• Title/Summary/Keyword: orthopedic

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Superior capsular reconstruction for irreparable rotator cuff tear: a review of current methods

  • Seok Won Chung;Dong-Hyun Kim;Hyun Joo Lee;Won Ki Hong;Seung Ho Chung;Jong Pil Yoon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.438-444
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    • 2023
  • Irreparable massive rotator cuff tears can significantly impact daily life; and these types of tears can be difficult to repair completely, especially in younger patients who are more active and have higher functional requirements. Since its introduction by Mihata and the colleagues, superior capsular reconstruction (SCR) has gained popularity in the treatment of irreparable massive rotator cuff tears and has shown promising short-term results. A variety of studies have focused on the clinical and biomechanical outcomes of this procedure. This article reviews the biomechanics, indications for the surgical procedure, graft options, surgical technique, and rehabilitation from SCR.

Normal ossification of the glenoid mimicking a glenoid fracture in an adolescent patient: a case report

  • Maria Galan-Olleros;Rosa M. Egea-Gamez;Angel Palazon-Quevedo;Sergio Martinez-Alvarez;Olga M. Suarez Traba;Marta Escribano Perez
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.306-311
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    • 2023
  • A 13-year-old male was diagnosed with a glenoid fracture following direct shoulder trauma, for which surgical treatment was considered. After referral to a center for pediatric orthopedic care, physical examination, contralateral shoulder X-ray, and detailed computed tomography examination ruled out the presence of fracture; these findings were later confirmed by magnetic resonance imaging. Normal ossification patterns in the adolescent shoulder may simulate a fracture in traumatic settings. To accurately diagnose and manage pediatric shoulder pathology, orthopedic surgeons must be aware of the normal anatomy of the growing shoulder, its secondary ossification centers, and growth plates.

The Result of Autologous Osteochondral Grafting for the Osteochondral Lesion of the Talus (거골의 골연골 병변에 대한 자가 골연골 이식술의 결과)

  • Ahn, Young-Joon;Hahn, Sung-Ho;Yang, Bo-Kyu;Yi, Seung-Rim;Yoo, Jae-Ho;Chung, Shun-Wook;Bin, Sung-Woo;Zoo, Min-Hong;Kim, Seong-Wan
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.48-55
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    • 2006
  • Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. Materials and Methods: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. Results: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. Conclusion: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.

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Limited Posterior Approach for the Surgical Treatment of Intraarticular Fracture of Calcaneus (제한적 후방 도달법을 이용한 관절내 종골 골절의 치료)

  • Hyun, Yun-Seok;Song, Kyung-Won;Shin, Sung-Il;Lee, Jin-Young;Lee, Seung-Young;Kim, Gab-Lae;Shin, Kun-Ho;Seo, Eun-Ho;Ban, Tae-Seo
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.79-85
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    • 2007
  • Purpose: To evaluate the clinical efficacy of the limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2000 to February 2006, we studied retrospectively 186 patients, 203 cases who were treated with open reduction and internal fixation through limited posterior approach and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared $B{\ddot{o}}hler$ angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 2 was 86.4, type 3 was 74.3, type 4 was 62.4. And by circle draw test, type 2 was 8.9 cm, type 3 was 7.2 cm, type 4 was 5.9 cm. $B{\ddot{o}}hler$ angle and Gissane angle were $7.6^{\circ}$, $102.4^{\circ}$, and it increased to $23.5^{\circ}$, $128.6^{\circ}$ after postoperative 1 year. Conclusion: Limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus was considered to an effective treatment modality.

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Survey on The Current Status of Orthopedic Manual Physical Therapy in South Korea (한국의 정형도수물리치료 실태조사)

