• Title/Summary/Keyword: bone anchor

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Arthroscopic transosseous anchorless rotator cuff repair reduces bone defects related to peri-implant cyst formation: a comparison with conventional suture anchors using propensity score matching

  • Hyeon Jang Jeong;Ji Soo Lee;Young Kyu Kim;Sung-Min Rhee;Joo Han Oh
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.276-286
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    • 2023
  • Background: The transosseous anchorless repair (ToR) technique was recently introduced to avoid suture anchor-related problems. While favorable outcomes of the ToR technique have been reported, no previous studies on peri-implant cyst formation with the ToR technique exist. Therefore, this study compared the clinical outcomes and prevalence of peri-implant cyst formation between the ToR technique and the conventional transosseous equivalent technique using suture anchors (SA). Methods: Cases with arthroscopic rotator cuff repair (ARCR) between 2016 and 2018 treated with the double-row suture bridge technique were retrospectively reviewed. Patients were divided into ToR and SA groups. To compare clinical outcomes, 19 ToR and 57 SA cases without intraoperative implant failure were selected using propensity score matching (PSM). While intraoperative implant failure rate was analyzed before PSM, retear rate, peri-implant cyst formation rate, and functional outcomes were compared after PSM. Results: The intraoperative implant failure rate (ToR, 8% vs. SA, 15.3%) and retear rate (ToR, 5.3% vs. SA, 19.3%) did not differ between the two groups (all P>0.05). However, peri-implant cysts were not observed in the ToR group, while they were observed in 16.7% of the SA group (P=0.008). Postoperative functional outcomes were not significantly different between the two groups (all P>0.05). Conclusions: The ToR technique produced comparable clinical outcomes to conventional techniques. Considering the prospect of potential additional surgeries, the absence of peri-implant cyst formation might be an advantage of ToR. Furthermore, ToR might reduce the medical costs related to suture anchors and, thereby, could be a useful option for ARCR. Level of evidence: III.

Optimization of orthodontic microimplant thread design (교정용 마이크로 임플란트의 나사산 디자인 최적화)

  • Kim, Kwang-Duk;Yu, Won-Jae;Park, Hyo-Sang;Kyung, Hee-Moon;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.41 no.1
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    • pp.25-35
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    • 2011
  • Objective: The purpose of this study was to optimize the thread pattern of orthodontic microimplants. Methods: In search of an optimal thread for orthodontic microimplants, an objective function stability quotient (SQ) was built and solved which will help increase the stability and torsional strength of microimplants while reducing the bone damage during insertion. Selecting the AbsoAnchor SH1312-7 microimplant (Dentos Inc., Daegu, Korea) as a control, and using the thread height (h) and pitch (p) as design parameters, new thread designs with optimal combination of hand p combination were developed. Design soundness of the new threads were examined through insertion strain analyses using 3D finite element simulation, torque test, and clinical test. Results: Solving the function SQ, four new models with optimized thread designs were developed (h200p6, h225p7, h250p8, and h275p8). Finite element analysis has shown that these new designs may cause less bone damage during insertion. The torsional strength of two models h200p6 and h225p7 were significantly higher than the control. On the other hand, clinical test of models h200p6 and h250p8 had similar success rates when compared to the control. Conclusion: Overall, the new thread designs exhibited better performance than the control which indicated that the optimization methodology may be a useful tool when designing orthodontic microimplant threads.

Effects of the Angulation of Orthodontic Mini-Implant as an Indirect Anchorage : A Three-Dimensional Finite Element Analysis (교정용 미니임플란트의 식립각도에 따른 간접골성 고정원의 효과에 대한 유한요소 해석)

  • Kim, Min-Ji;Park, Yong-Jin;Park, Sun-Hyung;Chun, Youn-Sic
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.3
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    • pp.293-304
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    • 2011
  • The purpose of this study was to investigate the displacement and pattern of stress distribution on periodontal ligaments of maxillary first and second molar, and on orthodontic mini-implant (OMI) surface, according to three different insertion angles to the bone surface of OMI using Dragon helix appliance, which is a newly introduced scissors-bite correcting appliance. OMI were placed between second premolar and first molar with three different insertion angles (45, 60, 90 degrees). Displacement and maximum stress distribution area (MSDA) were analyzed by finite element analysis. When the insertion angle to the alveolar bone surface was 90 degrees, maxillary first and second molar both exhibited MSDA at the palatal root apex. Maxillary first molar did not show any significant displacement, while the second molar exhibited intrusive and palatal displacement. On the OMI, as the insertion angle decreased, the MSDA shifted towards the tip, and the amount of displacement had increased. When the OMI was inserted at a 90 degree angle, anchor loss was minimized and scissors-bite correcting effect was maximized.

