• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.72-78
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• 2010

Purpose: Too develop a flexible drill device that can be inserted into the shoulder joint so that arthroscopic transosseous suture repair for Bankart lesion is possible. Materials and Methods: We created a device composed of a flexible drill unit and a guide pipe unit. The flexible drill unit was made of flexible multifilament wires (1.2 mm in diameter) that was twisted into one cord so that it can flex in any direction and a drill bit (1.2 mm in diameter) that is attached onto one end of the flexible wire. The guide pipe unit was a 150 mm long metal pipe (2.0 mm in inner diameter and 3.0 mm in outer diameter), with one end bent to 30 degrees. The flexible drill set was inserted into the shoulder joint through the posterior portal of the joint. The guide pipe component was placed onto the medial wall of the glenoid so that the pipe was placed 5 mm posterior to the margin of the anterior glenoid rim. The flexible drill was driven through the glenoid by the power drill so that holes were made in the glenoid. A non- absorbable suture was passed through the hole. Tying of a sliding knot tying was accomplished over the capsule and labrum after making a stitch through the capsule and labrum with a suture hook loaded with suture passer. The same procedures were done at the 2 and 4 O'Clock positions of the glenoid. Results: Five cases with Bankart lesion received arthroscopic transosseous repair with our flexible drill device. There were no intraoperative problems. Neither redislocation nor subluxation was reported at final follow-up. Conclusion: Arthroscopic transosseous suture repair without suture anchors and easy tying of a sliding knot are possible with a flexible drill set.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.162-168
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• 2006

Purpose: To compare the clinical results of arthroscopic transglenoid suture with thermal capsulorrhaphy and thermal capsulorrhaphy on multidirectional shoulder instability. Materials and Methods: From January 1993 to September 2001, 23 patients who received the artrhoscopic treatment were the subjects and follow up period were at least 2 years. Each were subdivided as Group A(7 cases), which took transglenoid suture with thermal capulorrhaphy and Group B(16 cases), who took only thermal capsulorrhaphy. Clinical results were evaluated by Rowe score before and after surgery. Results: After operation according to Rowe score 4(57.1%) were excellent, 1(14.3%) were good and 2(28.6%) were fair in the Group A. for Group B 6(37.5%) were excellent, 2(12.5%) were good, 5(31.3%) were fair and 3(18.8%) were poor. Shoulder instability was recurred in 1(14.2%) case of Group A and 8(50%) cases of Group B during follow up period. Conclusion: Thermal capsulorrhaphy is thought to be a good adjuvent method, if it done with anterior capsular shift by transglenoid suture in multidirectional shoulder instability.

• Journal of the Korean Arthroscopy Society
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• v.15 no.2
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• pp.92-98
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• 2011

Purpose: We describe a all-arthroscopic technique for decompression of spinoglenoid ganglion cyst and present our clinical results for this procedure. Materials and Methods: From March 2006 to June 2009, eight patients (7 males, 1 female; mean age 40.6 years; range: 21~61) were included who underwent arthroscopic decompression of spinoglenoid ganglion cyst. The most common symptoms were vague shoulder pain and external rotation weakness, which lasted 6.4 months (range: 3~8) on average. Five of eight patients were noted abnormalities on electromyographic (EMG) examination to have suprascapular nerve neuropathy and magnetic resonance imaging (MRI) showed spinoglenoid ganglion cysts in all eight patients and the cyst size was 2.6 cm (range: 1.8~3.6). Labral pathology was identified intraoperatively in all patients and the cysts were decompressed by the posterosuperior capsulotomy under arthroscopic control and labral repair with suture anchors was performed in six patients. Results: The average clinical outcome scores including Constant and Murley, Simple shoulder test (SST) all improved significantly at the time of the final follow-up and there were no complications resulting from the procedures. All patients including the patients with abnormal EMG study recovered strength on isokinetic strength testing. Follow-up MRI scans were performed on all patients at a mean of 5.2 months postoperatively (range: 3~12) revealed complete resolution of the cysts and no evidence of recurrences were seen at an average of 18 months (range: 12~26) of follow-up. Conclusion: Arthroscopic decompression of spinoglenoid ganglion cyst effectively restores patient function and all patients in this study showed improvement in their postoperative MRI findings. Arthroscopic decompression is also useful in the appropriate treatment for labral pathology and may contribute to decreased risk of cyst recurrence.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.150-158
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• 2009

Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.109-114
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• 2008

