• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.121-121
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• 2008

• Journal of Korean Orthopaedic Sports Medicine
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• v.4 no.1
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• pp.65-69
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• 2005

Numerous small fibrinous rice bodies are a common finding in joints afflicted with rheumatoid arthritis(RA) or seronegative arthropathy, Subacromial and subdeltoid bursitis of the shoulder associated with multiple rice body formation is a rare occurrence. To our knowledge, this is the first report to describe the arthroscopic treatment of massive rice bodies in both glenohumeral joint and subacromial-subdeltoid bursae combined with full thickness of rotator cuff in RA. Besides, the MR appearance of subacromial-subdeltoid bursal rice bodies have been previously described in only few recent reports. Therefore, we also describe the MR appearances subacromial-subdeltoid bursae associated with multiple rice bodies in RA.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.250-259
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• 2010

Purpose: The purpose of this study was to evaluate the usefulness and clinical results of arthroscopic double row repair with UU stitches for massive, full-thickness, rotator cuff tears. Materials and Methods: Between January 2007 and July 2009, we consulted on 36 massive tears in which it was possible to repair the middle area of the greater tuberosity by arthroscopy. One group consisted of 11 cases that had a double row repair with UU stitches. A second group consisted of 20 cases that had a single row repair with simple stitches. We compared the 2 groups for pain, Activities of Daily Living, UCLA score, and KSS score. We did this pre operatively, and at 6 months, 1 year and final follow-ups. Statistical analysis included Student's t test and a paired t est. Mean age was 59 (48~70); mean follow-up was 28 (12~43) months Results: VAS scores decreased from 7.5 pre operatively to 1.5 post operatively at the last f/u in the $1^{st}$ group (p<0.05). In the $2^{nd}$ group, the score decreased from 7.6 in pre op to 1.8 post operatively at the last f/u (p<0.05). There was no significant difference between the two groups (p>0.05). Mean ADL increased from 11.5 to 25.1 at the last f/u in the $1^{st}$ group (p<0.05); in the $2^{nd}$ group the ADL score increased from 11.3 to 27.5 (p<0.05). There was no significant difference between the two groups (p>0.05). The UCLA score increased from 13.9 to 31.6 in the $1^{st}$ group (p<0.05), while in the $2^{nd}$ group the score increased from 13.8 to 30.1 (p<0.05); there was no significant difference between the two groups (p>0.05). Comparing MRIs at 3 and 6 months post op, there were retears in 3 of 9 cases in the first group, and in 8 of 15 cases in the second group; there was no significant difference between the two groups (p>0.05). Conclusion: Arthroscopic double row repair with UU stitches for massive, full-thickness rotator cuff tears showed no differences in clinical results. However, it was associated with a significant difference in the incidence of retears.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.1
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• pp.35-40
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• 2010

Purpose: To compare the outcome of patients who underwent rotator cuff repair using all-arthroscopic mini-open repair techniques. Materials and Methods: We retrospectively reviewed 44 patients who underwent either arthroscopic (group I) or mini-open (group II) rotator cuff repair. 23 patients underwent an arthroscopic repair and 21 patients had a mini-open repair. The mean age was 50.4 years in the arthroscopic group and 56.7 years in the mini-open group. The outcomes for the 2 groups were evaluated using ROM, VAS, ASES, UCLA scale. Statistical analysis was performed using correlations, T-test, Paired T-test. The mean follow-up period in the arthroscopic and mini-open groups were 24.1months and 26.1months, respectively. Results: The group I (arthroscopic group) had 2 small-sized tears, 10 medium sized tears, and 11 large sized tears (3~5 cm). The group II (mini-open group) had 1 small sized tears, 8 medium sized tears, and 12 large sized tears. The mean cuff tear size of the group I and Group II were 3.8 cm and 4.2 cm, respectively. At last follow-up periods, ROM and functional scores were improved. In the group I and group II, there were no significant difference in ROM, VAS, ASES, UCLA score. Conclusion: The size of the tear did not produce different results at arthroscopic repair group but larger tear size was associated with a worse outcome in mini-open group. There were no significant clinical results between the arthroscopic and mini-open group.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.23-26
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• 2008

Ultrasonography (USG) is widely accepted diagnostic method for the rotator cuff tear. The availability, low cost, easy to access is main factors that favor USG as a primary diagnostic modality for various cuff disorders. We experienced a case of discrepancy between USG, MR arthrography (MRA) and arthroscopic examination. Seventy four year old female patient complained of right shoulder pain. USG depicted rotator cuff tear with the size of 1cm, and MRA demonstrated about 3cm sized tear. Complex massive tear with delamination of degenerated rotator cuff was identified in the arthroscopic examination. When we encounter a patient who has loss of rotator cuff power or severe symptom than findings of USG, MRA or repeat USG is warranted. We report a case of discrepancy between examination modalities with brief review of the literature.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.84-93
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• 2013

Purpose: The purpose of this study was to evaluate the repair integrity and clinical outcomes of delaminated tears following arthroscopic layered suture bridge rotator cuff repair in a prospective fashion. Materials and Methods: A consecutive series of 67 patients with delaminated rotator cuff tears who underwent surgery using the arthroscopic Layered Suture Bridge Technique were followed prospectively. Of 67 shoulders, 26 patients were male and 40 patients were female (one patient had bilateral tears); the mean age was 58.8(40~76) years. The clinical evaluation was performed according to ASES, UCLA, and KSS (Korea Shoulder Scoring System) scores with an average follow up period of 33 months. Repair integrity was estimated using MRI, which was performed six months postoperatively. Results: The average clinical outcome in ASES, UCLA, and KSS scores showed significant improvement at the time of the final follow-up compared to preoperatively, from 50.2 to 92.3, 15 to 31.3, and 54.4 to 90.7, respectively (p<0.001 for all scores). Follow up by MRI showed that 16 shoulders had a type-I; 14, a type-II; five, a type-III; two, a type-IV; one, a type-V re-tear. The overall rate of re-tear (types IV and V) was 7.9%. Conclusion: Use of the Arthroscopic Layered Suture Bridge Technique can result in improved functional and structural outcome in cases of delaminated rotator cuff tear.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.53-61
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• 2009

Purpose: This study was designed to evaluate the clinical usefulness of serial ultrasonography (USG) after arthroscopic rotator cuff repair and to assess the re-tear rate and the re-tear time according to the tear sizes and the repair method. Materials and Methods: Between January 2008 and June 2008, 52 patients were treated with arthroscopic rotator cuff repair, Of the 52 patients, 29 patients that had undergone more than six months follow-up underwent preoperative USG examinations and subsequent arthroscopic examinations. MRI and USG findings were compared with intraoperative results of arthroscopic examinations. The postoperative integrity of the rotator cuff was observed using serial USG examination performed postoperatively at two weeks, six weeks, three months, and six months. Results: Small to medium rotator cuff tear were identified in 10 patients where the double pulley suture bridge (DPSB) technique was performed; the re-tear rate was 20%. For 19 patients with large to massive rotator cuff tears, the re-tear rates was 100% for six patients who had undergone tendon to tendon (TT) repair, the re-tear rate was 50% for two patients who had undergone tendon to tendon and bone to tendon (TTBT) repair and the re-tear rate was 55% for11 patients where the DPSB technique was performed. Re-tear rates according to follow-up periods were 7% from two to six weeks, 66% from six weeks to three months and 27% from three to six months postoperatively. Conclusion: Serial USG examinations after arthroscopic rotator cuff repair were useful to assess the re-tear rate and the re-tear time. In addition, USG examination were useful for treatment planning during postoperative rehabilitation.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2005.03a
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• pp.14-15
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• 2005

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.222-226
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• 2006

Full-thickness rotator cuff tears are relatively uncommon in the young adults. One of the pathogenesis of such tear is thought to be closely related to the specific trauma event. Favorable outcome is expected in young patient rotator cuff tears when it is diagnosed early following prompt surgical repair. However, early detection is sometimes difficult when the acute rotator cuff tear is combined with other injuries especially around the shoulder joints such as ipsilateral humerus fractures. Authors report an uncommon case of acute traumatic rotator cuff tear accompanied by the midhumerus shaft fracture in young adult.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.155-160
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• 2009

Purpose: The purpose of this study was to evaluate the pain recovery pattern according to the integrity and to analyze the factors affecting the progress and level of pain postoperatively. Materials and Methods: We examined 153 patients, who were treated with arthroscopic rotator cuff repair. 101 rotator cuff tears were full-thickness tear and 52 were partial tear. The mean follow up duration was 20 months (12~30 months). We evaluated the visual analogue scale, range of motion, ASES (American Shoulder and Elbow Surgeons), and UCLA (University of California at Los Angeles) scores preoperatively and postoperatively. We analyzed the pain recovery pattern between partial and full thickness tear using Student T-test and the factors affecting the progress and level of postoperative pain using multiple regression analysis. Results: The change patterns of visual analogue scale after arthroscpoic repair were similar regardless of the tear integrity. The VAS showed a continuous decreasing pattern, but increased at first 3 weeks postoperatively and at 7 weeks postoperatively, and then, decreased thereafter. The average VAS was ${\leqq}2$ points by postoperative 3 months. The factor affecting the pain score at 3 months was related to the preoperative limitation in forward flexion ($r^2=0.377$, p=0.021). Conclusion: There was no differences of the pain recovery pattern according to the integrity, and the factor affecting the progress of postoperative pain was preoperative angle of forward elevation. So, the appropriate preoperative rehabilitation protocol that can improve motions of the shoulder joint would help to improve the level of postoperative pain and functional recovery.