• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.102-106
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• 2014

Background: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients. Methods: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days. Results: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment. Conclusions: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.173-177
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• 2006

Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint. Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 90 cases and evaluated the results with the functional grading system of Rows and Zarins after patients were followed up for more than 24 months. Results: Combined pathologies identified under arthroscopy were Hill-sachs lesion in 46 cases, SLAP lesion in 12 cases, Rotate cuff lesion in 7 cases. The results were excellent or good in 82(91.1%) cases and redislocation was happened only 3 cases. Conclusion: We concluded that arthroscopic Bankart repair with suture anchors is one of the reliable and effective method for recurrent shoulder dislocation with Bankart lesion.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.747-756
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• 2020

Objective : To evaluate the effectiveness and long-term outcome predictors of percutaneous sacroplasty (PSP). Methods : This single-center study assessed 40 patients with sacral insufficiency fractures using the short-axis technique under C-arm flat-panel detector computed tomography (CT). Two radiologists reviewed the patients' magnetic resonance and CT images to obtain imaging findings before PSP and determine technical success, respectively. The short-term outcomes were visual analog scale score changes and opioid usage reductions. Long-term outcomes were determined using telephone interviews and the North American Spine Society (NASS) patient-satisfaction index at least one year after PSP. Results : Technical success was achieved without any significant complications in 39 patients (97.5%). Telephone interviews were possible with 12 patients and failed in 10 patients; death was confirmed in 18 patients. Fifteen patients (50%) re-visited the hospital and received conservative treatment, including spinal injections. Nine patients reported positive satisfaction (NASS patient-satisfaction index 1 or 2), while the negative satisfaction group (NASS patient-satisfaction index 3 or 4, n=3) showed a higher incidence of compression fractures at the thoracolumbar spine level (66.7% vs. 22.2%) and previous spinal injection history (66.7% vs. 33.3%). The poor response group also showed higher incidences of facet joint arthrosis (100% vs. 55.6%), central canal stenosis (100% vs. 22.2%), neural foraminal stenosis (33.3% vs. 22.2%), scoliosis (100% vs. 33.3%), and sagittal malalignment (100% vs. 44.4%). Conclusion : PSP was effective for sacral insufficiency fractures and showed good long-term outcomes. Combined compression fractures in the thoracolumbar spine and degenerative lumbar pathologies could be possible poor outcome predictors.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.149-153
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• 2002

Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint .Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 54cases and evaluated the results with the functional grading system of Rowe and Zarins after patients were followed up for more than 12 months. Results: Combined pathologies identified under arthroscopy were Hill-Sachs lesion in 28 cases, SLAP lesion in 6 cases and chondromalacia of humeral head in 6 cases. The results were excellent or good in 50 cases(92.6$\%$), and redislocation was happened only two cases. Conclusion: We conclude that arthroscopic Bankart repair with suture anchors is one of the reliableand effective method for treatment of recurrent shoulder dislocation with Bankart lesion.

• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.1-9
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• 2018

Objectives Disuse muscle atrophy occurs in response to pathologies such as joint immobilization, inactivity or bed rest. Muscle disuse is accompanied by an increase in apoptotic signaling, which mediates some of the responses to unloading in the muscle. GB34 (Yanglingquan) is a acupuncture point on the lower leg and one of the most frequently used points in various skeletomuscular diseases. In this study, the hypothesis that the acupuncture at GB34 could attenuate immobilization-induced skeletal muscle atrophy was tested. Methods The left hindlimb immobilization was performed with casting tape in both GB34 group (n=10) and Control group (n=10). The rats in GB34 group were daily treated with acupuncture at GB34. After 2 weeks of immobilization, the morphology of right and left gastrocnemius muscles in both GB34 and Control groups were assessed by hematoxylin and eosin staining. To investigate the immobilization-induced muscular apoptosis, the immunohistochemical analysis of Bax and Bcl-2 was carried out. Results GB34 group represented the significant protective effects against the reductions of the left gastrocnemius muscles weight and average cross section area to compared with Control group. The acupuncture at GB34 significantly reduced the immunoreactivity of BAX and increased the immunoreactivity of Bcl-2 in gastrocnemius muscle compared with Control group. Conclusions These results suggest that the acupuncture at GB34 has protective effects against immobilization-induced muscle atrophy by regulating the activities of apoptosis-associated BAX/Bcl-2 proteins in gastrocnemius muscle.

