• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.65-66
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• 2007

• Investigative Magnetic Resonance Imaging
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• v.17 no.1
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• pp.26-32
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• 2013

Purpose : This study was performed to evaluate the presence and severity of Hill-Sachs (HS) lesions on MR arthrography (MRA) of shoulder in patients with Bankart lesions following anterior dislocation and to investigate their relationship with Bankart lesions and frequency of dislocations. Materials and Methods: 86 MRA of shoulder were evaluated in patients with arthroscopic Bankart repairs following anterior dislocations. The largest surface length of HS lesion on MRA and extent of Bankart lesions on arthroscopy were measured. Relationships between length of HS lesions and extent of Bankart lesions and frequency of dislocations were assessed. Results: HS lesions were identified on MRA in 78 patients. The largest surface length of HS lesion ranged from 9.3 mm to 29.6 mm (mean, 18.8 mm). The extent of Bankart lesion ranged from one to six o'clock extent (mean, 4.25 o'clock extent). Three patients had single dislocation and the other 75 patients had recurrent dislocations (mean 24.5 times). The largest surface length of HS lesions was positively correlated with extent of Bankart lesions (p = 0.001, r = 0.37), but not with frequency of dislocation. Conclusion: HS lesion was very common in patients with Bankart lesion. The severity of HS lesions was correlated with extent of Bankart lesions.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.134-137
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• 2018

Background: In a previous study undertaken to quantify capsular volume in rotator cuff interval or axillary pouch, significant differences were found between controls and patients with instability. However, the results obtained were derived from two-dimensional cross sectional areas. In our study, we sought correlation between three-dimensional (3D) capsular volumes, as measured by magnetic resonance arthrography (MRA), and multidirectional instability (MDI) of the shoulder. Methods: The MRAs of 21 patients with MDI of the shoulder and 16 control cases with no instability were retrospectively reviewed. Capsular areas determined by MRA were translated into 3D volumes using 3D software Mimics ver. 16 (Materilise, Leuven, Belgium), and glenoid surface area was measured in axial and coronal MRA views. Then, the ratio between capsular volume and glenoid surface area was calculated, and evaluated with control group. Results: The ratio between 3D capsular volume and glenoid surface area was significantly increased in the MDI group ($3.59{\pm}0.83cm^3/cm^2$) compared to the control group ($2.53{\pm}0.62cm^3/cm^2$) (p<0.01). Conclusions: From these results, we could support that capsular volume enlargement play an important role in MDI of the shoulder using volume measurement.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.36-42
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• 2015

Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.166-171
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• 2021

Background: This study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after arthroscopic rotator cuff repair (ACRC). Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography. Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.162-162
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• 2008

Many anomalous origins of the long head of the biceps tendon (LHBT) have been reported. However, developmental anomalies of the LHBT are rarely encountered in daily practice. We report a patient with an anomalous LHBT that was adherent to and confluent with the rotator cuff throughout its intra-articular course and present the clinical, magnetic resonance arthrography, and arthroscopic findings.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.2199-2206
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• 2014

This research, used an contrast agent, which weighs about 1mmol/mL, of twice as much amount of gadolinum, per unit, for the test of magnetic-resonance shoulder arthrography. the reasearch which was carried out from January, of the year 2012 to August of the year 2013. consisted, of target of 41, patients including 20 ones, of whom an original, contrast agent of amount of 0.5mmol/mL, 21, ones of whom, a new, of amount of 1mmol/mL was used on, were the test target, in order to figure out the differences, according to the amount of gadolinum, according to the test results, the SNR of the contrast agent, of amount of 1mmol/mL, which is of high amount of gadolinum, was noticeably higher than the one of amount of 0.5mmol/mL(the percentage of joint space 38.01%, the supraspinous muscle 8.40%, head of humerus 12.78%). and CNR of the contrast agent, of amount of 1mmol/mL, which is of high amount of gadolinum, was higher than the one of amount of 0.5mmol/mL(the percentage of joint space and supraspinous muscle 48.96%, the one of joint space and head of humerus 42.00%). In conclusion, one of the methods of increasing the reducing effect of T1, is to use contrast agent of amount of 1mmol/mL, in order to increase the reducing effect of T1, acquire the visual of high testing quality.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.11a
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• pp.29-33
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• 2009

단순촬영에서 견관절을 이루는 골격의 형태를 파악하고 MRI에서는 주로 회전근 개 건의 fraying및 파열, 오훼견봉인대의 견봉 부착부위의 fraying, 점액낭염, 활막염, 관절순의 병변, 연골연화와 같은 연부조직의 병변을 관찰한다. 회전근 개 파열의 고식적 MR 진단은 정확도가 93%, 민감도가 84~100%, 특이도가 88~97%, 지방억제 MR 관절강 조영술은 민감도 및 특이도가 90%및 75%에서 100%까지 최근 보고 되고 있다. 단순촬영검사로 충돌중후군의 일반적인 소견을 파악할 수 있고 impingement series에는 견관절 전후면, suprascapular outlet view (SSO), craniocaudal 30 degree tilt view (CC30T), axillary view를 포함한다. 특히 SSO에서 견봉 및 ACJ의 형태 및 골극의 유무를 파악하고, CC30T에서는 견봉 돌출의 정도를 파악할 수 있다. 최근 고해상도의 MDCT로서 얻은 3차원 영상이 충돌증후군의 전반적인 영상 소견을 파악할 수 있고 수술전 평가에 이용되고 있다. MRI 및 MR Arthrography의 영상은 일반적으로 극상건의 주행에 따른 고식적 MR 사위 관상면이 중요하고 사위 시상면에서 견봉돌기의 형태와 대결절에 부착되는 극상건의 파열 유무와 정도를 파악할 수 있다. MR 관절조영술 후 외전 및 외회전후 (ABER view)의 영상도 관절면 쪽으로 부분 파열된 극상건의 진단에 유용하다.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.23-26
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• 2008

Ultrasonography (USG) is widely accepted diagnostic method for the rotator cuff tear. The availability, low cost, easy to access is main factors that favor USG as a primary diagnostic modality for various cuff disorders. We experienced a case of discrepancy between USG, MR arthrography (MRA) and arthroscopic examination. Seventy four year old female patient complained of right shoulder pain. USG depicted rotator cuff tear with the size of 1cm, and MRA demonstrated about 3cm sized tear. Complex massive tear with delamination of degenerated rotator cuff was identified in the arthroscopic examination. When we encounter a patient who has loss of rotator cuff power or severe symptom than findings of USG, MRA or repeat USG is warranted. We report a case of discrepancy between examination modalities with brief review of the literature.

• 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.