권호 표지

Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society

  • Quarterly
  • /
  • 2288-8721(eISSN)

Domain

  • Health Sciences ＞ Clinical Medicine

Aim & Scope

Clinics in Shoulder and Elbow (Clin Shoulder Elbow, CiSE; eISSN: 2288-8721) (pISSN: 2383-8337 till 2018) is an international, peer-reviewed journal and the official journal of Korean Shoulder and Elbow Society. It was first launched in 1998 (from March 1998 to June 2010: Journal of the Korean Shoulder and Elbow Society). It is published quarterly in the first day of March, June, September, and December, with articles in English, and has been published as an online-only journal since 2019. The purposes of CiSE are: first, to contribute in the management and education of shoulder and elbow topics; second, to share latest scientific informations among international societies; and finally, to promote communications on shoulder/elbow problems and patient care. It can cover all fields of clinical and basic researches in shoulder and elbow. CiSE publishs papers on basic and clinical researches, focusing on areas such as the etiology and epidemiology, biomechanics and pathogenesis, management and surgery, complication and prognosis for disease of shoulder and elbow. The manuscripts in the following categories can be submitted: original articles, case reports, invited review articles, editorials and letters to the editor. All submissions are processed online (www.cisejournal.org). The publication is determined by the editiors and peer reviewers, who are experts in their specific fields of shoulder and elbow. Articles published in this journal can be obtained from the official website of CiSE (www.cisejournal.org) as contents, abstracts and full-text PDF files. Clinics in Shoulder and Elbow is indexed/tracked/covered by PubMed, PubMed Central (PMC), Korea Citation Index (KCI), KoreaMed, KoMCI, CrossRef, and Google Scholar.

