• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.1
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• pp.71-76
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• 2003

We evaluated biceps pulley as a stabilizing sling for the long head of biceps tendon in the rotator interval. We present 3 cases of detached biceps pulley which impinges on posterosuperior glenoid labrum in the position of late cocking. Pulley impingement related to anterior shoulder instability was relieved after Bankart repair. In another two cases, impingement symptoms were disappeared after resection of the detached biceps pulley.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.70-75
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• 2013

We experienced three cases with chronic shoulder pain due to a knot impingement after arthroscopic rotator cuff tear repair and treated with arthroscopic revision surgery. Ultrasonography is commonly used for an imaging scan and an useful diagnostic tool to follow up after rotator cuff repair recently. We also could diagnose three cases with the knot impingement using ultrasonography obviously. And we report these cases with a review of current literature.

• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.73-80
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• 2002

Purpose: Weight lifting is a good training to control body weight, to correct body shape and to relieve stress. How-ever if the training is continued by inadequate training method and technique, the risks of the shoulder injuries are relatively high. Main Subject: The rotator cuff injury is the most common disorder to wright lifters and often results from the train- ing program of upright row, military press and pectoral deck. The chances of subacromial impingement in these postures are high because the shoulder rotates under the acromion at 90 abduction state. Shoulder instability in weight lifters can develop due to various causes. aepeated microtrauma and excessive abduction and external rotation may result in laxity of the anterior capsular structure, ligament and muscles. Behind the neck and bench press are high risk training postures. Other than those injuries, idiopathic osteolysis of distal clavicle, acromioclavicular separation, pectoralis major muscle rupture, and triceps muscle rupture nay develop. Conclusion: The best treatment option of the shoulder injury to weight lifters is to eliminate the possible risk elements for the weight lifters in training program and to provide proper and prompt treatment as soon as possible.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.119-126
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• 2003

The shoulder is a complex joint and, by virtue of having a large range of motion, is inherently unstable, relying on the surrounding soft tissue structures for stability. The bony joint consists of the glenoid, acromion, and humoral head, while the soft tissues include the glenoid labrum, the glenohumeral ligaments. and coracoacromial ligament as well as the muscles of the rotator cuff, the long head of the biceps, and the scapulothoracic muscles. Dysfunction in any one of these components can cause shoulder problems. The throwing motion involves a series of phases that stress to their limits the dynamic and static restraints of the glenohumeral and scapulothoracic joints. . Therefore, maintaining a balance of proper biomechanical forces is essential to avoiding shoulder injuries in throwing athletes. Over the last decade, signficant advances have been made in the study and understanding of the shoulder mechanics, and pathophysiology of injury. Additionally, advances in surgical techniques, particularly arthroscopy , have aided in the diagnosis of and the developement of less invasive surgical treatments for injuries that do not respond to nonoperative measures. In this article, we reviewed the pathophysiology of injuries , diagnostic techniques, and surgical management of shoulder injuries in throwing athletes .

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.20-24
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• 2023

Background: The Friends and Family Test (FFT) developed by the UK National Health Service evaluates whether patients are satisfied with a service provided, where improvements are needed, and how likely patients are to recommend the intervention. Calculated from the FFT, the Net Promoter Score (NPS) creates a recommendation metric for treatment. The primary aim of this prospective study is to evaluate NPS for arthroscopic subacromial decompression (ASD) and rotator cuff repair (RCR). Secondary aims are to postoperatively evaluate 1-year changes in patients' Oxford Shoulder Scores (OSSs) in terms of the proportion of patients satisfied with their surgery and correlation with FFT. Methods: During a 2-year period, all patients undergoing ASD or RCR completed questionnaires prospectively. Collected preoperatively and postoperatively at 1 year. Results: NPSs were 31 for ASD (n=32) and 52 for RCR (n=39). OSSs increased by 4.3 and 6.9 for ASD and RCR, respectively (P<0.001). Overall, 75% of ASD and 77% of RCR patients were either "satisfied" or "very satisfied," respectively, with procedure outcomes. Scores from FFT had a positive correlation with improvement in OSS and satisfaction scores among patients undergoing arthroscopic shoulder surgeries (P<0.001). Conclusions: The current study shows positive NPS outcomes in patients with ASD and RCR. Scores from FFT correlate well with both satisfaction and OSS among patients. NPS can be an adjunct to traditional patient-reported outcome measures to provide global evaluation of patient experiences to aid in determining the clinical value of common procedures in shoulder orthopaedics. Level of evidence: III.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.84-87
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• 1999

