• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.70-75
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• 2004

Purpose: To evaluate the results of arthroscopic repair of traumatic anterior shoulder instability with glenoid bone defect. Materials and Methods: Nineteen patients who had underwent arthroscopic repair for the shoulder with traumatic anterior instability and glenoid bone defect were retrospectively reviewed. Mean age was 24.6 years(range, 20 to 39) and mean follow-up was 23 months(range, 19 to 55). No glenoid bone defect was greater than 7mm in length and 20% of the glenoid. The results were evaluated according to stability, range of motion and function. Results: All patients obtained excellent-good results according to Rowe scoring system. Two patients(10.5%) had instability. The mean loss of external rotation was 15 degrees (range, 0 to 25). Functionally, 17 patients could participate in preinjured work or sports to the same level with or without mild discomfort. The remained 2 patients who had 25 degree loss of external rotation could not play sports. Conclusion: Though arthroscopic repair is a good treatment for traumatic anterior shoulder instability with small glenoid bone defect, it is possible to cause loss of external rotation

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.21-21
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• 2009

There are some patients who have traumatic anterior shoulder instability due to minor injuries like overhead activities. The purpose of this study was to clarify characteristic features of traumatic anterior shoulder instability due to minor injuries. According to the mechanism of injury in an initial dislocation, 83 shoulders that underwent the stabilizing surgery for traumatic anterior shoulder instability were divided into two groups. Traumatic group included patients who suffered from a fall or a direct injury. Minor injury group included patients who suffered from the other injury like overhead activity. General joint laxity, range of motion and laxity under anesthesia, and intraarticular findings were compared between two groups. The morphology of superior and middle glenohumeral ligaments, Bankart lesion, Hill-Sachs lesion, and partial articular surface tendon avulsion lesion were observed in arthroscopy. Minor injury group consisted of 19 shoulders with 8 males, 11 females and the mean age of 22.5 years. Traumatic group consisted of 64 shoulders with 52 males, 7 females and the mean age of 24.3 years. Female in minor injury group was significantly more than that in traumatic group. There was no difference in general joint laxity and intraarticular findings between two groups. Range of external rotation in injured side in minor injury group was significantly more than that in traumatic group. Inferior laxity in both sides in minor injury group was more than that in traumatic group. In conclusion, the traumatic anterior shoulder instability due to minor injuries might incline to occur the shoulder in female and with inferior laxity of shoulder.

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.76-82
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• 2004

Purpose: In the traumatic anterior shoulder instability, the laxity of joint capsule and ligament is frequently demonstrated. Although a arthroscopic procedure to address anterior instability with joint capsular redundancy have generally provided good results, its recurrence rate is higher than open procedure. By reducing the capsular redundancy, thermal shrinkage is likely to improve the outcome of arthroscopic anterior stabilization. The objective of this study was to evaluate additional thermal capsular shrinkage as a treatment of joint capsular redundancy in anterior shoulder instability. Materials and Methods: From March 1999 to June 2000, 25 shoulders of 23 patients of recurrent anterior shoulder dislocation underwent arthroscopic Bankart repair with shrinkage procedure. The mean follow up was 29 months and average age at the time of operation was 26 years. Of these patients, 20 were male and 3 were female who had been experienced the average 8 times of dislocation before operation. Thermal shrinkage alone without Bankart repair was performed in two cases who did not have Bankart lesion. The clinical result was evaluated in according to Modified Rowe Score. Results: The Modified Rowe Score was improved from preoperative 35 points to postoperative 88 points. None of cases showed recurrence of dislocation. But, in two cases, temporary sensory hypesthesia of the axillary nerve was developed and in two cases of postoperative stiffness, arthroscopic capsular release and brisement were performed. Conclusion: Additional capsular shrinkage in arthroscopic technique to address recurrent anterior shoulder instability could treat effectively the capsular redundancy.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.105-110
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• 2006

