• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.14-21
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• 2009

Purpose: To investigate MRI findings of the repaired anterior cruciate ligament (ACL). Materials and Methods: Seventeen of arthroscopic ACL primary repair with sutures pull-out technique were followed for 21.4 months (range: 12 to 60 months). Stability was assessed with physical examination and KT-1000 arthrometer (MED metric, San Diego, CA) and postoperative MRI checked with time. The patients were divided into 2 groups according to the location of tear which was defined with the location of remained synovial sleeve. Group I (11 patients) comprised that the tear was located within proximal 1/3 of ACL substance and group II (6 patients) comprised below proximal 1/3. MRI findings of the repaired ACL were evaluated by its course, sharpness, thickness and signal intensity using 3 grade system and correlated with its location of tear. Results: In all cases, Lachman test and flexion-rotation drawer test were negative, pivot-shift test was less than grade 1 and the mean side-to-side difference by use of KT-1000 arthrometer was 1.4 mm (range: -1.0 to 2.5 mm). The overall continuity of the repaired ACL was well maintained in all cases. However, mild sagging was observed in 10 cases(58.8%), mild obscure contour in 6 cases (35.3%), increased thickness in 8 cases (47.1%) and slight increased signal intensity in 5 cases (29.5%). There was no statistical significance in all parameters between 2 groups. And a focal defect at the femoral attachment site in sagittal image was observed in 7 cases (41.2%) of all patients which comprised 2 cases (18.2%) of group I and 5 cases (83.3%) of group II. It was observed more frequently in group II with statistical significance (p=0.035). Conclusion: Some abnormal MRI findings such as mild sagged course, obscure contour, increased thickness and signal intensity, the focal defect at femoral attachment site could be observed even though the stability was well maintained clinically. We thought that the focal defect was affected by the location of tear of ACL.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.186-193
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• 2005

Purpose: To determine whether it is possible to differentiate between ALPSA(anterior labroligamentous periosteal sleeve avulsion) lesion and Bankart lesion using arthroscopic findings and to investigate the clinical significance of ALPSA lesion. Materials and Methods: This study was performed on 66 cases that underwent arthroscopic Bankart repair for the anterior instability of the shoulder. By the readings of MRI, there were 56 cases(85%) of Bankart lesion and ten cases(15%) of ALPSA lesion. Arthroscopic findings of Each cases were classified and their average follow-up period was 22 months. Results: It was observed that ALPSA lesions developed in younger age groups than Bankart lesions. Under the arthroscope, ALPSA lesions showed various forms, especially there were five cases of severe inferomedial displacements. Within Bankart lesion, 21 cases were observed to be severely displaced and from the arthroscopic findings, it was difficult to distinguish the difference of Bankart lesion cases displaced inferomedially from the neck of scapula without severe lateral displacements and ALPSA lesion. Regarding the recurrence, there were no redislocation but apprehension shows in two cases(20%) with severe inferomedial displacement in ALPSA group. In Bankart lesion, there were four recurrent cases(7.1%); one of redislocation; one case of subluxation; two of apprehension. Conclusion: It was difficult to differentiate Bankart lesion and ALPSA lesion with severe inferomedial displacement and severely displaced ALPSA lesion showed high rate of recurrence. Thus, complete detachment of ALPSA lesion should be performed more carefully to reduce the recurrence rate.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.111-116
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• 2010

Purpose: There are many known treatment modalities for spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy. However, to the author's knowledge, there is no report on the follow-up outcomes focused on remnant cysts. Materials and Methods: Six (n=6) patients with spinoglenoid ganglion cyst accompanied by suprascapular nerve palsy, with a mean follow-up of 15 months (12-23months) following arthroscopic cyst decompression and superior labral repair, were enrolled. Residual cyst was investigated by ultrasonography and MRI. Results: Immediate postoperative ultrasonography revealed complete remission of ganglion cyst in one patient and reduced ganglion cyst size in five patients. Three-month follow-up ultrasonography showed spontaneous complete remission of the residual cysts in all patients. No recurrence on MRI was seen at one-year follow-up. Conclusion: Residual spinoglenoid ganglion cyst remaining after arthroscopic decompression and superior labral repair tends to resolve spontaneously within 3 months of surgery.

• Journal of the Korean Arthroscopy Society
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• v.14 no.3
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• pp.180-187
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• 2010

Purpose: Rotator cuff tears involving the subscapularis are less common than those involving the superior and posterior rotator cuff. The purpose of the present study was to report the clinical results of repair of isolated traumatic tears of the subscapularis tendon. Materials and Methods: Fifteen patients (13 males, 2 females; mean age 46.2 years; range 35 to 52) with unilateral ruptures of the subscapularis tendon after trauma who underwent arthroscopic repair between February 2003 and October 2008 were reviewed retrospectively. All the cases were isolated tears of the subscapularis without the involvement of any other rotator cuff tendon and were followed for at least two years (mean 28 months). The entire subscapularis was involved in 9 cases and the tear was localized to the upper two thirds in 6 cases. The preoperative and postoperative status of patients with isolated subscapularis tears were analyzed using the Constant Score, American Shoulder and Elbow Society Index (ASES Index) and postoperative integrity was determined through magnetic resonance imaging. Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up. The constant shoulder score improved from 41.5 to 81.3 points (P<0.05) compared to before surgery and ASES index improved from 46.4 to 89.6 points (P<0.05) postoperatively. Thirteen patients (87%) were satisfied with the result of the treatment. The total tears were significantly more improved by surgery than the partial tears. In 12 of 15 patients (80%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 13 months postoperatively. The postoperative score was significantly lower for the patients with a failed repair than it was for those with an intact repair (P<0.05). Conclusion: Repair of traumatic isolated subscapularis tears through arthroscopic techniques effectively restores patient function with regard to pain, mobility, strength and postoperative tendon integrity. The postoperative integrity of the repair correlates with the functional results and the total tears were more improved by surgery than the partial tears, but future studies may be needed.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.94-97
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• 2009

