• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.93-98
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• 1999

Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

• 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.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.139-145
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• 2019

Background: The present study was undertaken to evaluate the relationship between location of the rotator cuff tear and shape of the subacromial spur. Methods: Totally, 80 consecutive patients who underwent arthroscopic repair for partial thickness rotator cuff tear were enrolled for the study. Bigliani's type of the acromion, type of subacromial spur, and location of partial thickness tear of the rotator cuff were evaluated using plain X-ray and magnetic resonance imaging. We then compared the groups of no spur with spur, and heel with traction spur. Results: Of the 80 cases, 25 cases comprised the no spur group, and 55 cases comprised the spur group. There was a significant difference in type of tear (p=0.0004) between these two groups. Bursal side tears were significantly greater (odds ratio=6.000, p=0.0007) in the spur group. Subjects belonging to the spur group were further divided into heel (38 cases) and traction spur (17 cases). Comparing these two groups revealed significant differences only in the type of tear (p=0.0001). Furthermore, the heel spur had significantly greater bursal side tear (odds ratio=29.521, p=0.0005) as compared to traction spur. Conclusions: The heel spur is more associated to bursal side tear than the traction spur, whereas the traction spur associates greater to the articular side tear.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.50-54
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• 2003

Object: To evaluate the efficiencies of the arthroscopic rotator cuff surgery which is Performed without the traction system in the lateral decubitus position. Methods: Twenty-nine cases of the arthroscopic rotator cuff surgery performed without the traction system in the lateral decubitus position were studied from February, 2002 to January, 2005. We performed a repair using the arthroscopic debridement and the arthroscopic rotator cuff repair, or using the mini-open incision technique after the confirmation of rotator cuff tear, then, the arthroscopic subacromial decompression was performed after the confirmation of subacromial lesions Results: We could easily find the subscapularis tear which was often overlooked in the arthroscopic rotator cuff surgery performed with the traction surgery by the relaxation of the subscapularis, as the arm position was internally rotate about 45 to 70 degrees from abducted position. We found that the operation time was reduced 14 minutes shorter than the operation time of the controlled group which had the surgery with the traction system on the average. We also found that there were no neurovascular complications from all cases. Conclusions: The arthroscopic rotator cuff surgery without traction system in the lateral decubitus position provided the better visual field, easy manipulation of the joint and reducing operation time.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.92-97
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• 2012

Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.21-26
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• 2021

Background: To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear. Methods: Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. Results: There were 402 female patients (79%) with mean age of 55 years (range, 31-87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0-35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1-10) and 47 (range, 8-95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05). Conclusions: This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.62-67
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• 2009

Purpose: The purpose of this study is to find out the accuracy and usability of the three dimensional ultrasonography in measuring the size of the rotator cuff tear, especially before and after the injection of normal saline into the glenohumeral joint. Materials and Methods: 14 patients of rotator cuff tear who were diagnosed and operated from August 2007 to September 2008 were included in this study and authors compared the size of rotator cuff tear measured with three dimensional ultrasonography with the real size measured intraoperatively. In preoperative ultrasonographic evaluation, horizontal and longitudinal length of rotator cuff tear before and after injection of normal saline intraarticularly. During the arthroscopic operation the size of tear was measured by passing a Kirschner wire through a spinal needle and direct measure was performed in open surgery. Results: The average difference was 8 mm in horizontal and 1.9 mm in longitudinal length of tear without saline injection between ultrasonographic and intraoperative measure. The average difference was 4.1 mm in horizontal and 1.6 mm in longitudinal length of tear after the normal saline injection. Conclusion: In three dimensional ultrasonographic evaluation in rotator cuff tear, intraarticular normal saline injection would produce more accurate results.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.30-34
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• 2004

Purpose: To report our experience of treatment of rotator cuff tear and evaluate the mid-term outcome. Materials and Methods: We have performed 50 cases of mini-open rotator cuff repair from March 1996 to March 1999. Male to female ratio was 34：16, the average age 46.5(23∼57) years old, mean follow-up period was 78(62∼93) months. All-arthroscopic repair and open repair cases were excluded. Mean symptomatic period was 12.5(6∼38) months, operation was indicated in cases of no improvement by 6 months of conservative management. Preoperative simple radiographs and Magnetic resonance arthrography were obtained in all cases. We also observed the inflammation, synovitis, thickness of tear and associated pathology intraoperatively. We evaluated pain, function, and range of motion by UCLA score. Results: Overall UCLA score was mean 29.5 points. Excellent 25, good 18, poor 7 cases. Mean pain score was improved 2.6 to 7.5, 44 cases(88%) were improved and 6 cases(12%) were not improved. Mean functional score was improved 3.4 to 8.5, and activity at follow up, 25 cases(50%) were same, 8 cases(14%) were above, 17 cases(34%) were below compared with preoperative level. Mean active forward flexion was preoperative 112° to postoperative 160°, forward flexion strength was improved 3.8 to 4.7. 43 cases(86%) of patients were satisfied at the result, 7 cases(14%) were not satisfied or aggravated. Results: Mini-open rotator cuff repair was effective method in treating rotator cuff tear.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.77-81
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• 2009

In patients with full-thickness tears of the rotator cuff, the tendon is usually detached from its bony insertion in the greater or lesser tuberosity. We experienced an unusual pattern of rotator cuff tear in two cases, in which complete rotator cuff tears occurred at the tendinous portion (i.e., intrasubstance tears) with more than a 1cm remnant attached to the greater tuberosity. Arthroscopic tendon-totendon repair was performed without remnant removal in both cases. Follow-up MRI at 6 months showed re-tear of the rotator cuff at the previous tear site in both of our patients. To prove the availability of arthroscopic tendon-to-tendon repair in such cases, a larger case follw-up and biomechanical studies are required.

• Clinics in Shoulder and Elbow
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• v.23 no.2
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• pp.80-85
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• 2020

Background: Atelocollagen has been studied for restoration of rotator cuff tendon. In this study, we attempted to evaluate the clinical outcome of ultrasound-guided atelocollagen injection in an outpatient clinic for patients with partial rotator cuff tear. Methods: We recruited 42 outpatients who visited our hospital from May 2019 to September 2019. Atelocollagen injection was performed in patients with partial rotator cuff tear diagnosed by magnetic resonance imaging and ultrasound. American Shoulder and Elbow Surgeons (ASES), Constant, Korean Shoulder Score (KSS) and Simple Shoulder Test (SST) scores, and range of motion were assessed before injection and after 2 months. Statistically, we analyzed the clinical results using the Wilcoxon signed-rank test. Results: Finally, 15 patients were enrolled for analysis. There was no significant difference between pre- and post-injection in terms of range of motion, ASES (57.0 vs. 60.4), Constant (56.4 vs. 58.9), KSS (64.6 vs. 68.5), and pain-visual analog scale (4.2 vs. 3.7), except function-visual analog scale (F-VAS; 6.3 vs. 7.1) and SST (6.6 vs. 6.9). A significant difference was found in SST (P=0.046) and F-VAS (P=0.009). According to the ultrasound results at 2 months, we found hyperechoic materials in three of seven patients. The most common complication of atelocollagen injection was post-injection pain (53%, 8/15). Conclusions: Ultrasound-guided atelocollagen injection for partial rotator cuff tear showed no significant change in terms of clinical outcomes, except for F-vas and SST score. Tendon regeneration was not clear due to the remnants of atelocollagen present at 2-month follow-up ultrasound. There seems to be alarming post-injection pain for 2 to 3 days in the patients who received atelocollagen injection in an outpatient clinic.