anterior acromion (P=0.006), anterior third (P=0.005), and middle third of the lateral border of the acromion level (P=0.005). The deltoid origin thickness at the posterior third of the lateral acromion was not significantly different between the arthroscopic and open groups. The arthroscopic group had significantly higher intact deltoid integrity with less scarring (P=0.04). There were no full-thickness deltoid tears in either the open or arthroscopic group. Conclusions: Open rotator cuff repair resulted in a thinner deltoid origin, especially from the anterior acromion to the middle third of the lateral border of the acromion, at the 1-year postoperative MRI evaluation. Meticulous reattachment of the deltoid origin is as essential as rotator cuff repair when an open approach is selected.

• 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.17 no.4
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• pp.166-174
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• 2014

Background: Our study was to determine the effect on shoulder isokinetic muscle strength and muscle endurance in isolated full-thickness supraspinatus tendon tear and combined other rotator cuff tear. Methods: Total of 81 male patients (mean age $57.8{\pm}7.4$ years) who were diagnosed as a full-thickness supraspinatus tendon tear were included. They were classified into isolated or combined tear. The isokinetic muscle strength and muscle endurance were measured using the Biodex multi-joint system $PRO^{(R)}$ (Biodex Medical Systems, Shirley, NY, USA) in following movements: shoulder abduction, adduction, flexion, extension, external rotation, and internal rotation. Then, the difference in muscle function according to the type of tears were assessed. Fifty-seven patients had isolated supraspinatus tendon (mean age $56.9{\pm}7.3$ years). They were classified into either anteroposterior tear or modified mediolateral tear. The size were measured using T2-weighted magnetic resonance imaging scans in sagittal plane. Results: Between subjects categorized into the type of tear, we found significant inter-categorical differences in isokinetic muscle strength during abduction, adduction, flexion, extension, and internal rotation, and in muscle endurance during flexion, extension, and internal rotation. Anteroposterior diameter tear, we did not show significant differences in either isokinetic muscle strength or muscle endurance during any movements. However, with modified mediolateral diameter, we found significant differences with isokinetic muscle strength during adduction, and in muscle endurance the external rotation and internal rotation. Conclusions: We found that a supraspinatus tendon tear associated with more numbers of rotator cuff tears has lower isokinetic muscle strength and muscle endurance than a tear found alone.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.126-130
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• 2002

Purpose : To evaluate the diagnostic efficiency of the subacromial bursoscopy with glenohumeral air infusion technique for detection of the full thickness tear which we used to think as a partial thickness tear, because it was hidden by bursal tissue. Materials and methods : We chose 65 cases and divided them into 2 groups. The group I was 18 cases with partial thickness rotator cuff tears on glenohumeral arthroscopic evaluation, and the group 2 was 37 cases with full thickness rotator cuff tears which were repaired. We inflated the glenohumeral Joint with 50-100ml of air and observed air bubble leakage simultaneously on bursoscopy. Results : In group I, we could detect air leakage in 3 cases and found that it was full thickness tear. In group II, 2 cases revealed too much air leakage proved that it was incomplete repair and was in need of additional suture. Conclusion : Air infusion technique is though to be a valuable method in differentiation between the partial and full thickness tear and for evaluation of the security of the repair.

• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.161-165
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• 2001

Purpose: The purpose of this study was to analyze the possible contributing factors and surgical results of rotator cuff tears in patients younger than 40 years of age. Materials and Methods: From July, 1996 to February, 2000, twelve patients were available to participate in the study. The average age was 35 years (range, 17 to 40 years) old. Follow-up averaged eighteen months (range, 12 to 55 months). There were eleven men and one women. Each shoulder was evaluated with UCLA shoulder functional assessment, return-to-work status, return-to-sport status, and overall postoperative satisfaction. Results: After operation, eleven patients (92%) reported diminished pain relative to their preoperative level, and ten patients (83%) were improved in shoulder function. eleven patients (92%) exhibited improved strength after operation. nine patients (75%) returned to employment, and six patients (50%) returned to sports activities. Preoperative UCLA score averaged 12 and postoperative score averaged 31. Ten patients (83%) were satisfied with the outcome of their treatment. Conclusion: A traumatic event was the etiology of the rotator cuff tears in patients younger than 40 years. Results of surgical treatment in this younger group were satisfactory.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.11-17
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• 2024

Background: Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods: A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results: Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05). Conclusions: These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity.