• Title/Summary/Keyword: bone anchor

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New Retear Pattern after Rotator Cuff Repair at Previous Intact Portion of Rotator Cuff

  • Choi, Chang-Hyuck;Kim, Sung-Guk;Nam, Jun-Ho
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.237-240
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    • 2016
  • Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.

Arthroscopic Double-pulley Suture-bridge Technique for Rotator Cuff Repair

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong;Yang, Jae-Hoon;Kim, Dong-Kyu;Yeon, Kyu-Woong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.162-162
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    • 2009
  • After preparation of the bone bed, two doubly loaded suture anchors with suture eyelets are inserted at the articular margin of the greater tuberosity. A retrograde suture-passing instrument penetrates the rotator cuff to retrieve the sutures through the modiWed Neviaser or subclavian portal. An ipsilateral pair of suture eyelets in the suture anchor is passed through the margins of the rotator cuff tear. The blue suture of the second and third pair is pulled out of the lateral cannula, and the threaded blue suture of the third pair in the needle is passed through the blue suture of the second pair. After retrieving the blue suture of the firrst pair through the anterior portal, it is pulled out to pass the blue suture of the third pair through the eyelet of the anteromedial anchor. The blue suture is linked between two anchors. The medial row of suture bridge is repaired with a sliding knot, and the sutures are not cut. Once the rotator cuff repair using the suture-bridge technique has been performed, the two blue strands in the anterior portal are tied. We describe our technique that possesses the advantages of both the double-pulley and suturebridge techniques, which improves the pressurized contact area and maximizes compression along the medial row.

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A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.574-578
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    • 2019
  • For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

The effect of early loading on the direct bone-to-implant surface contact of the orthodontic osseointegrated titanium implant (교정력이 골유착성 티타니움 임프란트의 초기 고정에 미치는 영향에 관한 실험적 연구)

  • Chung, Kyu-Rhim;Lee, Sung-Ja
    • The korean journal of orthodontics
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    • v.31 no.2 s.85
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    • pp.173-185
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    • 2001
  • The orthodontic osseointegrated titanium implant, a kind of intraoral skeletal anchorage can be an alternative to tooth-borne anchorage, in case that the conventional tooth-borne anchorage is not available or the anchorage is critical. This study was conducted to elucidate the effect of early loading on the osseointegration of the orthodontic titanium implant and the healing process of the impaired bone at the site of implant after removing it. In two adult beagle dogs24 osseointegrated titanium implants were inserted into the alveolar bone, with 12 implants placed in each dog. In dog1, 6 out of 12 implants were loaded with 200-300gm of force immediately after placing, and the remaining 6 implants were not loaded for 4weeks. In dog2, all 12 implants had healing period of 4weeks, and then were loaded with 200-300gm of force for another 4weeks. Following an observation period of 4 and 8 weeks, the animals were sacrificed. Then the implants and the surrounding bone of dog1 and dog2 were removed, respectively. Undecalcified sections along the long axis of implant were made and the degree of osseointegration was examined under the light microscope. The results were as follows. 1. In the histologic features of tissues around implants anchored in dog1, there was no difference between immediately loaded implants and unloaded implants. Immature woven bone was ingrowing into the thread spaces from the original compacta and in direct contact with the implant surface in part. 2. The premature loading just after 4weeks healing period did not halt the progress of the osseointegration between bone and implant surface. The woven bone around the implants was maturing into the lamellar bone which resembled the structure of the original compacta at the end of 8weeks observation period. 3. Most implants with the inflammed surrounding mucosa were lost or mobile. The mobile implants were encapsulated by fibrous connective tissue which separated the implant surface from the bone. 4. The impaired bone at the site of the implant failed to anchor was showing recovery without inflammatory reaction 2weeks after removing, with the immaure woven bone lined by active osteoblasts and osteoid. Based on the results of this study, the integration of this orthodontic implant seemed to be impaired by the inflammation of the tissue surrounding the Implant rather than by early loading on implant, and increased with time lapsed after placing the implant. The use of implant described in this report can be recommended as an orthodontic anchorage unit immediately after insertion under the careful control of orthodontic force applied and plaque.

