• 대한관절경학회지
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• 제12권2호
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• pp.134-138
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• 2008

견관절 상완순 전후방(SLAP: Superior labrum anterior to posterior) 병변은 상부 관절와순 단독 손상으로 발견되기도 하고, 견관절 재발성 탈구 환자에서 전하방 관절와순의 파열, 즉 Bankart 병변의 연장으로 상부 관절와순까지 파열이 진행된 동반 손상으로 발생하기도 하며, 드물게 후방 Bankart 병변을 동반하는 경우도 있다. 여러 가지 병변과 동반된 SLAP 병변이 보고되어 왔으나 그 중 후방 Bankart 병변과 동반하여 발생한 후방 II형 SLAP 병변에 대한 보고는 미미하고 그 병변에 대한 관절경적 복원술 시 봉합 나사(suture anchor)의 삽입과 봉합에 주의할 점이 있다. 저자들은 투구 동작과 같은 흔한 손상 기전이 아닌 팔을 뻗친 상태에서 넘어지면서 발생한 외상으로 야기된 본 증례에 대해 관절경적 복원술을 시행하여 만족할 만한 결과를 얻었기에 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제21권1호
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• pp.37-41
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• 2018

Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

• Clinics in Shoulder and Elbow
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• 제7권1호
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• pp.10-13
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• 2004

Superior labrum anterior to posterior (SLAP) lesions of the shoulder has recently been a popular issue to shoulder surgeons. Now we are correlating many shoulder symptoms to this SLAP lesion. A 45 year-old female patient injured her shoulder when her arm sleeve was entrapped in moving automobile door. A forceful pull of the arm in external and abduction position was suspected. She complained continuous shoulder pain with limited range of motion for 2 months. Magnetic resonance image showed possible SLAP lesion but no definite diagnosis were made prior to the operation. Arthroscopic evaluation revealed SLAP type Ⅱ lesion with concomitant avulsion of the superior glenoid cartilage. In addition anterior labrocapsular tear was seen from 7 to 9 o'clock of anterior glenoid. The SLAP lesion and the anterior capsulolabral lesion were repaired properly to the glenoid. We report a case of glenoid-cartilage avulsion type of SLAP Ⅱwith anterior labrocapsular lesion.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.78-82
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• 1998

The following will describe a method of evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder. We have named it the biceps load test. The biceps load test is performed with the patient in the supine position and the arm to be examined is abducted 90/sup°/, and the forearm is in the supinated position. First, the anterior apprehension test is performed. When the patient become apprehensive, the patient is allowed active flexion of the elbow, while the examiner resists elbow flexion. If the apprehension is relieved or diminished, the test is negative. If aggravated or unchanged, the test is positive. A prospective study was performed, in which 75 patients who were diagnosed as having recurrent unilateral anterior instability of the shoulder underwent the biceps load test and arthroscopic examination. The biceps load test showed negative results in 64 of these patients, of which the superior labral-biceps complex was intact'in 63 cases and only I shoulder revealed a type n SLAP lesion. E]even patients with a positive test were confirmed to have type n SLAP lesions. A positive biceps load test represents an unstable SLAP lesion in a patient with recurrent anterior dislocation of the shoulder. The biceps load test is a reliable test for evaluating the SLAP lesion in the recurrent anterior dislocation of the shoulder(sensitivity: ,9] .7%, specificity: 100%, positive predictive value: 1.00 and negative predictive value: 0.98). Biceps contraction increases the torsional rigidity ?of the glenohumeral joint and long head of biceps tendan act as internal rotator of the shoulder in the abducted and externally rotated position. These stabilize the shoulder in abduction and external rotation position in the biceps load test.

• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.95-101
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• 2000

Purpose : The purpose of this study was to evaluate the efficacy of oblique coronal MR images, oblique axial images of neutral, internal rotation and external rotation positions in the diagnosis of SLAP Ⅱ lesion. Materials and Methods: MR arthrography of the glenohumeral joint was evaluated retrospectively in 16 patients(16 shoulders) who underwent arthroscopic surgery(mean age; 38 years old, Male; 13, Female; 3). Oblique coronal fat-suppressed Tl-weighted spin echo images were performed with each shoulder in the neutral position of the arm and oblique axial images were performed in neutral, internal and external rotations of the arm respectively. The preoperative findings of MR were classified as definite tear, possible tear and no tear. Arthroscopic findings were correlated with MR findings of several different position of the arm. Results: Arthroscopic surgery revealed 8 SLAP Ⅱ lesion, 2 SLAP I lesion, and 6 normal superior labrum respectively. The accuracy of diagnosis in the 8 SLAP Ⅱ lesion were high on oblique axial image in external rotation which were interpreted as 8 definite tear, to compare with oblique axial images in neutral position which were interpreted as 4 definite tear, 3 possible tear, 1 no tear. The 6 normal superior labrum lesion were interpreted as no tear in all three position. The 2 SLAP I lesion were interpreted as 1 definite tear, 1 no tear on oblique axial image in neutral position and 1 definite tear, 1 possible tear on oblique axial image in external rotation. Conclusion: This study showed that axial MR images in external rotation of the arm combined with oblique coronal images have proved to be effective to detect SLAP Ⅱ lesion, and should be considered in imaging protocol for MR arthrography of the SLAP Ⅱ lesion.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.118-122
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• 2008

