• Title/Summary/Keyword: shoulder arthroscopy

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Improving visualization in shoulder arthroscopy

  • Emily R. McDermott;David J. Tennent;Daniel J. Song
    • Clinics in Shoulder and Elbow
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    • 제26권4호
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    • pp.455-461
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    • 2023
  • Arthroscopic shoulder procedures are one of the most common procedures used to restore function through minimally invasive techniques. With the demand for shoulder arthroscopic procedures comes the need for safe, effective, and efficient surgery that maximizes patient outcomes while minimizing complications. Many variables contribute to visualization in shoulder arthroscopy including vascular anatomy, blood pressure control, arthroscopic pump systems, turbulence control, epinephrine, and tranexamic acid. Furthermore, patient positioning can have a dramatic effect on visualization with both the beach chair position and lateral decubitus positioning having various strengths and weaknesses depending on the intended procedure being performed. The purpose of this review is to examine the benefits and complications reported in the literature for improving visualization in shoulder arthroscopy.

Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears

  • Kim, Sung-Jae;Kim, Young-Hwan;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • 제17권1호
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    • pp.44-47
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    • 2014
  • Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

Technical Note Transarticular Approach for Elbow Arthroscopy

  • Kim Sung-Jae;Jeong Jae-Hoon
    • 대한견주관절학회:학술대회논문집
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    • 대한견주관절학회 2004년도 연수강좌
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    • pp.176-179
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    • 2004
  • Arthroscopy of the stiff elbow joint is a technically difficult procedure because of the decreased joint space of the elbow joint. even to experienced surgeons. Problems encountered include limited access of instrument to the intra-articular ,pace and an increased risk of cartilage injury in the contracted elbow joint. This study describes a novel transarticular approach for elbow arthroscopy that allow, the safe and effective creation of the proximal medial and lateral portals.

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Intraoperative pulmonary embolism in shoulder arthroscopy in a patient with previous SARS-CoV-2 infection: a case report

  • de Lizana, Alejandro Holgado-Rodriguez;Izquierdo-Fernandez, Alberto;Mendez-Sanchez, Jesus Manuel;Diaz-Minarro, Jose Carlos
    • Clinics in Shoulder and Elbow
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    • 제25권3호
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    • pp.236-239
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    • 2022
  • The objective of this article is to describe intraoperative pulmonary embolism during shoulder arthroscopy in a patient with previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Further, we describe how the pandemic has influenced the population by increasing the rate of embolisms. Awareness of such cases will help to increase knowledge regarding SARS-Cov-2 and to determine if such patients should receive routine antithrombotic prophylaxis.

영아 화농성 견관절염의 관절경적 치료 - 증례 보고 - (Arthroscopic Treatment for Pyogenic Arthritis of the Shoulder in an Infant - A Case Report -)

  • 공규민;이수원;김성환;이은하
    • 대한관절경학회지
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    • 제15권1호
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    • pp.28-31
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    • 2011
  • 영아에서 견관절의 화농성 관절염은 매우 드문 질환으로, 조기 진단 및 그에 따른 적절한 치료가 예후를 결정하는데 매우 중요하다. 저자들은 생후 10개월 된 영아의 화농성 견관절염의 치료에 있어 관절경적 세척술 및 활액막 제거술로 관절 내를 직접 확인하면서 충분한 관절 세척을 시행하여 반흔을 적게 남기고, 후유증 없이 만족할 만한 임상 결과를 얻을 수 있었다.

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양측성 상완이두장건 결손과 견관절 불안정성 - 증례 보고 - (Shoulder instability with congenital absence of bilateral long head of biceps tendon - A Case Report -)

  • 나중호;정회정;김두섭
    • 대한관절경학회지
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    • 제14권3호
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    • pp.188-191
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    • 2010
  • 상완이두장건의 결손은 매우 드문 이상이다. 본원에 내원한 19세 남환은 우측 견관절 아탈구 증상을 주소로 내원하였다. MRI 상 상완골의 얕은 결절사이고랑이 관찰되었으며 상완이두장건의 결손이 관찰되었다. 견관절 내시경술을 시행하였으며 관절와순 파열과 함께 상완이두장건의 결손이 관찰되었다. 5개월 뒤 좌측 견관절에도 우측 견관절과 같은 증상이 발생하였고 MRI 및 견관절 내시경 소견 상 상완이두장건의 결손 소견 및 관절와순 파열 소견이 관찰되었다. 양측 견관절 모두 내시경적 관절와순 봉합술을 시행하였으며 수술 후 위팔 외전 보조기를 이용하여 고정하였다. 상완이두장건의 결손이 견관절의 불안정성을 유발할 수 있을 것이라고 생각한다.

