• Title/Summary/Keyword: Rotator Cuff repair

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The Results of Rotator Cuff Disease Treated by Arthroscopic Subacromial Decompression (회전근개 질환에서 시행한 관절경적 견봉하 감압술의 결과)

  • Kim Jae-Hwa;Han Seung-Kwan;Cho Duck-Yun
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.110-114
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    • 1999
  • We reviewed the results of arthroscopic surgery in patients with rotator cuff disease. Arthroscopic subacromial decompression(ASD) was performed on 22 patients with rotator cuff disease who had not responded to nonoperative measures. In the patients who had a complete tear of the rotator cuff(four of ten Neer's stage III patients), mini-open repair also was performed. Results were determined by questioning patients about their satisfaction with the outcome of surgery and by functional assessment of the shoulder with the parameters of pain, function, and range of motion according to the UCLA shoulder rating scale. The average follow-up was 21 months. The results were sixteen(72%) excellent, three(14%) good, two(9%) fair, and one(5%) poor. The following variables were analyzed to assess their influence on final outcome; duration of preoperative symptoms, Neer's stage(extent of damage to the cuff), type of acromion. Satisfactory results were achieved in thirteen of fourteen patients(93%) who had duration of preoperative symptoms below one year, and in four of six(67%) above 2 years. And satisfactory results were achieved in eleven of twelve patients(92%) who had Neer's stage II and in eight of ten(80%) stage III and achieved in six of seven patients(86%) who had Bigliani's acromion type I, in nine of eleven(82%) type II, and in four of four(100%) type III. There are multiple factors that may influence the recovery after ASD or the eventual outcome. However, although there is still a controversy about the pathogenesis of rotator cuff disease, We found that arthroscopic subacromial decompression and mini-open repair in patients with rotator cuff disease were well enough documented to be considered a standard treatment.

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Arthroscopic Repair of Full Thickness Rotator Cuff Tear (회전근개 전층 파열에서 관절경 감시하의 봉합술)

  • Ko, Sang-Hun;Cho, Sung-Do;Ryu, Suk-Oo;Gwak, Chang-Youl;Park, Moon-Soo
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.161-166
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    • 2003
  • Purpose: To evaluate the usefulness of arthroscopic repair that was related with full thickness rotator cuff tear and assess clinical result. Materials and Methods: Twenty-one cases of arthroscopically repaired full thickness tear of rotator cuffs were studied. Between October 1998 to July 2002 we have analysed 21 repairs of FTRCT the average age 54(42∼74) years old, mean follow-up was 24(12∼41) months We analyzed the results statistically by paired t-test. Results: Postoperative VAS of pain improved average 7.2 to 1.9, UCLA score improved 13.9 to 31.9, ADL improved 11.5 to 25.5 respectively(all, p<0.001). Eighty-seventh % of the patients showed excellent St good results at the final follow-up. The satisfied rate was 90.5%(19cases). Conclusions: Arthroscopic repair in full thickness rotator cuff tear is effective surgical methods.

A Comparative Analysis on Korean Medical and Western Medical Service Usage Tendency of Rotator Cuff Surgery Patients - Using HIRA's Patients Sample Data

  • Khang, Hyun-jin;Lee, Hye-Yoon;Lee, Se-Yeon;Kim, NamKwen;Song, YunKyung
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.133-149
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    • 2021
  • Objectives: To lay the foundation for future research into Korean Medicine treatment for Rotator Cuff repair surgery patients by analyzing Korean Medical and Western Medical service utilization and treatment duration. Methods: Data sampling was performed on 2015's HIRA patient data (confidence level of 97%) to analyze patients' Korean Medical and Western Medical service usage tendency. Sampled groups were divided into two groups: i) Patients who completed their treatment within five months after the rotator cuff surgery (termination group), ii) Patients who were treated for more than five months after the surgery (continuation group). Then the patients' Korean Medical and Western Medical service usage tendency was investigated and information of these patients are arranged. Results: Out of 1,453,486 patients who were gathered for sampling, 2,461 patients in total had gone through rotator cuff repair surgery. The termination group had 517 patients and the continuation group had 541 patients. The proportion of patients who visited a Korean Medicine clinic was lower in the termination group than the continuation group. Conclusion: The continuation group received more treatments (both in Western Medicine and Korean Medicine) and spent more on medical expenses compared to the termination group. Further research is highly recommended for more efficient Western Medicine and Korean Medicine treatments and reduced medical expenditure.

Similar Degree of Degeneration in the Articular and Bursal Layers of Delaminated Rotator Cuff Tear

  • Jo, Chris Hyunchul;Lee, Seung Hoo;Shin, Ji Sun;Kim, Ji Eun
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.197-201
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    • 2016
  • Background: The purpose of the study was to compare the degree of degeneration of the articular and bursal layers of delaminated supraspinatus tendons based on histological examination. Methods: Fifty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from the lateral torn edges of the articular and bursal layers of the delaminated tear. Harvested samples were stained with H&E dye and evaluated based on a semi-quantitative grading scale. Results: There were no significant differences in the seven histological characteristics of tendon degeneration: fiber structure, fiber arrangement, round nuclei, regional variations in cellularity, vascularity, collagen stainability, and hyalinization between the articular and bursal layers of the delaminated rotator cuff tear (all p>0.05). Total degeneration scores of articular and bursal sides were $13.1{\pm}3.85$ points and $13.2{\pm}3.42$ points, respectively, and were not significantly different (p=0.958). Conclusions: The study demonstrates that tendon degeneration was similar in the articular and bursal sides of the delaminated full-thickness rotator cuff tear, suggesting that degeneration would be a main etiology for the rotator cuff tear not only in the articular side but also in the bursal side. Considering potential disadvantages of subacromial decompression, this study tentatively suggests routine use of subacromial decompression as well as the need for halting or recovery from rotator cuff degeneration for better rotator cuff repair.

Prognostic factors affecting structural integrity after arthroscopic rotator cuff repair: a clinical and histological study

  • Pei Wei Wang;Chris Hyunchul Jo
    • 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.

Clinical Outcome and Causative Factor in Patients of Structural Failure after Rotator Cuff Repair (회전근 개 파열 봉합술 후 재파열 환자에서 임상결과와 원인 인자)

  • Chun, Jae-Myeung;Song, Jung-Suk;Sohn, Dong-Wook
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.29-36
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    • 2008
  • Purpose: We wanted to evaluate the relationship between the clinical outcomes and cuff integrity after open rotator cuff repair and we wanted to analyze the causes of rotator cuff retear. Materials and Methods: 78 patients who underwent open rotator cuff repair were enrolled from 2004 to 2006. All the patients were observed for a minimum follow-up of 12 months and they were evaluated by magnetic resonance imaging (MRI). The clinical outcomes were accessed by dividing the patients into the retear group and the intact group. The groups were also compared to analyze the cause of rotator cuff retear according to the preoperative tear size, the symptom duration, and so on. Results: The clinical outcome of the retear group (n=22) was improved significantly after operation (p<0.001, p<0.001), but the muscle power was not improved significantly (p=0.099, p=0.243). More retears were found in the patients who had a larger preoperative tear (p<0.001) and the symptom duration of the retear group was longer (p=0.027). Conclusion: Although there were retear after rotator cuff repair, the clinical outcomes were improved. Yet the muscle power of the supraspinatus and external rotator were not improved significantly. There were more retears for the cases that had a larger preoperative tear size and a longer duration of symptoms.