Purpose: Hibernoma is a very rare benign soft tissue tumor of the hypervascularized brown fat tissue with no malignant potential. Materials and Methods: However, it is difficult to differentiate a hibernoma from other malignant tumors, such as liposarcoma using computed tomography and magnetic resonance imaging, and a surgical resection with histological confirmation is the treatment of choice. Results: Histopathologically, hibernoma is composed of brown adipose cells that are polygonal and multivacuolated with a centrally located nucleus and granular cytoplasm, unlike white adipose cells. Conclusion: This article describes a patient with a histologically-confirmed hibernoma of the right shoulder.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.189-192
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• 2008

Sternoclavicular septic arthritis is a rare condition and it is usually related to predisposing conditions like intravenous drug abuse, diabetic mellitus, trauma and so on. A delayed diagnosis of this disease may cause severe complications like mediastinitis and chest wall abscess. Computed tomography or magnetic resonance imaging is needed to evaluate the complications. If the above complications are present, then joint resection should be considered. We report here on a case of a 52-year-old man who was diagnosed with primary sternoclavicular septic arthritis and he had no predisposing conditions. The pathogen on the aspiration-culture was S. aureus and it was susceptible to cefminox. The patient was cured with administering only antibiotic therapy for 6 weeks; intravenous cefminox therapy for 4 weeks followed by oral cefminox therapy for 2 weeks.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.7-12
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• 2014

Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.55-59
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• 2007

Synovial chondroma is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. We would like to present the case of a 65-year-old man suffering from synovial chondroma of the right elbow responsible for radial nerve entrapment neuropathy. This is a case of synovial chondroma of the right elbow in an 65-year-old man presenting with pain and restricted joint movement of the right elbow, loss of extension and sensation of the right thumb and wrist. Plain radiographs showed narrowing of elbow joint space, bony spur on the edge of the joint, and radio-opaque sclerotic change of subchondral area. MRI revealed $16{\times}12$ mm sized round mass on the radial head, homogenous low signal on T1WI, heterogenous high and low signal on T2WI. The patient underwent marginal excision of the mass, compressing the radial nerve. Diagnosis was confirmed by histologic examination.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.96-103
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• 2008

Purpose: This study investigated the rate of retear and related factors after arthroscopic repair of rotator cuff tears involving more than one tendon. Materials & Methods: Arthroscopic repair of 22 rotator cuff tears (average size 3.2cm: average age 58 years old) involving the supraspinatus and part or all of the infraspinatus were investigated using MRI on average 10 months after repair. The status of the repaired cuff was investigated using Sugaya's classification, and the change in muscle was evaluated with Goutallier's classification. Results: Retear (Sugaya grade IV, V) was found in 7cases(32%). Tears larger than 3cm had a higher retear rate(67%) than smaller tears(8%). Retear cases had Goutallier grade II or higher muscle changes preoperatively and showed aggravation of muscle atrophy postoperatively. Even without retear, reversal of muscle change was not seen Conclusion: Rotator cuff tears not confined to the supraspinatus had a 32% retear rate after arthroscopic repair. The size of the tear was the most crucial factor influencing retear. Retear was frequent in tear over 3cm. Atrophy of the cuff muscle worsened when the repair failed but did not improve even without retear.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.4
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• pp.2199-2206
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• 2014

This research, used an contrast agent, which weighs about 1mmol/mL, of twice as much amount of gadolinum, per unit, for the test of magnetic-resonance shoulder arthrography. the reasearch which was carried out from January, of the year 2012 to August of the year 2013. consisted, of target of 41, patients including 20 ones, of whom an original, contrast agent of amount of 0.5mmol/mL, 21, ones of whom, a new, of amount of 1mmol/mL was used on, were the test target, in order to figure out the differences, according to the amount of gadolinum, according to the test results, the SNR of the contrast agent, of amount of 1mmol/mL, which is of high amount of gadolinum, was noticeably higher than the one of amount of 0.5mmol/mL(the percentage of joint space 38.01%, the supraspinous muscle 8.40%, head of humerus 12.78%). and CNR of the contrast agent, of amount of 1mmol/mL, which is of high amount of gadolinum, was higher than the one of amount of 0.5mmol/mL(the percentage of joint space and supraspinous muscle 48.96%, the one of joint space and head of humerus 42.00%). In conclusion, one of the methods of increasing the reducing effect of T1, is to use contrast agent of amount of 1mmol/mL, in order to increase the reducing effect of T1, acquire the visual of high testing quality.