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ShakingTest of Waterfront Structure for Liquefaction Counter measure (항만구조물의 액상화 대책을 위한 진동대 실험에 대한 연구)

  • 박종관
    • Geotechnical Engineering
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    • v.8 no.3
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    • pp.37-50
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    • 1992
  • Liquefaction leads to severe damage to earth structures after an earthquake. In this study, shaking table tests were performed on model waterfront structures as a countermeasure against liquefaction. The waterfront structure was reinforced by a compacted Bone, which was investigated for its effectiveness in protecting the structure from excessive deformation induced by the lateral pressure of liquefied ground. Through the tests . on embankment, double sheet pile wall, and anchor sheet pile wall, good quantitative information on the behavior of flow failure and the extent of reinforcement was obtained. The extent of a compacted zone for the protection of the structure depends on the magnitude of the acceleration during the shaking. The measured deformation was represented in terms of the extent of the compacted zone and the magnitude of the input acceleration.

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Hook Plate Fixation for Isolated Greater Tuberosity Fractures of the Humerus

  • Lee, Kyoung-Rak;Bae, Ki-Cheor;Yon, Chang-Jin;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.222-229
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    • 2017
  • Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

Calcific Tendinitis of Shoulder Associated with Intraosseous Involvement -A Case Report- (골내 침범을 동반한 견관절 석회화 건염 - 증례 보고 -)

  • Ku, Jung-Hoei;Cho, Hyung-Lae;Park, Man-Jun;Kim, Jeong-Cheol
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.242-247
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    • 2011
  • Purpose: We present an atypical case of calcific tendinitis of the shoulder with intraosseous loculation. Materials and Methods: A 59 year-old female complained of acute exacerbation of chronic left shoulder pain and restricted range of motion. Simple radiographs showed a subacromial calcific deposit and magnetic resonance imaging revealed cortical erosion with intraosseous extension of calcific material mimicking infection or tumor. She was managed with arthroscopic excision of the calcific deposit, curettage of the intraosseous lesion and subsequent rotator cuff repair with a suture anchor. Results: Her acute pain promptly subsided. Her rehabilitation was uneventful and she gained full range of motion. Radiographs five months after the operation showed no recurrence of calcific material. Conclusion: Calcific tendinitis of the shoulder can present with a variety of images involving the adjacent bone. The correct recognition of this disorder may avoid unnecessary investigation and treatment.

Spatial changes of the upper dentition following en-masse space closure: A comparison between first and second premolar extraction (En-masse 견인에 의한 발치공간 폐쇄 후 상악치열의 이동양상 -제1소구치 및 제2소구치 발치 비교)

  • Kim, Hui-Jung;Chun, Youn-Sic;Jung, Sang-Hyuk
    • The korean journal of orthodontics
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    • v.35 no.5 s.112
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    • pp.371-380
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    • 2005
  • The purpose of this experimental study was to evaluate aㅜd compare maxillary arch dimensional and positional changes between first and second premolar extraction groups. The Calorific Machine was used to illustrate tooth movement in three dimensions. The experimental teeth except the first or second premolars were embedded in artifical alveolar bone. The extraction space was closed using arch wires with bull loops into which 15 degree gable bends were placed. Before and after space closure, radiographs were taken in the sagittal and occlusal directions using occlusal films. The results showed greater mean maxillary incisor retraction and less anchorage loss in the maxillary first premolar extraction group than in the maxillary second premolar extraction group. Mesiopalatal rotation of anchor teeth was greater after extraction of a maxillary second premolar than a maxillary first premolar (P<.001).

Implant-assisted removable partial denture for severely atrophied mandible (심한 하악 치조제 흡수를 가진 환자에서 임플란트를 이용한 가철성 국소의치로 수복한 증례)

  • Choi, Bada;Kim, Yeun Ju;Lee, Jae Hoon
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.2
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    • pp.171-175
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    • 2019
  • Mandible with severe alveolar bone atrophy poses a significant challenge in terms of reproducing clinically acceptable anatomy for a removable prosthesis. To overcome this potential complication, altered cast impression technique is often recommended to capture accurate and functional gingiva tissues. It becomes possible to get proper anchors functional impression by placing 2 implants crowns which were impossible in previous implant overdenture impression technique. In this case, an 80-year old female patient with severe mandibular ridge atrophy was treated with an implant-assisted removable partial denture with two implant crowns on the canine area. An altered cast impression was taken with an individual tray on a metal framework of removable partial denture on both posterior edentulous areas. The patient was satisfied with the final prosthesis after failure of 2 previous prostheses. Clinician had a difficult time to manage disabled patient and patient were suffered with ill-fitting denture due to inaccurate impression in conventional overdenture condition. The oral rehabilitation was completed with placing 2 implants as proper anchor.