• The Academic Congress of Korean Shoulder and Elbow Society
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• 1999.03a
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• pp.3-4
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• 1999

The electromyographic activity of four muscles of biceps, rotator cuffs (supraspinatus, infraspinatus and subscapularis) was measured from the non-dominant shoulders of 12 volunteers during six methods of provocative test for the biceps pathology. Any method of provocative test can not isolates the biceps activity prominently compared to the other rotator cuff muscles. But the Speed test can more isolates the activity of biceps than the other tests. Based upon this study, we think that the O'Brien's test is not a provocative maneuver by which the pain reproduced is not associated with the tension generated within the biceps tendon.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.172-179
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• 2017

Indications of reverse total shoulder arthroplasty (RTSA) have been consistently extended by technical advancements in reverse arthroplasty prosthesis, continuous development of the implants, accumulated experiences and its successful treatment outcomes; accordingly, its use has rapidly increased. RTSA has been performed for a variety of indications, with variable outcomes depending on the initial diagnosis. However, controversial opinions still exist regarding the design of reverse arthroplasty prosthesis (medialized or lateralized design and the neck-shaft angle of the humeral prosthesis), suture of the subscapularis tendon, use of cement during placement of the humeral prosthesis, and surgical procedures; therefore, these should be investigated so that they can be better understood.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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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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• v.14 no.1
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• pp.35-45
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• 2011

Purpose: The purpose of this study was to document the structural features of the tendinous portions within the non-pathologic subscapularis muscle by performing high resolution MR imaging of the shoulder. Materials and Methods: Between April 2007 and May 2010, we retrospectively obtained the MR scans of 88 consecutive young patients (88 shoulders) who were in their twenties. MRI and MR arthrography were performed using a 3.0-T system for the evaluation of glenohumeral instability and nonspecific shoulder pain. None of the patient in this study had any evidence of injury to the tendon or muscle belly of the subscapularis. On MR images, we recorded the transverse length of a stout tendinous band and the total tendinous portion of the subscapularis. In addition, we recorded the number of intramuscular tendinous slips of the susbscapularis. Results: The mean transverse length of the tendinous band was 15.0 mm (range: 8 to 20 mm). The mean transverse length of the total tendinous portion was 48.9 mm (range: 40 to 60 mm). The number of intramuscular tendinous slips on the base of the glenoid fossa was 3 in 20 (22.72%), 4 in 45 (51.14%) and 5 in 23 shoulders (26.14%). On the lateral portion, the intramuscular tendinous slips became gradually rounder and thicker and they gave converge in the superior direction. Conclusion: In this study, the structural features of the tendinous portions of the subscapularis on the MR scans were identified. This will in return give good justification for the lines to be pulled during biomechanical stimulation and also for the surgical approach to restore the biomechanical function.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.112-116
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• 2008

Ultrasonography of shoulder joint recently enlarges its utility since the knowledge of the shoulder disease is increased by numerous researches. Ultrasonography is not only noninvasive, safe, and relatively cheap, but also an unique modality that can monitor tendon movement during shoulder motion. Sonographic examination generally starts from the front side of the shoulder joint and finishes at back side in sitting position. Many structures in shoulder joint such as muscles, ligaments, glenoid labrum, bone, and especially rotator cuff tendon can be examined by ultrasonography. The rotator cuff is a motion unit consisted with subscapularis, supraspinatus, infraspinatus, and teres minor muscles. It functions as fulcrum and compresses the humeral head onto the glenoid, and steers for shoulder joint.

• Investigative Magnetic Resonance Imaging
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• v.22 no.4
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• pp.229-239
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• 2018