• Clinics in Shoulder and Elbow
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• v.25 no.2
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• pp.101-105
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• 2022

Background: Rotator cuff tears cause pathologies of the long head of the biceps tendon (LHBT). One of the surgical treatments for such a tear is LHBT tenodesis to the humerus. This study aims to compare simultaneous rotator cuff repair and LHBT tenodesis with or without detachment of the proximal end of the LHBT (PELHBT) from its site of adhesion to the glenoid. Methods: This retrospective study involved patients affected by LHBT pathology with rotator cuff tear. The patients were divided into two groups, with or without PELHBT detachment from the glenoid. Therapeutic outcomes were investigated by evaluation of patient satisfaction, pain based on visual analog scale, shoulder function based on Constant score and simple shoulder test, and biceps muscle strength based on the manual muscle testing grading system before surgery, at 6 months, and at the final visit after surgery. Results: Groups 1 and 2 comprised 23 and 26 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). Shoulder function, biceps muscle strength, pain, and satisfaction rate improved over time (p<0.05) but were not significantly different between the two groups (p>0.05). No post-surgical complication was found in either group. Conclusions: There was no difference in final outcomes of tenodesis with or without detachment of the PELHBT from the supraglenoid tubercle. Such tendon detachment is not necessary.

• Journal of Korean Foot and Ankle Society
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• v.28 no.2
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• pp.60-67
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• 2024

Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.46-52
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• 2009

Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.237-247
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• 2020

Objective : Fixation of the C1-2 segment is challenging because of the complex anatomy in the region and the need for a high degree of accuracy to avoid complications. Preoperative 3D-computed tomography (CT) scans can help reduce the risk of complications in the vertebral artery, spinal cord, and nerve roots. However, the patient may be susceptible to injury if the patient's anatomy does not match the preoperative CT scans. The intraoperative 3D image-based navigation systems have reduced complications in instrument-assisted techniques due to greater accuracy. This study aimed to compare the radiologic outcomes of C1-2 fusion surgery between intraoperative CT image-guided operation and fluoroscopy-guided operation. Methods : We retrospectively reviewed the radiologic images of 34 patients who underwent C1-2 fusion spine surgery from January 2009 to November 2018 at our hospital. We assessed 17 cases each of degenerative cervical disease and trauma in a study population of 18 males and 16 females. The mean age was 54.8 years. A total of 139 screws were used and the surgical procedures included 68 screws in the C1 lateral mass, 58 screws in C2 pedicle, nine screws in C2 lamina and C2 pars screws, four lateral mass screws in sub-axial level. Of the 34 patients, 19 patients underwent screw insertion using intraoperative mobile CT. Other patients underwent atlantoaxial fusion with a standard fluoroscopy-guided device. Results : A total of 139 screws were correctly positioned. We analyzed the positions of 135 screws except for the four screws that performed the lateral mass screws in C3 vertebra. Minor screw penetration was observed in seven cases (5.2%), and major pedicle screw penetration was observed in three cases (2.2%). In one case, the malposition of a C2 pedicle screw was confirmed, which was subsequently corrected. There were no complications regarding vertebral artery injury or onset of new neurologic deficits. The screw malposition rate was lower (5.3%) in patients who underwent intraoperative CT-based navigation than that for fluoroscopy-guided cases (10.2%). And we confirmed that the operation time can be significantly reduced by surgery using intraoperative O-arm device. Conclusion : Spinal navigation using intraoperative cone-beam CT scans is reliable for posterior fixation in unstable C1-2 pathologies and can be reduced the operative time.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.128-134
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• 2008

Purpose: We prospectively evaluated the clinical usefulness of the patellar inferior pole (PIP) as a landmark of the anteromedial (AM) portal for the arthroscopic surgery of the medial mensiscus posterior horn (MMPH). Materials and Methods: Group 1 (50 normal left knees of adults), Group 2 (10 normal knees under anesthesia), and Group 3 (50 consecutive knees undergoing elective arthroscopic surgery for relatively simple intraarticular pathologies, or diagnostic arthroscopy) were included. In Group 1 and 2, the true lateral (A) and valgus stress lateral radiographs (B) on $30^{\circ}$ flexion were obtained, and the lines (AM portal line) passing through the PIP and distal-most medial femoral condyle (MFC) were drawn under the condition without considering the thickness of articular cartilage of MFC (1, 2-A, B group), and considering it as 2.5mm on B (1, 2-C group). Then, we investigated the meeting point of the AM portal line with medial tibial plateau (C-D percentage), and measured the distance between the PIP and the anterior joint line (E-length), and medial tibial-femoral joint space (F-length). In Group 3, the AM portal was made at the PIP level and clinical usefulness of the approach to the MMPH and body of the lateral meniscus (LM) was analyzed. Results: The average C-D percentage came out as 85.8, 101.3, 69.1% for each Group 1-A, B, C, and 102.4, 144.6, 116.8% for each Group 2-A, B, C. Measured E-length was an average of 15.1 (Group 1-A), 15.5 (Group 1-B, C), 13.1 (Group 2-A), and 12.9 mm (Group 2-B, C) and the change by valgus stress had no statistical significance. The F-length increased about 1.2 (Group 1) and 3.6 mm (Group 2) when valgus stress was applied, which had statistical significance (p<0.001, p<0.001). In Group 3, 49, 48 knees were classified as good for the MMPH, and the body of LM in aspect of the clinical usefulness of AM portal made on the PIP level. Conclusion: We identified the clinical usefulness of the PIP as a skin landmark of AM portal for the arthroscopic surgery of the MMPH.