• Title/Summary/Keyword: 광범위 근개 봉합

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Clinical Outcomes of Diverse Patch Grafts (광범위 회전근개 파열의 봉합술에서 Patch Graft 종류별 임상적 결과)

  • Lho, Taewoo;Chung, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.472-483
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    • 2021
  • With increased development of patch graft, the number of repair using patch graft in massive rotator cuff tear has increased. Understanding characteristics of various patch graft might be helpful for selection of type of patch, and to improve the outcomes for the treatment of massive rotator cuff tears using patch grafts. Therefore, this paper reviews various studies dealing with clinical outcomes of rotator cuff repair using diverse patch grafts in massive rotator cuff tears.

Massive Rotator Cuff Tear Repair (광범위 회전근 개 파열의 봉합술)

  • Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.167-174
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    • 2010
  • Purpose: Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. Materials and Methods: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan. Results: Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up. Conclusion: Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.

Clinical Result of Arthroscopic Partial Repairs in Massive Rotator Cuff Tears (광범위 회전근 개 파열의 관절경하 부분 봉합술의 임상적 결과)

  • Yoo, Jae-Chul;Ko, Kyung-Hwan;Woo, Kyung-Jea
    • 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.

Acromio-Clavicular joint Cyst Associated with Rotator Cuff Re-tear Followed by Ultrasonography (초음파검사로 추시한 회전근 개 재파열에 동반된 견봉 쇄골 관절의 낭종)

  • Oh, Chung Hee;Kim, Joon Yub;Kim, Sae Hoon;Kim, Je Kyun;Oh, Joo Han
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.65-68
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    • 2010
  • Acromio-clavicular (AC) joint cyst have been reported in small series of the orthopedics literature in association with extensive rotator cuff tear, pseudotumor, infection of the shoulder or chondrocalcinosis. Authors experienced one case of AC joint cyst with rotator cuff re-tear after arthroscopic rotator cuff repair, clinicians may need pay attention to AC joint bulging or mass lesion after arthroscopic rotator cuff repair as an important sign to check follow-up imaging study for the cuff integrity. Especially, ultrasonography is recommended for this follow up study, because it is simple to be operated, economic, easily accessible.

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Arthroscopic Subscapularis Tendon Repair - Preliminary Report of 8 cases study - (관절경하 견갑하건 봉합술 - 8 례에 대한 예비보고 -)

  • Yun, Ho-Hyun;Moon, Gi-Hyuk;Jang, Jong-Hoon;Yoo, Yon-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.124-131
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    • 2004
  • Purpose: To validate and introduce the technique of the arthroscopic repair for the treatment of the Subscapulris tendon tear. Materials and Methods: From April 2003 to April 2004, Arthroscopic repairs were performed in 8 patient with subscapularis tendon tear. The mean follow-up period was 11months. two cases involved only subscaplaris tendon tear. Four cases were associated small sized posterosuperir. rotator cuff tear and two cases were in large size. The type of subscapularis tendon showed upper portion full-thickness tear in 6 cases, partial-thickness tear localized at articular surface in 1 case, complete tear in 1 case. The results were analyzed by using subjective satisfaction, inferior movenent of superior displaced humeral head, Constant-Murley functional scoring Results: Constant-Murley scoring was improved from 55 point preoperatively to 75 point postoperatively following 11 months. Mean score was 71 point except 2 cases of large superoposterior rotator cuff tear, Most humeral heads were distaracted postoperatively. The subjective result for the 8 shoulders were very satisfying in 5 cases, satisfying in 1 case and dissatisfying in 2 cases. Therefore satisfactory results were noted in 6 cases (75%) of this overall treatment group. Conclusion: The arthroscopic repair for the subscapularis tendon tear is thought to be available method, which could reduce severe complications following the weakness of deltoid muscle and postoperative pain. Especially Partial Subscapularis tear not associated with superoposterior rotator cuff tear including PASTA lesion was the sutable indication of the Arthroscopic repair.

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Mid-term Results of Biceps Incorporating Suture Without Deteaching the Biceps Tendon from the Flenoid in the Large or Massive Cuff Tear (회전근 개 대파열 및 거대 파열에서 상완 이두 근 장두를 포합한 회전근 개 봉합술의 중기 추시 결과)

  • Ji, Jong-Hu;Park, Sang-Eun;Kim, Young-Yul;Kim, Weon-Yoo;Kewon, Oh-Su;Jang, Dong-Gyun;Moon, Chang-Yun
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.104-111
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    • 2008
  • Purpose: The aim of this study is to analyze the clinical results of using the technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff. Material and Methods: Form January 2005 to January 2007, we performed the arthroscopic biceps repair with incorporating suture to the rotator cuff for 21 patients with large or massive rotator cuff tear. The mean follow up period was 23 months (range: 6-48months). The number of males and females was 9 and 13, respectively. The age distribution ranged from 47 to 73 years with a mean age of 60.3 years. We compared the preoperative score with the postoperative scores using the University of California Los Angeles (UCLA) score, the shoulder index of the American Shoulder and Elbow Surgeons (ASES) and a simple shoulder test (SST). Results: The improvement in the VAS, ASES and the UCLA and SST scores was statistically significant at the final follow up (average follow-up 23 months) (p>0.05). Two of nine cases were found to have partial tear with continuity but seven cases were found to have complete tear according to the ultrasonography and MRI. Conclusion: The technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff is considered to be recommendable.