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Clinical Outcome and Causative Factor in Patients of Structural Failure after Rotator Cuff Repair.

Jae Myeung CHUN ; Jung Suk SONG ; Dong Wook SOHN

Journal of the Korean Shoulder and Elbow Society.2008;11(1):29-36.

PURPOSE: We wanted to evaluate the relationship between the clinical outcomes and cuff integrity after open rotator cuff repair and we wanted to analyze the causes of rotator cuff retear. MATERIALS AND METHODS: 78 patients who underwent open rotator cuff repair were enrolled from 2004 to 2006. All the patients were observed for a minimum follow-up of 12 months and they were evaluated by magnetic resonance imaging (MRI). The clinical outcomes were accessed by dividing the patients into the retear group and the intact group. The groups were also compared to analyze the cause of rotator cuff retear according to the preoperative tear size, the symptom duration, and so on. RESULTS: The clinical outcome of the retear group (n=22) was improved significantly after operation (p<0.001, p<0.001), but the muscle power was not improved significantly (p=0.099, p=0.243). More retears were found in the patients who had a larger preoperative tear (p<0.001) and the symptom duration of the retear group was longer (p=0.027). CONCLUSION: Although there were retear after rotator cuff repair, the clinical outcomes were improved. Yet the muscle power of the supraspinatus and external rotator were not improved significantly. There were more retears for the cases that had a larger preoperative tear size and a longer duration of symptoms.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscles ; Rotator Cuff

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Preoperative Three Dimensional Ultrasonographic Evaluation of the Rotator Cuff Tear.

Jae Kwang YUM ; Yong Woon SIN ; Jungil HAN

Journal of the Korean Shoulder and Elbow Society.2008;11(1):24-28.

PURPOSE: We wanted to determine if preoperative three dimensional (3D) ultrasonographic evaluation for rotator cuff tear is useful to measure the real size of a torn rotator cuff for performing an operation MATERIALS AND METHODS: This study included 15 cases (7 males and 8 female), and these patients were confirmed to have a full thickness tear of the rotator cuff by 3D ultrasonography and the operative findings, as well as on the magnetic resonance imaging (MRI). The average age of the patients was 55.4yrs. RESULTS: The average difference between the 3D ultrasonographic and operative measurements of the full thickness tear of the rotator cuff was 0.7 mm in the transverse length and 2.0 mm in the longitudinal length. CONCLUSION: The low error between the 3D ultrasonographic and intraoperative measurements of rotator cuff tear shows the usefulness of preoperative 3D ultrasonographic evaluation for rotator cuff tear.
Humans ; Magnetic Resonance Imaging ; Male ; Rotator Cuff ; Shoulder

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Bursoscopic Finding in Primary Adhesive Capsulitis of the Shoulder.

Ki Young NAM ; Young Lae MOON ; Dong Hui KIM

Journal of the Korean Shoulder and Elbow Society.2008;11(1):19-23.

PURPOSE: To evaluate the bursoscopic findings of refractory primary adhesive capsulitis of the shoulder and to determine the clinical correlation. MATERIALS AND METHODS: Arthroscopic capsular release was performed in 21 refractory adhesive capsulitis patients who had not responded to conservative treatment. The VAS for pain, range of motion, UCLA score was checked before and after surgery, and at the last follow up. RESULTS: Bursitis, mild friction and impingement on coracoacromial ligament, as well as adhesion were observed. The function and pain improved earlier than after simple acromiohumeral joint capsular release. CONCLUSION: Subacromial bursoscopy helps rule out a hidden secondary frozen shoulder or secondary changes with primary adhesion. In addition, it has the advantage of being both a treatment and procedure for making a prognosis.
Adhesives ; Bursitis ; Friction ; Humans ; Imidazoles ; Joint Capsule Release ; Joints ; Ligaments ; Nitro Compounds ; Range of Motion, Articular ; Shoulder

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Physical Examinations of Rotator Cuff Tear.

Kyung Cheon KIM ; Kwang Jin RHEE ; Hyun Dae SHIN ; Ki Yong BYUN

Journal of the Korean Shoulder and Elbow Society.2008;11(1):13-18.

Successful treatment of any pathological condition of the shoulder requires an accurate diagnosis. Physical examination represents an integral part of the assessment of shoulder disorders. Pain, loss of strength, decreased range of motion, and instability are the most common symptoms caused by a great variety of different shoulder pathologies. Therefore, a sophisticated clinical approach to the patient with shoulder pathology is essential. A standardized evaluation including a variety of diagnostic tests and clinical assessments improves the diagnostic accuracy by specifically examining one component of the shoulder complex. In most cases a careful physical examination will establish or suggest a diagnosis and special investigative techniques such as imaging procedures can be applied more selectively for confirmation or further evaluation of the pathological entity.
Diagnostic Tests, Routine ; Humans ; Investigative Techniques ; Physical Examination ; Range of Motion, Articular ; Rotator Cuff ; Shoulder

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Physical Examination in SLAP Lesion.

Jae Chul YOO ; Hong Je KANG ; Kyung Hawn KOO

Journal of the Korean Shoulder and Elbow Society.2008;11(1):6-12.

With the increasing use of arthroscopy and MRI for the diagnosis of shoulder problems, SLAP (superior labrum from anterior to posterior) lesions are more commonly diagnosed, and the incidence of SLAP repair surgery is increasing. Clinical diagnosis of SLAP is difficult to achieve, and many specific physical exam maneuvers have been described. However, neither these exam maneuvers nor history can provide a definitive diagnosis of a SLAP lesion. Despite this limitation, it is helpful to establish a more precise and accurate examination and to construct a preoperative plan. The purpose of this article is to review the original descriptions for specific physical exam maneuvers in SLAP, along with statistical analysis where available. This will help clinicians in deciding which tests are useful, how they should be implemented, and how to interpret the results.
Arthroscopy ; Incidence ; Physical Examination ; Shoulder

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Physical Examination of Shoulder Instability.

