• 대한한의학방제학회지
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• 제18권2호
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• pp.259-265
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• 2010

Objectives : The purpose of this study is to report the improvement after Sweet BV herbal acupuncture therapy of shoulder impingement syndrome with Subacromial bursitis. Methods : We treated a patient having shoulder pain due to shoulder impingement syndrome with Sweet BV herbal acupuncture therapy. We checked visual analogue scale (VAS) score and range of movement (ROM). Results : We treated shoulder pain. Thereafter ROM improved and VAS score dropped to the level 3 points from 10 points at onset. Conclusions : This report shows Sweet BV herbal acupuncture therapy has effectiveness on shoulder impingement syndrome with Subacromial bursitis.

• PNF and Movement
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• 제20권3호
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• pp.399-408
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• 2022

Purpose: This study investigated the differences in winged scapula between the symptomatic side and asymptomatic side, the reliability of the winged scapula test, and the correlation between winged scapula and the stability of the scapula in patients with subacromial impingement syndrome. Methods: Twenty-four patients with unilateral subacromial impingement syndrome participated in this study. Winged scapula was compared between the symptomatic and asymptomatic sides using a scapulometer. The reliability of the scapulometer was assessed by calculating the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID). The correlation between winged scapula and the results of the upper quarter Y-balance test were also obtained. Conclusion: Winged scapula was significantly greater on the symptomatic side compared with the asymptomatic side (p < 0.05). High to excellent ICCs were obtained for the winged scapula test, and SEM and MCID values were obtained for winged scapula (SEM: 0.2-0.3 cm, MCID: 0.6-0.8 cm); however, winged scapula and the results of the upper quarter Y-balance test were not correlated. Conclusion: The scapulometer is useful for measuring winged scapula in patients with subacromial impingement syndrome.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.35-39
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• 1998

From May 1994 to May 1995, we performed a prospective controlled double-blind clinical study of 85 patients(85 shoulders). For inclusion in the study all patients met the following criteria: 1) a diagnosis of impingement syndrome by lidocaine injection test; 2) symptoms for at least three months; 3) no previous subacromial injection; 4) no evidence of rotator cuff tear. We excluded the patients from the study who showed a instability or other clear primary cause. The patients were randomized to receive either 5/subcc/ 2% lidocaine with 4ee of 20mg/cc Depomedrol(Group 1) in 45 cases or 5/subcc/ 2% lidocaine solely(Group 2) in 40 cases. At three month follow-up, all results were better in steroid group than control group. But at one year, improvement of pain and daily activity showed no difference between two groups. So we conclude that the use of subacromial steroid injection is effective for short-term therapy in the treatment of subacromial impingement syndrome, but the long-term effectiveness is doubtful.

• Clinics in Shoulder and Elbow
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• 제20권3호
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• pp.167-171
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• 2017

Here, a case of a 59-year-old man with rotator cuff tear and impingement syndrome caused by an ossified coracoacromial ligament is presented. Ossification of the coracoacromial ligaments can occur because of degenerative changes due to trauma or repeated stress, which can lead to impingement syndrome. Therefore, when coracoacromial ligament ossification is present, rotator cuff damage due to impingement syndrome should be considered. Here, we conducted arthroscopic subacromial decompression, removal of the ossified coracoacromial ligament, and supraspinatus and subscapularis tendon repairs. We achieved satisfactory surgical outcomes without relapse; therefore, we report this case with a literature review.