The Buford complex is unusual variant of the glenohumeral joint. This complex is distinguished by a cord-like middle glenohumeral ligament that oriented directly form the superior labrum at the base of the biceps tendon and crosses the subscapularis tendon to insert on the humerus. There is no anterior-superior labral tissue present between this attachment and the mid-glenoid notch. This anatomical variation may lead the surgeon to confuse this complex with a sublabral hole, pathologic labral detachment, Bankart lesion or SLAP lesion. We report a case of Buford complex which was found incidentally during the operation of impingement syndrome with stiffness and treated with subacromial decompression only.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.9-16
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• 2010

Purpose: The purpose of this study was to compare modified sling exercise and general isometric exercise in patients with shoulder impingement syndrome. Methods: Twenty subjects were studied. The control group, n1 = 10, received instructions for doing general isometric (ISO) exercise. An experimental group, n2 = 10, received instructions for doing push-ups from standing and sitting positions and modified scapular exercises using a sling (3 sets, 3 times per week for 6 weeks). To evaluate the effects of exercise, subjects were evaluated using a visual analog scale for pain, a goniometer for range of motion, and electromyography for onset time of muscle contraction. Statistical analysis was done using the Wilcoxon Signed rank and Mann-Whitney U tests. Results: Pain in the sling group was significantly decreased after 6 weeks of treatment (p<0.05) pain in the general ISO exercise group was not significantly decreased (p>0.05). Flexion and external rotation were significantly increased after 6 weeks of treatment in both groups (p<0.05) and the change in the Sling group was greater than in the ISO group (p<0.05) in the flexion test. Time of onset of contractions in the Sling group for the upper trapezius, lower trapezius and serratus muscle were significantly decreased after 6 weeks of treatment (p<0.05), but the onset time for the middle trapezius did not significantly decrease (p>0.05). Conclusion: Scapular stabilizing exercise using a sling increases range of motion and decreases pain, and onset time of muscle contraction in patients with impingement syndrome.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.47-51
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• 2015

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.271-277
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• 2009

Purpose: Scapular dyskinesis is an alteration in the normal position or motion of the scapula during coupled scapulohumeral movements. Vast majority of shoulder pathologies are known to be related with scapular motion abnormalities. Because there being enthusiasm about scapular pathology in recent literatures, understanding scapular dyskinesis seems to be an important subject. The authors describe the importance of scapular abnormality in terms of shoulder pathology. Materials and Methods: Usually the inhibition or disorganization of activation patterns in scapular stabilizing muscles lead to scapular dyskinesis. This motion abnormality has more important values in Elite Athletes because it might be the sign of future shoulder pathology; for example, SLAP and internal impingement. Treatment of scapular dyskinesis is directed at managing underlying causes and restoring normal scapular muscle activation patterns by kinetic chain-based rehabilitation protocols. Treatment is also important to prevent secondary shoulder injuries. Results and Conclusion: Understanding scapular pathology may be the main key to approach to the shoulder pathology. Also treating scapular pathology might be important in preventing secondary shoulder injuries.

• Journal of the Korean Arthroscopy Society
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• v.17 no.1
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• pp.61-65
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• 2013

Tophaceous gout, which is usually presented in the synovial fluid, bursal lining, cartilage or other soft tissues, may cause a nonoutlet impingement in the rotator cuff and bursa. In chronic tophaceous gout patient with the shoulder pain, a surgeon should consider the possibility of the tophaceous gout of the rotator cuff. We report a surgical experience of a 50-year-old man with tophaceous gout of the rotator cuff causing impingement syndrome. The patient was treated successfully with arthroscopic debridement and subacromial decompression.