Jae Hwa KIM

Journal of the Korean Shoulder and Elbow Society.2008;11(1):1-5.

Shoulder instability is generally diagnosed from a detailed history, physical examination and various radiological studies. Although, a physical examination is essential for making a diagnosis, it is quite difficult. For a precise physical examination, a thorough anatomical knowledge and a great deal of experience is needed. In addition, normal translation and pathologic laxity should be differentiated. An anatomical and biomechanical understanding of a stable and unstable shoulder joint and a precise physical examination are needed to determine the direction and extent of the instability as well as to diagnose the associated lesions and improve the surgical results.
Physical Examination ; Shoulder ; Shoulder Joint

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The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture.

Chang Meen SUNG ; Se Hyun CHO ; Soon Taek JUNG ; Sun Chul HWANG ; Hyung Bin PARK

Journal of the Korean Shoulder and Elbow Society.2007;10(1):92-98.

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years (range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2(6~10), 6.6(2~8), and 6.9(4~8). The total UCLA score was an average of 21.7(12~26). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.
Aged ; Axillary Artery ; Brachial Plexus ; Classification ; Female ; Follow-Up Studies* ; Fractures, Comminuted ; Hemiarthroplasty* ; Humans ; Joints ; Male ; Rupture ; Shoulder ; Shoulder Fractures*

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Metallic Radial Head Prosthesis in Korea.

Sang Hwan HAN ; Jun Gyu MOON ; Jong Wong PARK ; Ki Mo JANG

Journal of the Korean Shoulder and Elbow Society.2007;10(1):84-91.

Purpose: The aim of this study was to report seven cases of metallic radial head prosthesis and present the limit of use in Korea. Materials and Methods: Metallic radial head arthroplasty was performed on 7 patients between April 2006 and December 2006, who had complex elbow injury including comminuted radial head fracture. Indication, operative findings and outcome were assessed. Availability and payment of implant were investigated. Results: All of the patients had more than one associated injury including coronoid fracture, olecranoan fracture, and ligament ruptures. According to Mason classification, there were three type III and four type IV fractures. All radial head fractures were too comminuted to reconstruct. There were two excellent results, four good, and one poor, as graded by Mayo score. There were no patient with instability and implant related complications. Insufficient supply of implant did not enable to do scheduled surgery in 2 cases. Current medical insurance did not cover charge for radial prosthesis, five patients could not help paying for that by themselves. Conclusion: Metallic radial head implants are useful when the radial head cannot be repaired reliably. Preoperative preparing and coverage by medical insurance based on appropriate indication are helpful for decision for a treatment option.
Arthroplasty ; Classification ; Elbow ; Head* ; Humans ; Insurance ; Korea* ; Ligaments ; Prostheses and Implants* ; Radius ; Rupture

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Tenodesis of Long Head of the Biceps Brachii Tendon with Bioabsorbable Interference Screw.

Jae Kwang YUM ; Yong Woon SIN ; Sang Jin LEE

Journal of the Korean Shoulder and Elbow Society.2007;10(1):78-83.

Purpose: This study reports the clinical results of the tenodesis of long head of the Biceps brachii tendon with bioabsorbable interference screw by minimal open procedure. Materials and Methods: Ten cases of 10 patients (7 male, 3 female) were included in this study. The average age was 45.8 years old and the average period from the symptom onset to operation was 13.7 months. Average preoperative ASES score was 38.5. The causes of injury was; sports activities in 4 patients, unknown in 4 patients, industrial accident in 1 patient and traffic accident in 1 patient. The average follow up period was 12.1 months. Tenodesis with bioabsorbable interference screw by minimal open precedure was performed in all cases. Results: The ASES score improved to 87.5 at last follow up period and 6 cases had full range of motion of the shoulder. 4 cases had mild limited range of motion of the shoulder without any problem in normal daily activity. Conclusion: It was assumed that tenodesis of long head of the biceps brachii tendon with bioabsorbable interference screw by minimal open precedure was one of the good methods with good clinical results.
Accidents, Occupational ; Accidents, Traffic ; Follow-Up Studies ; Head* ; Humans ; Male ; Range of Motion, Articular ; Shoulder ; Sports ; Tendons* ; Tenodesis*

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Arthroscopic Repair of Type II SLAP lesion with Bio-knotless Anchor.

Jae Kwang YUM ; Hyung Jin CHUNG ; Ho Jong RA

Journal of the Korean Shoulder and Elbow Society.2007;10(1):73-77.

Purpose: This study reports the clinical results of the arthroscopic repair of type II SLAP lesion with bio-knotless anchor. Materials and Methods: 25 cases of 25 patients (20 male, 5 female) were included in this study. The average age was 44.5 years old. Preoperative ASES score was average 44. Arthroscopic SLAP repair with 1 or 2 bio-knotless anchors were performed in all cases. The average follow up period was 15 months. Results: The ASES score improved to average 92.7 at last follow up period and 23 cases had full range of motion of the shoulder. 2 case had mild limited range of motion of the shoulder without any problem in normal activity. Conclusion: Arthroscopic repair with bio-knotless anchor in type II SLAP lesion is one of the good methods because of the good clinical results.
Follow-Up Studies ; Humans ; Male ; Range of Motion, Articular ; Shoulder

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