• Title/Summary/Keyword: 개방적 봉합술

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A Mid-Term Reults of Arthroscopic Versus Open Repair for Large and Massive Rotator Cuff Tears (회전근 개 대 파열 및 광범위 파열에 대한 관절경적 봉합술과 개방적 봉합술 간의 중기 결과)

  • Wang, Seong-Il;Park, Jong-Hyuk
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.222-228
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    • 2011
  • Purpose: To compare the mid-term clinical results of arthroscopic and open repair for large to massive rotator cuff tear. Materials and Methods: We retrospectively reviewed 48 patients who underwent either arthroscopic or open repair for large to massive rotator cuff tear. 28 patients underwent arthroscopic repair and 20 patients had open repair. The clinical outcome for the 2 groups was evaluated using range of motion, Visual Analogue Scale (VAS) for pain and function, American Shoulder and Elbow Society (ASES) score and Korean Shoulder Scoring System (KSS) score. Results: The range of motion, VAS for pain and function and ASES score was improved significantly in both groups at the final follow-up visit compared with preoperative values. However, there were no significant differences between the two groups statistically (p>0.05). There were no significant differences between the two groups statistically at the final follow-up KSS score (p>0.05) either. Conclusion: We could obtain improved mid-term clinical outcomes in both arthroscopic repair and open repair without any statistically significant differences between the two groups.

Suture Anchor Capsulorraphy in the Traumatic Anterior Shoulder Instability: Open Versus Arthroscopic Technique (봉합나사를 이용한 Bankart 봉합술의 관절경적 및 개방적 수술의 비교)

  • Kim Seung-Ho;Ha Kwon-Ick;Kim Sang-Hyun
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.157-169
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    • 1999
  • Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.

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Intraoperative Ultrasound-Guided Percutaneous Repair of a Ruptured Achilles Tendon: A Comparative Study with Open Repair (초음파 유도하 경피적 아킬레스건 봉합술: 개방적 봉합술과의 비교 연구)

  • Kang, Dong Hun;Kang, Chan;Hwang, Deuk Soo;Song, Jae Hwang;Choi, Bo Sung
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.522-529
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    • 2018
  • Purpose: To compare the clinical outcomes of ultrasound-guided percutaneous repair (USPR) and open repair in a ruptured Achilles tendon. Materials and Methods: The outcomes of 12 patients with USPR (group A) and 18 patients with open repair (group B) from January 2015 to February 2017 were analyzed retrospectively. The postoperative clinical evaluations were performed using the Arner-Lindholm scale, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Achilles tendon total rupture score (ATRS), and visual analogue scale for the overall satisfaction and cosmetic satisfaction with the scar, and the starting time of single heel raises. The complications were also evaluated. Results: The Arner-Lindholm scale, AOFAS ankle-hindfoot score, ATRS, starting time of single heel raises were similar in both groups (all p>0.05). Group A showed a significantly higher overall patient's satisfaction and cosmetic satisfaction in than group B (all p<0.05). Two cases of Achilles tendon elongation were encountered in group A, and 1 case of re-rupture with deep infection and 1 case of superficial infection were experienced in group B. Conclusion: USPR showed good clinical outcomes and high satisfaction as well as a low rate of complications, such as sural nerve injury. Therefore, USPR can be considered as an effective surgical treatment option for Achilles tendon ruptures.

The Radiologic and Clinical Changes after Open Complete Repair of Massive Rotator Cuff Tears (개방적 완전 봉합술로 치료한 광범위 회전근 개 파열 환자에서 치료 전후의 방사선학적 및 임상적 소견의 변화)

  • Moon, Eun-Sun;Choi, Min-Sun;Kim, Myung-Sun;Kong, Il-Kyu;Kim, Byoung-Jin
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.109-114
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    • 2009
  • Purpose: This study evaluated the preoperative and postoperative radiologic findings of patients with complete repairs after massive rotator cuff tears along with the incidence of re-tear and the clinical outcomes. Materials and methods: This study evaluated 33 cases who had open complete repairs for massive rotator cuff tears and these patients were followed up for more than 24 months. The clinical evaluation was performed according to the shoulder joint function test of the American Shoulder and Elbow Surgeons (ASES), and the degree of arthritis related to the massive rotator cuff tears was evaluated using the Hamada classification. Results: The ASES scores improved from 37.6 preoperatively to 85.6 postoperatively. The mean preoperative acromio-humeral interval (AHI) score was 6.5 mm, which increased to 9.3 mm immediately after surgery, and there was a decreased to 6.5 mm noted at the last follow up. The lower radiology stages of arthritis according to the classification showed better preoperative and postoperative results. Conclusion: An open complete repair as the surgical treatment for a massive rotator cuff tear showed satisfactory results for pain relief and an improvement in the shoulder joint function though re-tear after surgery.

Clinical Outcome and Causative Factor in Patients of Structural Failure after Rotator Cuff Repair (회전근 개 파열 봉합술 후 재파열 환자에서 임상결과와 원인 인자)

  • Chun, Jae-Myeung;Song, Jung-Suk;Sohn, Dong-Wook
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.29-36
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    • 2008
  • 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.

Correlation of Clinical Outcome and Cuff Integrity after Open Repair in Large and Massive Rotator Cuff Tears (대형 및 광범위 회전근 개 파열의 개방적 봉합술 후 임상적 결과와 회전근 개 연속성(integrity)의 상관 관계)

  • Noh, Haeng-Kee;Wang, Joon-Ho;Kim, Dong-Hwee;Park, Jong-Woong;Kim, Jae-Gyoon;Park, Jung-Ho
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.65-72
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    • 2007
  • Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.

Medial Retracted Large Rotator Cuff Tears (내측으로 퇴축된 대범위 회전근 개 파열)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Kim, Tae-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.212-219
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    • 2009
  • Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

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