목적: 강직을 동반한 제 2형 SLAP 병변에 대하여 수술적 가료를 시행한 후에 임상적 결과를 알아 보고자 한다. 대상 및 방법: 강직을 동반한 제 2형 SLAP 병변 13예를 대상으로 하였으며 수술은 관절경적 관절막 유리술과 봉합술 및 동반 병변에 대한 치료을 하였다. 추시 기간은 평균 12개월 이상(평균 14.9개월) 이었다. 결과: 술 후 평균 VAS 점수는 1.5, ROWE의 점수는 92.3점으로 술 전에 비해서 의미 있는 호전을 보였다(P<0.001). 술 후 평균 관절 운동 범위도 술 전에 비해서 의미 있는 호전을 보였으며(p<0.001) ROWE의 점수는 13예 모두에서 우수의 결과를 얻었다. 결론: 강직을 동반한 제 2형 SLAP 병변에서 관절경적 관절막 유리술과 봉합술 및 동반 병변에 대한 치료는 통증 감소 및 관절 운동 범위 증가에 효과적인 치료방법이라고 생각된다.

• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.6-12
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• 2008

관절경 수술 및 MRI가 보편적으로 쓰이면서 SLAP (superior labrum from anterior to posterior) 병변은 최근 많이 진단되고 있으며 수술 역시 널리 시행되고 있다. 그러나 임상적으로 SLAP 병변을 진단 내리기는 힘들어 이를 진단하기 위한 다양한 이학적 검사법이 소개되고 있으나 그 민감도와 특이도에 이견이 많아 확진 검사로 쓰이기는 힘들다. 하지만 임상적으로 SLAP 병변이 의심되는 경우 이학적 검사가 SLAP 진단 과정에 도움이 되는 것은 사실이며, 다른 정밀검사를 하도록 도와줄 수 있고 수술 전 계획을 수립하는데도 도움을 준다. 따라서 자세한 병력과 함께 정확한 이학적 검사법을 알고 시행하는 것이 SLAP 병변의 진단과 치료에 중요하다고 할 수 있다. 이 종설에서는 현재 보고된 SLAP 병변의 이학적 검사법들을 나열하여 원문 기술(original descriptions)과 통계학적 분석에 기술하여 어떠한 검사법이 있으며 어떻게 검사를 시행 해야 되며 그 검사 결과를 어떻게 판정해야 되는지를 알아보고자 한다.

• Clinics in Shoulder and Elbow
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• 제10권1호
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• pp.73-77
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• 2007

목적: 견관절의 제 2형 SLAP 병변에 대하여 흡수성 봉합 나사못을 이용하여 관절경적 봉합을 시행한 후 임상적 결과를 보고하고자 한다. 대상 및 방법: 이 연구에는 25명에 대한 25례(남자가 20명, 여자가 5명)가 포함되었다. 평균 연령은 44.5세였다. 수술 전 ASES 점수는 평균 44점이었다. 모든 예에서 SLAP 병변을 관절경적으로 1개 또는 2개의 흡수성 봉합 나사못을 사용하여 수술을 시행하였다. 평균 추시 기간은 15개월이었다. 결과: 최종 추시시 ASES 점수는 평균 92.7점으로 향상되었으며 견관절의 운동 범위는 23례에서 완전한 회복을 보였으나 2례에서 경미한 운동범위 제한이 있었으나 일상 생활에는 문제가 없었다. 결론: 제 2형 SLAP 병변에 대하여 흡수성 봉합 나사못을 이용한 관절경적 봉합 수술이 만족할 만한 임상적 결과의 소견을 보여 매우 좋은 수술 방법으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.115-119
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• 1999

Purpose: We reviewed the SLAP lesions and associated injuries, also evaluated a hypothesis that the type II posterior SLAP lesion is related with posterior rotator cuff tear and gives rise to the postero-superior instability. Materials and Methods: The patient recording papers, MRI, video and operation sheets were reviewed with the 28 SLAP lesions confirmed by the arthroscopy among 242 cases. Among these SLAP lesions, type II was 22 cases and classified to the anterior, posterior(16 cases), combined subtype(6 cases) based on the main anatomic location. There were 14 cases of the type II accompanying rotator cuff tear. The average follow-up(13 months) results were evaluated with the ASES and Rowe rating score after repair or debridement of the SLAP lesions. Results: In the type II lesions accompanying the rotator cuff tears(14 cases), the posterior(l0 cases) and combined type(4 cases), cuff lesions were all existed posteriorly. Also We could confirm the drive-through sign in the eleven cases, though did not check the disappearance of this sign after repair because of retrospective study. We could followed up the 22 cases, 18 cases(77%) were excellent or good, fair 3 cases(14%) and poor 1 case(4%). Also, type II lesions with the rotator cuff tear(14 cases) were showed better results in the repair(8 cases) than the debridement(6 cases) of the unstable type II with the cuff repair. Conclusion: The type II lesions were frequently associated with the cuff tear in the specific location. We could presume the possibility of postero-superior instability in the SLAP lesion with the cuff injuries. Also, satisfactory results could be experienced when the unstable SLAP lesions with the cuff tear were repaired at the same time.

• 대한정형외과스포츠의학회지
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• 제10권1호
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• pp.1-3
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• 2011

어떠한 술전 검사도 SLAP 병변을 확일 할 수 없으며, 관절경 검사 만이 진단적 가치가 있다. 저자들은 환자의 증상, 평가 및 치료 방식에 대하여 논하고자 한다.