  • Hwang, Seong-soo;Kim, Myung-joon;Jeon, Beom-su
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.1
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    • pp.41-49
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    • 2021
  • Background: The purpose of this survey was to know the current states and future suggestions of orthopedic manual physical therapy (OMPT) system on Korea. Methods: Questionnaires were directly distributed to physical therapists who participated in the training and collected at the educational or clinical site. The questionnaire was sent and collected by E-mail. Data were classified into two groups, metropolitan and city, and clinical experience was grouped into four groups. Then, 337 subjects (male: 195, female: 142) were recruited from us. Results: The states of Korea, 72.1% of therapists have been executed orthopedic manual physical therapy, the fee of one treatment was 50,000 ~ 60,000 Korean won, the time of treatment was 21~30 minutes, the number of patients of one day was under 9. The suggestion of future orthopedic manual physical therapy of Korea, 83.4% of therapist were agreed with manual physical therapy system, the education center of certificate for manual therapist was manual therapy academic group, the career of clinical experiences was 3 years, the training hours was more 300 hours, academic degree was diploma. Conclusion: In the future orthopedic manual physical therapy proposal, the environment and education system differ from country to country, but Korean OMPT agreed to an accredited orthopedic manual physical therapy system and wanted systematic management.

YouTube videos provide low-quality educational content about rotator cuff disease

  • Kunze, Kyle N.;Alter, Kevin H.;Cohn, Matthew R.;Vadhera, Amar S.;Verma, Nikhil N.;Yanke, Adam B.;Chahla, Jorge
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.217-223
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    • 2022
  • Background: YouTube has become a popular source of healthcare information in orthopedic surgery. Although quality-based studies of YouTube content have been performed for information concerning many orthopedic pathologies, the quality and accuracy of information on the rotator cuff have yet to be evaluated. The purpose of the current study was to evaluate the reliability and educational content of YouTube videos concerning the rotator cuff. Methods: YouTube was queried for the term "rotator cuff." The first 50 videos from this search were evaluated. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (range, 0-5). Educational content was assessed using the global quality score (GQS; range, 0-4) and the rotator cuff-specific score (RCSS; range, 0-22). Results: The mean number of views was 317,500.7±538,585.3. The mean JAMA, GQS, and RCSS scores were 2.7±2.0, 3.7±1.0, and 5.6±3.6, respectively. Non-surgical intervention content was independently associated with a lower GQS (β=-2.19, p=0.019). Disease-specific video content (β=4.01, p=0.045) was the only independent predictor of RCSS. Conclusions: The overall quality and educational content of YouTube videos concerned with the rotator cuff were low. Physicians should caution patients in using such videos as resources for decision-making and should counsel them appropriately.

Neurotropin protects rotator cuff tendon cells from lidocaine-induced cell death

  • Abe, Ryunosuke;Ohzono, Hiroki;Gotoh, Masafumi;Nakamura, Yosuke;Honda, Hirokazu;Nakamura, Hidehiro;Kume, Shinichiro;Okawa, Takahiro;Shiba, Naoto
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.224-230
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    • 2021
  • Background: Local anesthetics often are used in rotator cuff tears as therapeutic tools, although some cases have reported that they have detrimental effects. Neurotropin (NTP) is used widely in Japan as a treatment for various chronic pain conditions and is shown to have protective effects on cartilage and nerve cells. In this study, we investigated the protective effect of NTP against lidocaine-induced cytotoxicity. Methods: Tenocytes from rotator cuff tendons were incubated with lidocaine, NTP, lidocaine with NTP, and a control medium. Cell viability was evaluated using the WST-8 assay. Cell apoptosis was detected via annexin V staining using flow cytometry. The expression of BCL-2 and cytochrome c, which are involved in the intrinsic mitochondrial pathway of apoptosis, was evaluated via Western blotting and immunohistochemical staining. Results: In the cell viability assay, lidocaine decreased cell viability in a dose-dependent manner, and NTP did not affect cell viability. Moreover, NTP significantly inhibited the cytotoxic effect of lidocaine. The flow cytometry analysis showed that lidocaine significantly induced apoptosis in tenocytes, and NTP considerably inhibited this lidocaine-induced apoptosis. Western blotting experiments showed that lidocaine decreased the protein expression of BCL-2, and that NTP conserved the expression of BCL-2, even when used with lidocaine. Immunohistochemical staining for cytochrome c showed that 0.1% lidocaine increased cytochrome c-positive cells, and NTP suppressed lidocaine-induced cytochrome c expression. Conclusions: NTP suppresses lidocaine-induced apoptosis of tenocytes by inhibiting the mitochondrial apoptotic pathway. Intra-articular/bursal injection of NTP with lidocaine could protect tenocytes in rotator cuff tendons against lidocaine-induced apoptosis.