Purpose: This study reports the clinical results of the arthroscopic Bankart repair in traumatic anterior instability of the shoulder with bio-knotless anchor. Materials and Methods: 21 cases of 21 patients (20 male and 1 female) were included in this study. The average age was 24.8 years old and the period from the first injury to operation was average 37.2 months. All cases had Bankart lesion and 12 cases had Hill-Sachs' lesion. The SLAP lesion was associated in 6 cases. Preoperative Rowe score was average 29.1. Arthroscopic Bankart repair with bio-knotless anchor were performed in all cases; 3 anchors at 3, 4, 5 O'clock position of the glenoid were used in 11 cases and 2 anchors at 4, 5 O'clock position were used in 10 cases. All the associated SLAP lesions were repaired arthroscopically with bio-knotless anchor. Thermal capsular shrinkage at the anterior and inferior shoulder capsule after the Bankart repair was performed in 3 cases. The average follow up period was 20.2 months. Results: The Rowe score improved to 92.8, excellent in 17 cases and good in 4 cases, at last follow up period and 20 cases had full range of motion of the shoulder. 1 case had mild limited range of motion of the shoulder (150 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation) without any problem in normal activity. The arthroscopic revision surgery of the shoulder was performed in 1 case because of multiple traumatic injuries of the shoulder with pain postoperatively. Conclusion: Arthroscopic Bankart repair with bio-knotless anchor in traumatic anterior shoulder instability is one of the good methods because of the good clinical results.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.76-79
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• 2009

Purpose: Capsulolabral reconstruction in a traumatic anterior instability of the glenohumeral joint is successful not only for the prevention of recurrent instability but also for the restoration of function. Materials and Methods: However, a capsulolabral procedure alone cannot guarantee a successful result when there is severe bone loss of the glenoid. Results: We report the surgical technique and results of capsulolabral repair and extraarticular bone block with an autogenous iliac crest graft performed on three cases (all male, average age 28 years, minimum follow-up 12 months) with traumatic anterior instability associated with more than 30% glenoid bone loss.

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.65-69
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• 2004

Purpose: The purpose of this study is to evaluate the short-term clinical outcome of the capsulolabral repair using absorbable suture anchor in traumatic anterior instability of shoulder. Materials and Methods: From June 2000 to September 2001, 15 shoulders with recurrent anterior instability were operated with arthroscopic Bankart repair using absorbable suture-anchor 'PANALOK' (Mitek, westwood, MA), and were followed up over 1 year (average; 13 months). The mean age was 23-years. There were fourteen males and one female. The mean duration from the initial symptoms to the operation was 24 months. Associated pathologies were Hill-Sachs defect in 12 cases, SLAP in 6 cases, and partial rotator cuff tear in 2 cases. The results were evaluated by patien's satisfaction, Modified Rowe Score in regard to joint stability, mobility, pain and function in comparison with the preoperative ones, and other complications. Results: At the last follow-up, the total Rowe Score increased from 38 points to 92 points. There were no recurrence and 14 patients among 15 patients gained pre-operative level of sports activity and no other complications. Conclusion: Effective capsulolabral repair could be obtained by the absorbable anchoring without any untoward complications. This procedure is simple and safe one and this system can be a good substitute for the metallic anchor.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.36-42
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• 2007

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.03a
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• pp.17-18
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• 2002

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.17-17
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• 2007

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.169-175
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• 2018

Traumatic anterior dislocation of the shoulder is one of the most common directions of instability following a traumatic event. Although the incidence of shoulder dislocation is similar between young and elderly patients, most studies have traditionally focused on young patients due to relatively high rates of recurrent dislocations in this population. However, shoulder dislocations in older patients also require careful evaluation and treatment selection because they can lead to persistent pain and disability due to rotator cuff tears and nerve injuries. This article provides an overview of the nature and pathology of acute primary anterior shoulder dislocation, widely accepted management modalities, and differences in treatment for young and elderly patients.