There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were $1.10{\pm}0.54$ at $25^{\circ}$, $2.50{\pm}0.50$ at 30^{\circ}$, $2.85{\pm}0.36$ at $35^{\circ}$ and $2.33{\pm}0.47$ at $40^{\circ}$, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at $35^{\circ}$, $30^{\circ}$ and $40^{\circ}$ with the almost same score. However, the degree of distortion at $40^{\circ}$ was more severe than that at $30^{\circ}$. Ultimately, $30-35^{\circ}$ views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.115-118
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• 2004

Purpose: The purpose of this study is to measure the internal and external rotation of shoulder and compare with normal volunteer and patients diagnosed as SLAP lesion. Materials and Methods: Thirty-eight cases (group 1) who had SLAP lesions at shoulder arthroscopy and fourty young volunteers(group 2) were analyzed retrogradely with medical record, intra-operative arthroscopic photo & video for SLAP lesions and the ROM of shoulder Under the interscalene anesthesia, the range of motion of internal rotation and external rotation were measured on flxed scapula and 90 degree abduction of shoulder, and the same method for group 2. We analyzed the results with two sample T-test and Wisconsin signed ranks test. Results: There was a significant difference between group 1 and group 2 for the ROM of shoulder. (IR; p<0.001,ER; p<0.001).For the group 1, internal and external rotation with the arm abducted 90 averaged 50 and 64 degrees and for the group 2, internal and external rotation averaged 77 and 90 degrees with significant difference(IR; p<0.001,ER; p<0.001).Conclusion: The range of motion of shoulder, especially internal and external rotation significantly decreased in SLAP lesions. Our results suggest that a limited rotational motion of shoulder closely related with SLAP lesion.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.231-234
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• 2006

We experienced a case of impingement caused by a bone fragment which was impacted between acromion and humeral head in a child. The bone fragment came from antero-inferior glenoid fracture. Satisfactory clinical results and stability were obtained by arthroscopic bone fragment removal. In case that bone fragment is located in the upper shoulder joint and results in impingement, We must consider not only greater tubercle fracture but also glenoid fracture. Magnetic resonance imaging can assist in the preoperative diagnosis.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.62-65
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• 2008

Isolated acromial fracture is not common and it frequently accompanies fractures to the coracoid process and glenoid bone and also injuries to the acromioclavicular joint. Furthermore, most of these combined acromial fractures have minimal displacement, which needs no additional treatment other than protection for a certain period of time. We have experienced a case of isolated fracture of the posterolateral angle of the acromion, which we reduced and fixated using K-wire and cannulated screws. We report on the technical aspects and clinical results of this reduction and fixation, along with a review of the literature.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.86-90
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• 2008

Purpose: To evaluate the differences between blindly and ultrasonography (US)-guided during multiple needling and dextrose injection technique for calcific tendinitis of shoulder. Materials and Methods: We chose 36 symptomatic calcific tendinitis patients, whose age ranged from 27 to 69. Our procedures were multiple needling and injection of dextrose over the lesion of calcific deposits. The bind injection group were 19 patients whose age ranged from 27 to 64-year-old (mean 52.2), and the US-guided injection group were 17 patients ranged from 31 to 69-year-old (mean 49.0). We compare these groups by VAS (visual analogue scale) and range of motion before and after procedures. Results: There is no difference between two groups in VAS and ROM before procedure (p>0.05). Two groups revealed significant improvement without limitation of shoulder function, however, the group under US-guided revealed better results than under blind (VAS:p=0.001, Flexion:p=0.000, Abduction:p=0.000, External rotation: p=0.016). Conclusion: Ultrasonography-guided procedure showed better results than blind, so the use of ultrasonography is more promising procedure.

• PNF and Movement
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• v.10 no.2
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• pp.9-16
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• 2012

본 연구는 43세 남성 환자의 관절가동술과 슬링을 이용한 유착성 관절낭염 환자의 치료사례를 조사하여 그 과정과 결과를 알아보고자 하였다. 어깨통증장애지수(shoulder pain and disability index) 측정과 어깨관절의 굽힘(flexion), 벌림(abduction), 바깥돌림(external rotation), 안쪽돌림(internal rotation)에 대한 관절가동범위를 측정하여 비교하였으며 견관절 주위에 비스테로이드 소염진통 주사 1회, 약물치료를 병행하며 주 3회 8주간 보존적인 물리치료인 온습포(hot pack)와 간섭파(ICT), 관절가동술, 그리고 슬링을 이용한 운동치료를 실시하였다. 결과는 관절가동술과 슬링운동치료의 적용이 유착성 관절낭염 환자의 통증을 줄이고 관절가동범위를 증진시키는데 효과가 있는 것으로 판단된다.