• PNF and Movement
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• 제21권1호
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• pp.75-86
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• 2023

Purpose: This study aims to determine the effect of proprioceptive neuromuscular facilitation (PNF) pectoralis minor stretching and lower trapezius strengthening exercise on posture change, shoulder range of motion (ROM), and pain in rotator cuff repair patients with a rounded shoulder posture (RSP). Methods: Following baseline measurements, the subjects (n = 25) with rotator cuff repair were randomized into two groups: the PNF group (n = 13), which engaged in PNF pectoralis minor stretching and lower trapezius strengthening exercise, and the control group (n = 12), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The RSP values for the postural changes, flexion and abduction ROM, and visual analogue scales (VASs) of both groups were recorded at both pre- and post-intervention. In addition, before and after the intervention, a paired t-test was conducted to compare the within-group changes and an independent t-test to compare the between-group differences. Results: After the two-week intervention, both groups experienced significantly decreased RSP and VAS values (p < 0.05) and a significantly increased ROM (p < 0.05). Meanwhile, the PNF group showed greater improvements in RSP, ROM, and VAS than the control group (p < 0.05). Conclusion: These results suggest that PNF pectoralis minor stretching and lower trapezius strengthening exercise reduce posture and shoulder pain and enhance ROM in rotator cuff repair patients with RSP.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.147-155
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• 2021

Background: This study aimed to evaluate the co-administration effect of atelocollagen combined with hyaluronic acid (HA) injections for treatment of full-thickness rotator cuff tear (RCT). Methods: Eighty patients who underwent arthroscopic rotator cuff repair for full-thickness RCT from March 2018 to November 2019 were enrolled. The patients were randomly allocated to the following groups: combined atelocollagen and HA injection (group I, n=28), only HA injection (group II, n=26), and no injection (group III, n=26). Clinical outcomes were assessed at 3, 6, and 12 months after surgery using the American Shoulder and Elbow Surgeons score, visual analog scale pain score, functional scores (pain visual analog scale, function visual analog score), and range of motion. Magnetic resonance imaging was performed 12 months after surgery to evaluate rotator cuff integrity. Results: Preoperative demographic data and postoperative clinical outcomes did not differ significantly among the three groups (p>0.05). However, in group I, the number of steroid injections after surgery was significantly lower than that in the other groups (p=0.011). The retear rate on follow-up magnetic resonance imaging was significantly higher in group II (9.5%, n=2) and group III (13.6%, n=3) than in group I (0%) (p=0.021). Conclusions: Co-administration of atelocollagen and HA improves healing of the rotator cuff and increases the integrity of the rotator cuff repair site. This study provides encouraging evidence for use of combined atelocollagen-HA injections to treat patients with full-thickness RCT.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.296-303
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• 2022

Background: A previous study reported that hyperlipidemia increases the incidence of tears in the rotator cuff tendon and affects healing after repair. The aim of our study was to compare the gene and protein expression of torn rotator cuff tendons in patients both with and without hypercholesterolemia. Methods: Thirty patients who provided rotator cuff tendon samples were classified into either a non-hypercholesterolemia group (n=19, serum total cholesterol [TC] <200 mg/dL) and hypercholesterolemia group (n=11, serum TC ≥240 mg/dL) based on their concentrations of serum TC. The expression of various genes of interest, including COL1A1, IGF1, IL-6, MMP2, MMP3, MMP9, MMP13, TNMD, and TP53, was analyzed by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). In addition, Western blot analysis was performed on the proteins encoded by interleukin (IL)-6 and TP53 that showed significantly different expression levels in real-time qRT-PCR. Results: Except for IGF1, the gene expression levels of IL-6, MMP2, MMP9, and TP53 were significantly higher in the hypercholesterolemic group than in the non-hypercholesterolemia group. Western blot analysis confirmed significantly higher protein levels of IL-6 and TP53 in the hypercholesterolemic group (p<0.05). Conclusions: We observed an increase in inflammatory cytokine and matrix metalloproteinase (MMP) levels in hypercholesterolemic patients with rotator cuff tears. Increased levels of IL-6 and TP53 were observed at both the mRNA and protein levels. We suggest that the overexpression of IL-6 and TP53 may be a specific feature in rotator cuff disease patients with hypercholesterolemia.

• Clinics in Shoulder and Elbow
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• 제17권4호
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• pp.209-217
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• 2014

Most studies on the pathophysiology, natural history, diagnosis by imaging and outcomes after operative or nonoperative treatment of rotator cuff tear have focused on those of full-thickness tears, resulting in limited knowledge of partial-thickness rotator cuff tears. However, a partial-thickness tear of the rotator cuff is a common disorder and can be the cause of persistent pain and dysfunction of the shoulder joint in the affected patients. Recent updates in the literatures shows that the partial-thickness tears are not merely mild form of full-thickness tears. Over the last decades, an improved knowledge of pathophysiology and surgical techniques of partial-thickness tears has led to more understanding of the significance of this tear and better outcomes. In this review, we discuss the current concept of management for partial-thickness tears in terms of the pathogenesis, natural history, nonoperative treatment, and surgical outcomes associated with the commonly used repair techniques.