Arthroscopic Repair of Full Thickness Tear of The Supraspinatus; Evaluation of the Clinical Outcome and the Postoperative Rotator Cuff Integrity (견관절 극상건 전층 파열의 관절경적 복원술; 임상적 결과 및 술후 회전근개 상태의 평가)

  • Noh, Kyu-Cheol;Chung, Kook-Jin;Kim, Sung-Woo;Yoo, Jung-Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.50-57
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    • 2006
  • Purpose: The purpose of this study was to evaluate the tendon healing of arthroscopic repair in full-thickness supraspinatus tears. We evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement. Materials and Methods: Thirty consecutive full-thickness supraspinatus tears were repaired arthroscopically in 19 patients with a one row of anchor and 11 patients with two rows of anchors. Patients ranged in age from 51 to 79 years (average 63 years). Average follow-up was 16 month (range, 12 to 28 months). To evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement, we calculate the Constant, ASES, UCLA scores. The 30 patients had either an MR Arthrogram (25 cases) or an MRI (5 cases), performed between 5 months and 20 months (mean 10 months) after surgery. Results: The cuff was healed in 21/30 cases (70%) and partially torn in 3 cases (10%) after the arthroscopic repair of full-thickness supraspinatus tear. Although the supraspinatus tendon was totally torn to the tuberosity in 6 cases(20%) after the arthroscopic repair, the size of the tear was smaller than the initial in 5 cases. The Constant score improved from an average of $55.7{\pm}7.1$ points preoperatively to $77.7{\pm}9.7$ points at the last follow-up (p<0.001), and the average ASES score improved from $39.2{\pm}7.4\;to\;72.4{\pm}12.6$ (p<0.001), and the average UCLA score improved from $17.9{\pm}2.2\;to\;26.8{\pm}5.0$ (p<0.001). Strength of elevation was significantly better $(7.1kgs{\pm}2.4)$ in the shoulders with a healed tendon that in those with an total or partial re-tear tendon $(4.5kgs{\pm}1.0)$ (p<0.05). Factors adversely affecting tendon healing were increasing age, Only 41.7% of the repairs completely healed in patients over 65 years (p<0.05). Conclusion: Arthroscopic repair of isolated full-thickness tear of the supraspinatus leads to completely healing in 70% of the cases. Total or partial re-tear of the repaired rotator cuff is associated with a decreased strength. Older patients had significantly lower healing rates.

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An experimental study on the dynamic tooth movement of two molar uprighting springs by calorific machine (두 종류의 구치직립 스프링 사용시 저항원 및 근심경사치의 동적인 치아이동 양상에 관한 연구)

  • Chun, Youn-Sic;Row, Joon
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.273-285
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    • 2000
  • The aim of this investigation was to evaluate the differences of two canti-leyer springs by using a new simulation system. This was done using a Calorific machine that compared iron uprighting spring and root uprighting spring. The Calorific machine was designed to allow observation of the whole process of tooth moving, and is composed of three parts(a temperature regulating system, electro-thermodynamic teeth, and an artificial alveolar bone component). The experiment of both mechanics were repeated five times and measured two times. The intra-examiner agreement and inlet-examiner agreement were $96.54\%\;and\;95.73\%$ and these data were statistically tested by paired t-test. The obtained results were as follows. 1. Distal and buccal movement of the anchor teeth were observed greater in the root uprighting spring than the crown uprighting spring. 2. Crown uprighting spring showed distal movement of the crown of lower second molar for 3.29mm but root uprighting spring showed only 1.68mm. 3. Crown uprighting spring exhibited forward movement of mesial and distal root of the lower second molar for 3.91mm, 3.60mm but the root uprighting spring showed 6.76mm, 6.26mm.

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Arthroscopic Rotator Cuff Repair: Serial comparison of outcomes between full-thickness rotator cuff tear and partial-thickness rotator cuff tear

  • Park, Jin-Young;Chung, Kyung-Tae;Yoo, Moon-Jib
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.72-79
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    • 2003
  • Purpose: To compare the results of arthroscopic rotator cuff repair and subacromial decompression in partial thickness rotator cuff tear (PTRCT) with those in full thickness rotator cuff tear (FTRCT). Subjects and method: Of the 46 patients who were rested of the rotator cuff tear based on the operational findings, 42 patients who were able to receive a serial follow-up for 2 years were selected as the study subjects. The average age of the patients at the time of the operation was 55 years, and the mean duration of the follow-up was 34 months. The subjects included 22 cases of PTRCT and 20 cases of FTRCT. In terms of rotator cuff repair, the average number of tendon to tendon repair (TTR) was 1 in both PTRCT and FTRCT, and that of tendon to bone repair (TBR) was 1 and 3 in PTRCT and FTRCT, respectively. The average number of use of suture anchor was 1 and 2 in PTRCT and FTRCT, respectively. The level of shoulder pain and function of the subjects were measured using shoulder functional evaluation score of American shoulder and elbow society (ASES score) at before and 2 years following the operation. Results: At the final follow-up following the operation, PTRCT group showed changes in scores from 7.2 to 0.9 on average pain score and 34 to 91 on ASES score, whereas FTRCT group showed changes in scores from 7.6 to 1.2 on pain score and 29 to 88 on ASES score. There were no significant differences between the two groups (P > 0.05). The average range of motion of shoulder significantly increased in both groups at the final follow-up in comparison with the pre-operative time point. The evaluation at the final follow-up showed that 93% of the total subjects showed good or excellent results, and 95% showed satisfactory results from the procedure with regard to pain reduction and functional outcomes. Two cases of the 3 fair results were caused by acromioclavicular arthritis. Conclusion: It may be anticipated that arthroscopic rotator cuff repair and subacromial decompression may bring satisfactory post-operative outcomes in both PTRCT and FTRCT on pain relief and functional recovery. However, careful preoperative examination of the acromioclavicular joint is critical to avoid failures of these procedures.

Functional Evaluation after Modified Brostrom Procedure with Suture Bridge Technique for Chronic Ankle Instability in Athletes (운동선수의 만성 발목관절 불안정성에서 교량형 봉합술을 이용한 변형 Brostrom 술식 후의 기능평가)

  • Park, Ji-Kang;Park, Kyoung-Jin;Cho, Byung-Ki;Im, Chae-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.3
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    • pp.108-114
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    • 2014
  • Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.