Purpose: To assess the diagnostic performance in detecting rotator cuff tears at 3T of non-arthrographic shoulder magnetic resonance imaging (MRI) using 3D isotropic turbo spin-echo (TSE-SPACE) sequence as compared with 2D sequences. Materials and Methods: Seventy-four patients who were arthroscopically confirmed to have underwent non-arthrographic shoulder MRI with 2D sequences and TSE-SPACE were included. Three independent readers retrospectively scored supraspinatus and infraspinatus tendon (SST-IST) and subscapularis tendon (SCT) tears on 2D sequences and TSE-SPACE. Results: The mean sensitivity, specificity, and accuracy of the three readers were 95%, 100%, and 95% on TSE-SPACE and 99%, 93%, and 98% on 2D sequences for detecting SST-IST tears, respectively, whereas those were 87%, 49%, and 68% on TSESPACE and 88%, 66%, and 77% on 2D sequences for detecting SCT tears, respectively. There was no statistical difference between the two sequences, except for in the specificity of one reader for detecting SCT tears. The mean AUCs of the three readers on TSE-SPACE and 2D sequences were 0.96 and 0.98 for detecting SST-IST tears, respectively, which were not significantly different, while those were 0.71 and 0.82 for detecting SCT tears, respectively, which were significantly different (P < 0.05). Conclusion: TSE-SPACE may have accuracy and reliability comparable to conventional 2D sequences for SST-IST tears at non-arthrographic 3T shoulder MRI, whereas TSE-SPACE was less reliable than conventional 2D sequences for detecting SCT tears.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.226-231
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• 2009

Purpose: Bilateral traumatic locked posterior dislocations of the shoulder are very rare and there has been no report on the operative treatment for this injury in the Korean medical literature. Materials and Methods: We present here a case of bilateral locked posterior dislocations of the shoulders after trauma and this was successfully treated with open reduction and lesser tuberosity transfer on the right shoulder and subscapularis tendon transfer on the left shoulder. Results and Conclusion: Twenty-four months later, the clinical and radiologic results were excellent.

• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.45-48
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• 2013

A 12-year-old male poodle weighing 2.0 kg presented for evaluation of right thoracic limb lameness. The owner reported that the dog showed recurrent bilateral shoulder joint luxation after a car accident for a year. Recently, the left shoulder joint appeared well maintained, but right shoulder joint luxation was exacerbated. On physical examination, the dog showed non-weight bearing lameness on the right thoracic limb. Craniocaudal radiographic views revealed medial displacement of the right humerus. Mediolateral radiographic views revealed overlap of the glenoid cavity and humeral head. Muscle atrophy of the right thoracic limb, reduced biceps brachii muscle tendon tone, a tear of the medial glenohumeral ligament, and a rupture of the subscapularis tendon were identified intraoperatively. Transposition of the biceps muscle tendon was performed. However, at 7 days, there was evidence of right shoulder reluxation on radiographs. The second surgery was performed with two $2mm{\times}6mm$ cortical bone anchors and a $4mm{\times}6mm$ cancellous bone anchor placed in the cortical bone of the distal scapula and the cancellous bone of the proximal humerus respectively. Two scapular bone anchors were then connected with a humeral bone anchor using heavy nylon suture to minimize shoulder abduction range of motion. On radiographs right after surgery and 6 weeks after surgery, the affected limb revealed no evidence of medial shoulder luxation. At 6 months, no evidence of lameness was noted on the right thoracic limb.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.27-31
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• 2001

Purpose : The purpose of this study was to evaluate results of the arthroscopic treatment of calcific tendinitis of the shoulder resistant to conservative treatment. Materials and Methods : From March, 1996 to June, 1998, fourteen patients underwent shoulder arthroscopy to treat resistant calcific tendinitis of the rotator cuff despite conservative treatment for more than 6 months. Calcium deposits were localized to the supraspinatus tendon only in eleven patients, the supraspinatus and infraspinatus tendon in two patients, and to the supraspinatus and subscapularis tendon in one patient. Each shoulder was evaluated with UCLA shoulder rating scale and Constant-Murley score Results : The Constant-Murley pain score improved from average score 3.2 before surgery to average score 8.3 after surgery, and the UCLA functional average score improved from 4.5 preoperatively to 8.3 postoperatively. Preoperative ROM averaged $110^{\circ}$ of flexion, $45^{\circ}$ of external rotation, $90^{\circ}$ of abduction, and internal rotation with the thumb reaching to the spinous process of the third lumbar vertebra, but postoperative range of motion averages improved as follows: $170^{\circ}$ or flexion, $50^{\circ}$ of external rotation, $140^{\circ}$ abduction, and internal rotation with the spinous process of the twelveth thoracic vertebra. Overall 3 patients were rated excellentm 9 were good, 2 were fair. Conclusion : Shoulder arthroscopy is an effective treatment in patients with refractory calcific tendinitis.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.49-52
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• 2010

Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.