• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.67-72
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• 2011

Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.86-90
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• 2012

Purpose: We studied the need for distal clavicle resection by comparing rotator cuff tear patients who underwent non-surgical treatment with and without acromioclavicular joint pathology. Materials and Methods: 45 cases that had been under follow up care for at least 9 months after receiving rotator cuff repair in our hospital between Jan. 2005 and Jun. 2011 had been studied. Acromioclavicular joint pathology group and control group were classified by physical examination and MRI findings. The temporal changes in shoulder joint abduction, internal and external rotation strength, ASES and KSS score of the two groups were measured and analyzed. Results: The acromioclavicular joint pathology complicated rotator cuff injury group's strength measurements for abduction, internal rotation, external rotation were each 8.05 (${\pm}4.54$), 11.33 (${\pm}6.05$), 10.24 (${\pm}5.27$) preoperatively and improved to 13.26 (${\pm}5.50$), 17.51 (${\pm}6.80$), 15.60 (${\pm}5.37$) post operatively while the KSS score and ASES score were each 49.07 (${\pm}15.28$) and 48.65 (${\pm}13.27$) preoperatively, improving to 84.48 (${\pm}10.96$) and 84.65. (${\pm}9.86$). The measurements for the group without complicating acromioclavicular pathology are as follows. The strength for abduction, internal rotation, external rotation was each 6.42 (${\pm}3.11$), 7.59 (${\pm}4.81$) and 7.93 (${\pm}4.49$) preoperatively, improving to 15.85 (${\pm}7.35$), 19.18 (${\pm}9.14$), 16.95 (${\pm}5.70$) post operatively, while the KSS score and ASES score each went from 42.12 (${\pm}6.43$) and 41.37 (${\pm}7.42$) to 83.44 (${\pm}6.30$) and 83.17 (${\pm}7.01$) respectively. The measurements for the two groups, however, did not show a statistically significant difference (p>0.05). Conclusion: Analysis of the rotator cuff injury groups with and without AC joint pathology showed that both groups had improved strength, ASES and KSS scores with no statistical difference difference among the groups. As such, it thought that conservative treatment is an acceptable alternative to distal clavicle resection.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.242-248
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• 2009

Purpose: To evaluate the clinical and radiologic results of the arthroscopic rotator cuff repair for partial articular surface tendon avulsion lesion. Materials and Methods: Twelve patients with symptomatic, partial articular surface tendon avulsion underwent arthroscopic rotator cuff repair between Mar. 2006 and Sep. 2008. The mean follow-up period was 18.3 months(12~36 months), and the mean age at the time of surgery was 46.9-year-old(19~64 years). Three cases had underwent rotator cuff repair after conversion to full-thickness tear and nine cases had transtendon repair with preserving bursal side cuff. Results: The mean VAS during motion was 6.2 before treatment and 2.0 at final follow-up (p<0.001). The passive forward flexion improved from $163.3^{\circ}$ preoperatively to $169.8^{\circ}$ postoperatively (p=0.038). The mean UCLA score improved from 18.4 preoperatively to 30.1 with 2 excellent, 8 good and 2 fair results at final follow-up. The mean KSS improved from 61.8 preoperatively to 76.8 at final follow-up. By examining the postoperative MR images of 5 patients, complete healing was observed in all of them. Conclusion: Arthroscopic rotator cuff repair may be an effective procedure for partial articular surface tendon avulsion in pain relief and improvement of the range of motion. If the remaining bursal side cuff fibers are intact, transtendon repair procedure with preserving the intact bursal layer of the tendon can be considered. If the remaining bursal side cuff fibers are friable or little, completion from partial-thickness to full-thickness tears with subsequent cuff repair can be considered.

• Clinics in Shoulder and Elbow
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• v.15 no.2
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• pp.99-108
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• 2012

Purpose: To evaluate the clinical results of arthroscopic repair with UU-Tension Band suture for full thickness rotator cuff tear above 4 cm sized. Materials and Methods: From January 2006 to October 2011, in 71 full thickness tears above 4 cm sized which is possible to arthroscopic repair to medial margin of greater tuberosity. The group I is 71 patients which is arthroscopic repair with UU-Tension Band suture, and the group II is 20 cases which is arthroscopic repair with simple suture. Both groups were compared with a VAS score for pain, Activity of Daily Living, UCLA score, KSS score in pre operation, 7 months, 1 year and last follow-up. Statistical analysis was performed by student t test and paired t est. Mean age was 63.2 (52~80) year old, mean follow-up was 38.4 (13~62) months. Results: The VAS scores for pain decreased from 8.1 at preoperative period to 1.6 at postoperative last follow-up period in group I (p<0.05), the score decreased from 7.6 at preoperative period to 1.8 postoperative last follow-up period in group II (p<0.05). The significant difference was not noted between two groups (p<0.05). Mean ADL scores increased from 12.5 at preoperative period to 29.0 post operative last follow-up period in group I (p<0.05), the score increased from 11.3 in pre op to 27.5 post-operative last follow-up in group II (p<0.05). The significant difference was not noted between two groups (p<0.05). The UCLA score increased from 12.9 at preoperative period to 28.7 postoperative last follow-up period in group I (p<0.05), the score increased from 13.8 at preoperative period to 30.1 postoperative last follow-up period in group II (p<0.05). The significant difference was not noted between two groups (p<0.05). In comparing of retear which was checked by MRI and ultrasound evaluated at postoperative period 7 months (mean: 27.5 weeks), the retears were 28% in the group I, and 11 shoulders out of 20 shoulders in the group II. The significant differences were noted between two groups (p<0.05). Conclusion: Arthroscopic repair with UU-Tension Band suture and simple suture for full thickness rotator cuff tear above 4 cm sized were not different clinical result between both groups. However, the significant differences were noted in point of failure rate between both groups.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.377-390
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• 2021