http://www.cisejournal.org KSCI KCI

Volume 22 Issue 1

  1. Kim, Sae Hoon 1
    https://doi.org/10.5397/cise.2019.22.1.1 PDF KSCI
  2. Jun, Yong Cheol;Moon, Young Lae;Bhardwaj, Havinder Dev;Lim, Jae Hwan;Cha, Dong Hyuk 3
    https://doi.org/10.5397/cise.2019.22.1.3 PDF KSCI HTML
    Background: This study aimed to compare the subscapularis muscle volume between the intact groups (group I) and supraspinatus tendon tear groups (group T) based on the sex and three different age groups. Methods: Subjects with a group I and subjects with group T without any other lesions were retrospectively evaluated from among patients who received a magnetic resonance imaging (MRI) scan between January 2011 and December 2013. The MRI scans were studied by a consultant radiologist. The subscapularis muscle volume was compared according to the age and sex; the age groups were categorized as patients in their 40s, 50s, and 60s. The volume of subscapularis muscle was measured by three-dimensional reconstructed images acquired through the axial section of 1.5T MRI. Results: No statistically significant differences were observed between subscapularis muscle volume of the group I and group T, except for male patients in their 50s (group I: $100,650mm^3$ vs. group T: $106,488mm^3$) and 60s (group I: $76,347mm^3$ vs. group T: $99,549mm^3$) (p<0.05). Males had a larger mean volume of subscapularis muscle than females, and the subscapularis muscle volume decreased in a linear manner with increasing age. Conclusions: Decrease in subscapularis muscle volume was observed with increasing age, and the impact of supraspinatus tear on subscapularis muscle volume is age and sex dependent.
  3. Lim, Tae Kang;Bae, Kyu Hwan 9
    https://doi.org/10.5397/cise.2019.22.1.9 PDF KSCI HTML
    Background: Latissimus dorsi (LD) tendon transfer is used as a treatment option for massive irreparable posterosuperior rotator cuff tears, and recently, an arthroscopic-assisted technique was introduced. This study was undertaken to evaluate the clinical and radiological outcomes of arthroscopic-assisted LD tendon transfer for the management of irreparable rotator cuff tears in active middle-aged patients. Methods: The records of five patients (two males) with irreparable tears involving the supraspinatus and infraspinatus tendons managed by arthroscopic-assisted LD tendon transfer were retrospectively reviewed. Clinical outcomes were assessed using the visual analogue scale (VAS) pain scale, American Shoulder and Elbow Surgeon's (ASES) scores, the University of California Los Angeles (UCLA) scale, and ranges of motion. Postoperative integrities of transferred tendon were evaluated by magnetic resonance imaging in 4 patients and by ultrasound in one. Results: Mean patient age was 55 years (range, 48-61 years), and mean follow-up period was 20 months (range, 12.0-27.2 months). Mean VAS score significantly improved from $6.6{\pm}2.6$ preoperatively to $1.8{\pm}2.5$ postoperatively (p=0.009), mean ASES score increased from $67.6{\pm}9.2$ to $84.6{\pm}15.1$, and mean UCLA score from $18.0{\pm}1.4$ to $28.8{\pm}8.5$ (all p<0.001). Postoperative imaging of the transferred LD tendon showed intact repair in 4 patients. The remaining patient experienced LD transfer rupture and a poor outcome. Conclusions: Arthroscopic-assisted LD tendon transfer improved shoulder pain and function in patients with massive, irreparable rotator cuff tears, and may be an option for this condition, especially in physically active patients.
  4. Yoon, Jong Pil;Kim, Dong Hyun;Jung, Jae Wook;Lee, Chang-Hwa;Min, Seunggi;Lee, Hyun Joo;Kim, Hee-June 16
    https://doi.org/10.5397/cise.2019.22.1.16 PDF KSCI HTML
    Background: We aimed to evaluate whether the use of our novel patient-specific guide (PSG) with 3-dimensional reconstruction in reverse total shoulder arthroplasty (RTSA) would allow accurate and reliable implantation of the glenoid and humeral components. Methods: 20 fresh-frozen cadaveric shoulders were used. The PSG group (n=10) and conventional group (n=10) was evaluated the accuracy and reproducibility of implant positioning between before and after surgery on the computed tomography image. Results: The superoinferior and anteroposterior offset in the glenoid component were $0.42{\pm}0.07$, $0.50{\pm}0.08$ in the conventional group and $0.45{\pm}0.03$, $0.46{\pm}0.02$ in the PSG group. The inclination and version angles were $-1.93^{\circ}{\pm}4.31^{\circ}$, $2.27^{\circ}{\pm}5.91^{\circ}$ and $0.46^{\circ}{\pm}0.02^{\circ}$, $3.38^{\circ}{\pm}2.79^{\circ}$. The standard deviation showed a smaller difference in the PSG group. The anteroposterior and lateromedial humeral canal center offset in the humeral component were $0.45{\pm}0.12$, $0.48{\pm}0.15$ in the conventional group and $0.46{\pm}0.59$ (p=0.794), $0.46{\pm}0.06$ (p=0.702) in the PSG group. The PSG showed significantly better humeral stem alignment. Conclusions: The use of PSGs with 3-dimensional reconstruction reduces variabilities in glenoid and humerus component positions and prevents extreme positioning errors in RTSA.
  5. Oh, Joo Han;Lee, Sanghyeon;Rhee, Sung-Min;Jeong, Hyeon Jang;Yoo, Jae Chul 24
    https://doi.org/10.5397/cise.2019.22.1.24 PDF KSCI HTML
    Background: Glenoid baseplate location is important to good clinical outcomes of reverse total shoulder arthroplasty (RTSA). The glenoid vault is the determining factor for glenoid baseplate location, but, to date, there are no reports on the effect of central cage location within the glenoid vault on RTSA outcomes when using the $Exactech^{(R)}$ $Equinoxe^{(R)}$ Reverse System. The purpose of this study was to determine the appropriate cage location in relation to the glenoid vault and monitor for vault and/or cortex penetration by the cage. Methods: Data were retrospectively collected from the Samsung Medical Center (SMC) and Seoul National University Bundang Hospital (SNUBH). Patients who underwent RTSA between November 2016 and February 2018 were enrolled. Glenoid vault depth, central cage location within the vault were examined. Inferior glenoid rim-center distance, inferior glenoid rim-cage distance, and center-cage center distances were collected. Results: Twenty-two patients were enrolled. Three SNUBH patients had inappropriate central cage fixation (33.3%) versus 4 SMC patients (30.8%). All cage exposures were superior and posterior to the glenoid vault. Mean center-cage distance was 5.0 mm in the SNUBH group and 5.21 mm in the SMC group. Center-prosthesis distance was significantly longer in the inappropriate fixation group than in the appropriate fixation group (p<0.024). Conclusions: To ensure appropriate glenoid baseplate fixation within the glenoid vault, especially in a small glenoid, the surgeon should place the cage lower than usually targeted, and it should overhang the inferior glenoid rim.
  6. Lee, Seung-Jin;Hyun, Yoon-Suk;Baek, Seung-Ha 29
    https://doi.org/10.5397/cise.2019.22.1.29 PDF KSCI HTML
    Background: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. Methods: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. Results: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was $148^{\circ}$. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). Conclusions: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.
  7. Weng, Hung-Kai;Chang, Wei-Lun;Yeh, Ming-Long;Su, Wei-Ren;Hsu, Kai-Lan 37
    https://doi.org/10.5397/cise.2019.22.1.37 PDF KSCI HTML
    Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.
  8. Kim, Seung Jae J.;Kang, Yusuhn;Kim, Dae Ha;Lim, Jae Young;Park, Joo Hyun;Oh, Joo Han 40
    https://doi.org/10.5397/cise.2019.22.1.40 PDF KSCI HTML
    Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients' magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients' symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.
  9. Kim, Dong Hyun;Min, Seunggi;Lee, Hyun Joo;Kim, Hee-June;Lee, Hoseok;Yoon, Jong Pil 46
    https://doi.org/10.5397/cise.2019.22.1.46 PDF KSCI HTML
    A 73-year-old woman presented with a recurrent cystic mass around her left olecranon. She had a history of 8 steroid injections due to elbow pain beginning 3 years ago and twice had undergone aspiration of olecranon bursitis that developed two months prior to presentation. She had been taking medications for hypertension and diabetes with no pertinent past history. On magnetic resonance imaging (MRI), there were multiple nodules in the olecranon bursa, which were isointense to muscle on T1-weighted images and hyperintense to muscle on T2-weighted images. Our initial diagnosis was synovial chondromatosis. On bursoscopy, masses of gray-white colored nodules were observed in the bursa. Finally, synovial chondromatosis and non-tuberculous mycobacterial infection were concurrently diagnosed. In conclusion, uncalcified synovial chondromatosis and rice bodies can have similar visual and MRI characteristics; therefore, we suggest that clinicians should be aware of the possibility of other infections in cases of this type.
  10. Rho, Joseph Y.;Kwon, Yong suk;Choi, Sungwook 50
    https://doi.org/10.5397/cise.2019.22.1.50 PDF KSCI HTML
    Rotator cuff tear is a common cause of shoulder pain and disability in adults. Due to the various nature of progression of rotator cuff tears and the complex biomechanics of the shoulder joint, repair and treatment of large-to-massive tears are challenging for many surgeons. Despite the recent popularity of reverse total shoulder arthroplasty as a treatment option for large-to-massive irreparable rotator cuff tears, biological and mechanical repair augmentation has also shown promise as a viable treatment option. The purpose of this study was to briefly summarize and review current studies on the assessment and arthroscopic treatment of large-to-massive rotator cuff tears, whether repairable or irreparable, to aid in developing a consensus on future treatment directions.