• 대한정형외과 초음파학회지
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• 제2권2호
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• pp.107-112
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• 2009

회전근 개 질환에 대한 초음파 검사는 비침습적이며 동적인 검사이며, 최근의 발달을 통해 MRI에 비견할 만한 결과를 보여주고 있다. 또한 초음파 유도하의 주사 치료뿐 만 아니라 회전근 개 복원술 등의 수술적 치료 후 추적 검사로도 유용하게 사용될 수 있다. 초음파 장비의 발전, 검사자의 숙련도 및 병증에 대한 사전 지식은 초음파를 이용한 회전근 개 질환의 진단과 치료에 있어 무엇보다 중요한 요소로 알려지고 있다.

• Clinics in Shoulder and Elbow
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• 제23권2호
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• pp.109-117
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• 2020

Repair of the rotator cuff tear is a joint-tightening procedure that can worsen joint stiffness. This paradoxical phenomenon complicates treatment of rotator cuff tear with joint stiffness. As a result, there is controversy about how and when to treat joint stiffness. As many treatments have been published, this review discusses the latest findings on treatment of rotator cuff tear with joint stiffness.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.122-122
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• 2008

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.96-103
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• 2008

목적: 다발성 건을 침범한 관절경적 회전근 개 복원 술 후 재 파열의 발생률 및 관련된 요인을 알아 보고자 하였다. 대상 및 방법: 극상건과 극하건을 포함한 회전근 개 파열을 보인 22예의 관절경적 복원 술 후(평균 파열크기 3.2 cm, 평균 연령: 58세) 평균 10개월 후 자기공명영상으로 조사 하였다. 복원된 건의 상태 평가는 Sugaya의 분류를 이용하였으며 근육의 상태 변화는 Goutallier의 등급을 이용하였다. 결과: 총 22예 중 7예(32%)에서 재파열을 보였다(Sugaya 분류 IV, V형). 3 cm이상의 파열에서 높은 재파열률 을 보였으며(67%) 반면 3 cm 이하에서는 8%의 재파열률 을 보였다. 재파열을 보인 경우 수술 후 Goutallier II등급 이상의 근육의 변성을 보였다. 반면 재파열이 발생하지 않은 군에서도 근 위축이 호전된 경우는 볼 수 없었다. 결론: 다발성 건을 침범한 회전근 개 파열에서 관절경 적 복원 술 후 32%의 재파열을 보였다. 파열의 크기가 재파열의 중대한 요소이며 파열의 크기가 3 cm 이상인 경우 재파열이 더 자주 발생하였다. 재파열을 보인 경우 근 위축은 진행 하였으며 복원상태가 유지 되어도 근 위축이 호전된 경우는 볼 수 없었다.

• 대한정형도수물리치료학회지
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• 제22권2호
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• pp.15-20
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• 2016

Background: The purpose of this study was to compared of scapular position between operation side and non-operation side to the rotator cuff surgery. Methods: This study was carried out with a total 34 patients: male (n=14), female (n=20). Shoulder range of motion (ROM), the quadruple visual analogue scale (QVAS), the shoulder pain and disability index (SPADI), and the scapular index (SI) were used to assess shoulder posture and function. SI was the resting position of the scapular was determined by measuring the distance from the mid-point of the sternal notch (SN) to the medial aspect of the coracoid process (CP) and the horizontal distance from the posterolateral angle of the acromion (PLA) to the thoracic spine (TS) with a soft tape measure. The SI was calculated using the equation: [(SN to CP/PLA to TS) ${\times}$ 100]. Results: There were no significant difference in ROM, QVAS to rotator repair patients according to SI (p>.05). There were significant differences in SI between the operation side and the non-operation side (p<.01). Conclusions: Scapular position was operation side more internal rotation, protraction, abduction than non-operation side. Therefore, health professionals managing for rotator cuff tear repair patients should consider scapular position.

• 대한정형외과 초음파학회지
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• 제3권2호
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• pp.65-68
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• 2010

견봉쇄골 관절 낭종은 광범위 회전근개 파열, 가성 종양, 견관절 감염, 연골 석회증과 관련되어 소수만 보고 되고 있다. 저자들은 관절경적 회전근개 봉합술 후 재파열과 동반된 견봉 쇄골 관절 낭종의 증례를 경험하였으며, 환자가 회전근개파열 수술 후 견봉쇄골 관절의 돌출이나 종괴를 보일 때 임상의들은 회전근 개 치유 여부에 대한 추시 영상 검사를 고려해야 할 것으로 사료된다. 특히, 초음파 검사는 사용 간편성과 경제적 측면에서 우수하며, 접근성이 용이하다는 점에서 이런 추시 영상 검사에 추천된다.