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Anatomic factors associated with degeneration and fraying of the coracoacromial ligament

  • Ryan Lopez;Jaspal Singh;Mohammad Ghoraishian;Thema Nicholson;Stephen Gates;Surena Namdari
    • Clinics in Shoulder and Elbow
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    • 제27권1호
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    • pp.26-31
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    • 2024
  • Background: The coracoacromial ligament (CAL) is frequently observed to be damaged during arthroscopy and it is unclear how demographic, anatomic, and radiographic factors are related to CAL degeneration in full-thickness rotator cuff tears. Methods: A prospective study was conducted of patients at a single institution undergoing shoulder arthroscopy for first-time, full-thickness rotator cuff tears. We evaluated preoperative anteroposterior radiographs to obtain critical shoulder angle, glenoid inclination, acromial index, acromiohumeral distance, lateral acromial angle, and acromial morphology. We documented CAL quality, rotator cuff tear size and pattern during arthroscopy. Multiple logistic regression was used to identify predictive factors for encountering severe CAL fraying during arthroscopy. Results: Shoulders had mild CAL degeneration in 58.1% of cases, whereas severe CAL degeneration was present in 41.9% of shoulders. Patients with severe CAL attrition were significantly older (62.0 years vs. 58.0 years, P=0.042). Shoulders with severe CAL attrition had large rotator cuff tears in 54.1% of cases (P<0.001), and tears involving the infraspinatus (63.2% vs. 29.6%, P=0.003). The severe degeneration group was more likely to have a larger critical shoulder angle measurement on preoperative radiographs than those in the mild attrition group (36.1°±3.6° [range, 30°-45°] vs. 34.1°±3.8° [range, 26°-45°], P=0.037). Conclusions: While the clinical impact of CAL degeneration remains uncertain, increased severity of CAL degeneration is associated with older age, larger rotator cuff tear size, presence of infraspinatus tearing, and increased preoperative critical shoulder angle. Level of evidence: III.

사각근간 차단을 이용한 어깨 관절경수술에서 좌위에 따른 Bezold-parish 반사 (Bezold-Jarish Reflex during Shoulder Arthroscopy (in the Sitting Position) under Interscalene Block)

  • 이두익;원시권;김동우;김동옥;최영규;신광일
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.166-169
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    • 1997
  • Background: We have noted a high incidence of vasovagal episodes associated with use of interscalene block(ISB) for shoulder arthroscopy in the sitting position. The purpose of this retrospective study is to alert the possibility of potentially dangerous vasovagal events, describe the characteristics of this problem, and propose therapeutic devices. Methods: Results 62 patients who underwent shoulder arthroscopy in the sitting position with ISB were retrospectively analyzed. Group 1, 10 patients experienced vasovagal events characterized by sudden hypotension and bradycardia. Remaining 52 patients, Group 2, did not experience these symptoms. All patient charts were reviewed for age, sex, side of surgery, premedication, preoperative fluid and intraoperative medications. Perioperative hemodynamic changes were also compared between the two groups. Results: Vasovagal events experienced in 16% of patients(10/62) and occurred $39{\pm}18$ min after sitting position and $22{\pm}18$ min after start of operation. Number of patients who receiving anticholinergics for premedication were significantly lower in Group 1 than Group 2(2/10 vs. 28/52, p<0.05). Conclusions: Bezold-parish reflex is a potential mechanism for sudden hypotension and bradycardia which can occur during shoulder arthroscopy in sitting position. Therefore anticholinergic pretreatment and meticulous monitoring during operation are recommended to prevent B-J reflex.

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