Reverse total shoulder arthroplasty (RTSA) is a surgical method that has recently been conducted in widely irrepairable rotator cuff tears with pseudoparalysis, cuff tear arthropathy, and osteoarthritis of the shoulder joint. Several topics can be described, but this review article provides an opinion on the criteria for the choice of implant in RTSA.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.141-146
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• 2008

퇴행성 변화에 의한 회전근 개 파열은 보통 관절면측에서 파열이 먼저 시작되어 전층 파열로 진행되는 것이 보편적인 반면 점액낭면 파열은 견봉하 충돌 증후군에 의해 주로 발생하지만 충돌 증후군에 의해 관절면 또는 건내 파열도 발생할 수 있다. 따라서 연령에 따른 퇴행성 변화와 더불어 생역학적 기전 등의 내적 요인과 충돌 증후군 또는 외상 등의 외적인 요인이 복합적으로 작용하는 회전근 개 파열은 관절면과 점액낭면에 파열이 공존할 수 있다. 결론적으로 회전근 개 파열은 보통 퇴행성 변화가 가장 기본적인 원인으로 생각되나 하나의 원인을 독립적으로 생각하기 보다는 다양한 원인이 동시에 혹은 단계적으로 작용하여 임상적으로 의미있는 병적인 상태로 진행한다고 보는 것이 타당하리라 생각된다.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.4
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• pp.97-103
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• 2022

The objective of this study is to report the improved case of Korean medicine treatment with Aconitum ciliare decaisne pharmacopuncture for supraspinatus tendon full-thickness tear. We used Aconitum ciliare Decaisne pharmacopuncture with other Korean medicine treatments (acupuncture, electroacupuncture, and cupping) for this patient. This case is measured and assessed by the numerical rating scale (NRS), shoulder range of motion (ROM), shoulder pain and disability index (SPADI) and shoulder physical examination. As the result, we found the improvement of NRS, SPADI, ROM, and shoulder physical examination. This study suggested that Korean medicine treatment with Aconitum ciliare Decaisne pharmacopuncture is proved to be helpful to relieve pain and recover function for supraspinatus tendon full-thickness tear. But further clinical studies are needed to clarify the effect of Aconitum ciliare Decaisne pharmacopuncture therapy for patients with supraspinatus tendon full-thickness tear.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.90-95
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• 2008

Purpose: We wanted to assess the accuracy of ultrasound for detecting abnormality of the long head of the biceps tendon in patients with rotator cuff disorders. Materials and Methods: Between January 2006 and March 2007, we reviewed the arthroscopic findings of biceps tendons in 67 patients with rotator cuff disorder and who underwent ultrasonography pre-operatively. The patients' average age was 58 years and there were 41 males and 26 females. The statuses of the biceps tendons were described as 'normal', 'dislocation', 'subluxation', 'partial or complete tears', and 'tendinopathy'. We investigated the correspondence between the arthroscopic and ultrasonographic findings. Results: On ultrasonography, the biceps tendons were 'normal' in 37 patients and 'abnormal' in 30 patients. On arthroscopy, 5 biceps tendons turned out to have partial tears, which were 'normal' on ultrasonography. On the other hand, 8 biceps tendons were 'normal' which were 'abnormal' on ultrasonography. Three dislocations and 4 complete tears of biceps tendons were identified on arthroscopy, and all of them were detected by ultrasonography. Of the 20 cases of 'tendinopathy' seen on ultrasonography, 15 patients had partial tears and the remaining 5 patients were normal on arthroscopy. Conclusion: Ultrasonography is accurate for detecting some biceps pathologies, such as dislocation or complete tear, but it is not accurate for the detection of partial tear.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.94-99
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• 2013

Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p<0.05). Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.215-220
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• 2009

Purpose: This study is to analyze the prevalence of various intra-articular lesions in patients with traumatic recurrent anterior dislocation of shoulder over 40 years and suggest clinical implications for treatment. Materials and Methods: We retrospectively studied 16 cases that underwent surgical treatment for recurrent anterior dislocation of shoulder from January 2001 to May 2009. There were 9 males and 7 females, and the mean age was 52.7years. We carried out arthroscopic exam for all patients based on standard protocol, which included labrum, capular lesion, cuff, bony lesions. Results: All 16 cases showed Hill-Sachs lesion, 3 patients (19%) had bony Bankart lesion, 6 patients (38%) had labral tear. Capsular tear were found 15 patients (94%). Twelve (75%) had ruptured supraspinatus and 5 (31%) had subscapularis tear. Only one (6%) had SLAP lesion. Conclusion: There was relatively higher incidence of capsular and rotator cuff tears in patients over age 40 years. Preoperative planning to address these lesions is highly recommended.