• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.90-90
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• 2008

• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.244-254
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• 2022

Radiographic osteolysis after total shoulder arthroplasty (TSA) remains a challenging clinical entity, as it may not initially manifest clinically apparent symptoms but can lead to clinically important complications, such as aseptic loosening. A thorough consideration of medical history and physical examination is essential to rule out other causes of symptomatic TSA-namely, periprosthetic joint infection-as symptoms often progress to vague pain or discomfort due to subtle component loosening. Once confirmed, nonoperative treatment of osteolysis should first be pursued given the potential to avoid surgery-associated risks. If needed, the current surgical options include glenoid polyethylene revision and conversion to reverse shoulder arthroplasty. The current article provides a comprehensive review of the evaluation and management of osteolysis after TSA through an evidence-based discussion of current concepts.

• Physical Therapy Korea
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• v.22 no.1
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• pp.9-18
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• 2015

This study aimed to compare the characteristics of breast cancer surgery and shoulder surgery patients on the shoulder range of motion (ROM), degree of pain and dysfunction, and scapular position. This study was carried out with a total of 90 women: a breast cancer surgery group (BS, $n_1=30$), a shoulder surgery group (SS, $n_2=30$) and a control group ($n_3=30$). Shoulder ROM, the Quadruple Visual Analogue Scale (QVAS), the Shoulder Pain and Disability Index (SPADI), and the Scapular Index (SI) were used to assess shoulder function. Statistical analyses were performed using a one-way analysis of variance, crosstab test, and independent sample t-test. Post-hoc testing was carried out with Bonferroni test. There were significant differences in shoulder ROM when the BS and the SS were compared with the control group. However, there was no significant difference in ROM between the BS and SS. Furthermore, there was a significant difference in shoulder pain between both surgery groups, and there was greater shoulder dysfunction in the SS than in the BS. There was also a significant difference in upper extremity posture when the BS and the SS were compared to the control group. Finally, there was no significant difference in upper extremity posture between the BS and the SS. This study compared shoulder ROM, pain, dysfunction, and upper extremity postures between the BS and SS. While there were no significant differences in shoulder ROM, pain, and upper extremity posture between both surgery groups, the level of dysfunction was found to be significantly different. Therefore, health professionals managing for breast cancer surgery or shoulder surgery patients should consider these outcomes.

• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.78-83
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• 2016

Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.343-350
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• 2023

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.167-171
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• 2015

Humeral head chondrolysis has been widely reported as a devastating complication after arthroscopic shoulder surgery; however little is known about post-arthroscopic humeral head osteonecrosis. We experienced a 66-year-old female patient with rapidly progressive osteonecrosis of the humeral head only seven months after arthroscopic Bankart and rotator cuff repair. The patient had no systemic risk factors for osteonecrosis. A satisfactory result was achieved with reverse total shoulder arthroplasty for severe humeral head destruction and an irreparable massive rotator cuff tear. Shoulder surgeons should be aware of such severe complication, perform routine radiographs, and pay close attention to the presence of constant pain or loss of motion after arthroscopic shoulder surgery.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.18-23
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• 2017

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.117-125
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• 2024

While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.186-186
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• 2016

• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.245-248
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• 2016

A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.