• Journal of the Korean Arthroscopy Society
• /
• v.8 no.2
• /
• pp.103-108
• /
• 2004

Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.

• Physical Therapy Korea
• /
• v.26 no.4
• /
• pp.53-62
• /
• 2019

Background: Shoulder function is achieved by the coordinated movements of the scapula, humerus, and thoracic spine, and shoulder disorders can be associated with altered scapular kinematics. The trunk plays an important role as the kinematic chain during arm elevation. Objects: The purpose of this study was to determine the effects of thoracic hyperkyphosis on scapular orientation and trunk motion. Methods: Thirty-one subjects (15 in the ideal thorax group and 16 in the thoracic hyperkyphosis group) performed right-arm abduction and adduction movements in an unconstrained plane. The scapular orientation and trunk motion were recorded using a motion analysis system. Results: Those subjects with thoracic hyperkyphosis displayed greater scapular posterior tilting at a $120^{\circ}$ shoulder elevation, greater scapular internal rotation throughout the arm raising phase, and greater trunk axial rotation at the upper ranges of the shoulder elevation, compared to those subjects with an ideal thorax (p<.05). Conclusion: Thoracic hyperkyphosis can cause scapular instability, greater trunk rotation and greater scapular posterior tilting, and may contribute to preventing the achievement of a full range of humeral abductions in an unconstrained plane.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.47-52
• /
• 2010

Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.

• Journal of the Korean Arthroscopy Society
• /
• v.10 no.1
• /
• pp.23-25
• /
• 2006

• 대한관절경학회:학술대회논문집
• /
• 2007.10a
• /
• pp.41-42
• /
• 2007

• Clinics in Shoulder and Elbow
• /
• v.24 no.2
• /
• pp.98-105
• /
• 2021

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss' kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.2
• /
• pp.110-116
• /
• 2006

Lesion of the superior glenoid labrum and the insertion of the biceps tendon are a common cause for shoulder pain in patients performing overhead sports. Medial shearing stress during overhead throwing may cause biceps instability and associated rotator cuff problem aggravates the symptoms. Careful attention to the history and physical examination and may arouse suspicion of injury to the biceps tendon and the superior labral complex. Progress in shoulder arthroscopy has led to the identification of the lesion and normal variation. Treatment should be directed according to the type of lesion and related symptoms.

• Clinics in Shoulder and Elbow
• /
• v.20 no.4
• /
• pp.195-200
• /
• 2017

Background: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus. Methods: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24-105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up. Results: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up. Conclusions: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

• Journal of International Academy of Physical Therapy Research
• /
• v.2 no.1
• /
• pp.229-236
• /
• 2011

The purpose of this study was to comparatively analyze the active stability of shoulder joints according to the frequency of overhead motions, such as serving and spiking, engaged in by female professional volleyball athletes who play different positions, and to provide the results as the basic data for developing exercise programs to prevent shoulder joint injuries. The subjects of this study were 50 Korean female professional volleyball players and positions were as follows: left and right attackers, centers, setters, and liberos. The external rotation and internal rotation muscle strength and muscle strength ratios of the dominant and non-dominant arms of all subjects were measured using Biodex. The results of this study are as follows: Frist, no significant differences were found in the internal and external rotation muscle strength of the dominant and non-dominant arms between positions. Second, for the shoulder joint muscle strength ratio of the dominant arm, by position, the setter showed significantly greater stability compared to the other positions. Third, for the shoulder joint muscle strength ratio of the non-dominant arm, by position, no significant difference in stability between positions was found. Fourth, it was found that the dominant arm had significantly greater instability of the shoulder joint than the non-dominant arm for attackers and centers, but no significant difference was found for setters and liberos. This study comparatively analyzed the muscle strength ratios of the external/internal rotations and dominant/non-dominant arms, which can determine the stability of the shoulder joints between female professional volleyball playing positions that engage in jumps and spikes using only the dominant hand and positions that do not.

• Clinics in Shoulder and Elbow
• /
• v.11 no.1
• /
• pp.13-18
• /
• 2008

Successful treatment of any pathological condition of the shoulder requires an accurate diagnosis. Physical examination represents an integral part of the assessment of shoulder disorders. Pain, loss of strength, decreased range of motion, and instability are the most common symptoms caused by a great variety of different shoulder pathologies. Therefore, a sophisticated clinical approach to the patient with shoulder pathology is essential. A standardized evaluation including a variety of diagnostic tests and clinical assessments improves the diagnostic accuracy by specifically examining one component of the shoulder complex. In most cases a careful physical examination will establish or suggest a diagnosis and special investigative techniques such as imaging procedures can be applied more selectively for confirmation or further evaluation of the pathological entity.