• Clinics in Shoulder and Elbow
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• 제2권2호
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• pp.99-105
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• 1999

We investigated the effectiveness of arthroscopic decompression in stage Ⅱ subacromial impingement after long term follow up. Arthroscopic subacromial decompression was done in 104 consecutive patients who had stage Ⅱ sub­acromial impingement. After average of 8.4 years follow up, the final results were as following; 57 shoulders(55%) in excellent, 25(24%) in good, 16(15%) in fair and 6(6%) in poor. All parameters-pain, function, muscle strength and motion-were improved significantly(p<0.00l). Rotator cuff tear was developed in 10 shoulders after decompression. Among them, 8 shoulders had unfavorable results including two poor. In 6 failures, two had rotator cuff tear, three had recurrence of impingement with degenerative change and reflex sympathetic dystrophy was developed in one. Reoperations were done in 4 shoulders. Improvement of impingement symptoms was maintained in the most of patients(79%) after long term follow up. Arthroscopic decompression surgery was very effective means for stage Ⅱ impingement syndrome.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.160-166
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• 1998

The purpose of this study was to assess the results of arthroscopic subacromial decompression in patients with chronic impingement and to evaluate the results according to the rotator cuff pathology. We evaluated the clinical results of treatment for chronic impingement syndrome in 28 patients from Feb 1996 to Feb 1997. There were twenty men and eight women in age from 24 to 72 years (mean age 51) with dominant arm involvement in sixteen patients. Follow up evaluations averaged 15(range 12-24)months. The average duration of symptoms were 15(range 6­60)months. The final diagnoses which were based on the physical examination, plain radiographs and arthroscopic findings, were stage II impingement in 16 patients and stage ill impingement in 12 patients. We excluded the patients with acromioclavicular arthritis or glenohumeral instability in this study. All patients were managed non-operatively a minimum of six months. During the operation we performed contouring and smoothing the acromial undersurface and only resecting of the anterolateral band of the coracoacromial ligament. The clinical results were quantitated using UCLA shoulder rating score. Satisfactory results were obtained in 23(80%) patients. Unsatisfactory results were obtained in 5(18%) patients with posterior cuff tear. The average UCLA pain score showed significant improvement from 2.8(constant pain) to 7.2(present during heavy activities) at final follow up. The function and active forward flexion scores also increased from their preoperative value. There was no significant differences according to the surface and severity of tear and NeeI' stage (P>0.05). These results compared favorably with those reported following open acromioplasty. While arthroscopic subacromial decompression is a demanding technique with a learning curve, it is a reliable treatment for chronic impingement syndrome. A less aggressive approach to subacromial decompression and preserving the posteromedial band of the coracoacromialligament does not appear to compromise results.

• Clinics in Shoulder and Elbow
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• 제2권2호
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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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• 제1권1호
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• pp.19-25
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• 1998

Appropriate clinical examination and imaging may lead to early diagnosis and treatment of the shoulder impingement syndrome, thus preventing progressing to a complete tear of rotator cuff. The impingement syndrome was caused by repeated entrapment and compression of supraspinatus tendon between the proximal end of humerus inferiorly, particullary its greater tuberosity. and one or m <)re component of coracoacromial arch superiorly. The purpose of this study is to critically, evaluate the result of twenty-five consecutive subacromial decompression with impingement syndrome and to assess the diagnostic accuracy of MR imaging by using oblique coronal and oblique sagittal plan. These patients were treated by arthroscopic subacromial decompression after their pains failed to improve with conservative therapy over three month. The average follow up was 25 month(range, 12 to 50). The mean age was 43 year old. The results were rated based on subjective response and the UCLA shoulder rating scale of the result. Ten patients(40%) were rated as excellent, 11patients(44%) were good. while four patients(16%) were fair. Radiologic evaluation suggested that the oblique sagittal plan of MRI can be helpful in evaluation of bony and soft-tissue structure of the coracoacromial arch and determining depth of bony resection. There were no infection or neurovascular injury. In reviewing our result, it appears that the arthroscopic subacromial decompression can be successful sugery for shoulder impingement syndrome and diagnostic accuracy of supplimentary oblique sagittal view of MRI was relatively higher than oblique coronal view alone for apprqpriate surgical plan.

• Clinics in Shoulder and Elbow
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• 제26권4호
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• pp.390-396
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• 2023

Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified. Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection. Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores. Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1995년도 학술대회
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• pp.13-13
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• 1995

The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.