• Clinics in Shoulder and Elbow
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• v.21 no.2
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• pp.59-66
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• 2018

Background: Massive, irreparable rotator cuff tears (RCTs) are a challenging clinical problem in young patients. In recent years, arthroscopic superior capsular reconstruction (ASCR) is a popular treatment in the massive, irreparable RCTs. However, studies reporting clinical results of ASCR are rare in the literature. Methods: Between 2013 and 2015, six patients underwent ASCR. One patient treated with dermal allograft, while five patients with autogenous fascia lata graft. Demographic data, as well as preoperative and last follow-up clinical data including pain, range of motion (ROM), strength, American Shoulder and Elbow Surgeons system, the Constant system, the University of California at Los Angeles system, the Simple Shoulder Test, and the Shoulder Pain and Disability Index system were obtained. Acromiohumeral distances and Hamada classification were measured on standard anteroposterior x-ray. Results: All patients were men, and the average age was $59.5{\pm}4.18years$ (range, 53-65 years).The minimum follow-up was 18 months with a mean follow-up was $27.33{\pm}7.58months$ (range, 18-36). All patients had postoperative improvement in pain scores and functional scores. The ROM and strength did not improve after surgery. The Hamada score progressed of radiographic stage in 2 patients. In the case of dermal allograft, there was graft failure 6 weeks after ASCR. Conclusions: Our results support the ASCR as a viable treatment for surgical salvage in massive, irreparable RCTs. This treatment option may provide patients with decreased pain and increased function. And studying our case of dermal allograft failure provides opportunities to decrease graft failure in ASCR using dermal allograft.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.149-152
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• 2004

Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.109-114
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• 2010

Purpose: The purpose of this study was to report the surgical outcome of reconstruction of neglected chronic Achilles tendon ruptures with various methods including Achilles tendon allograft. Materials and Methods: Between October 2003 and November 2008, 8 consecutive neglected chronic Achilles tendon ruptures with the defect gap of more than 4 cm underwent surgical reconstruction including V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus transfer and Achilles tendon allograft. There were 7 males and 1 female who were evaluated at more than 18 months after surgery. At the time of followup, all patients were assessed with regard to postoperative complications, their self-reported level of satisfaction, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, 10 repetitive single heel rise, single leg hopping test, and ankle range of motion. Results: The AOFAS score increased from average 71.4 (50-87) to 96.4 (86-100). All patients were able to perform 10-repetitive single heel raise and single leg hopping at the latest follow up. No patient experienced wound complications and deep infection. Six patients were rated as 'excellent' and the other two as 'good'. Conclusion: Neglected chronic Achilles tendon ruptures could be successfully treated with careful selection of the reconstruction method according to the amount of defect gap. With an extensive defect, Achilles tendon allograft can be a good option when the reconstruction is not feasible otherwise.

• The korean journal of orthodontics
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• v.44 no.1
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• pp.28-35
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• 2014

Objective: To determine Korean facial profile preferences based on lip position as assessed by Hispanic-Americans of varying western adaptation levels and to determine whether the age and sex of the rater had any influence. Methods: For this study, 132 Hispanic-Americans and 68 Caucasians of varying age, sex and western adaptation levels volunteered to rate their preference of Korean male and female facial silhouettes having lips ranging from retruding to protruding. The Hispanic-Americans were also asked to complete a Bidimensional Acculturation Scale questionnaire to determine their western adaptation status: low-acculturated Hispanics (LAH; lesser western-adapted Hispanic participants) or high-acculturated Hispanics (HAH; higher western-adapted Hispanic participants). Results: The LAHs preferred significantly more retruded lip positions (p < 0.05) while HAHs showed some similarities with Caucasian participants in the results for the Korean male profile, even though HAHs preferred more retruded lip positions for the Korean female profile than Caucasians did (p < 0.05). The age and sex of raters did not influence the preference of facial profiles (p > 0.05). Conclusions: The results of this study suggest that Hispanic-Americans prefer a flatter Korean lip profile. It would be prudent for orthodontists to offer patients the option of altering lip profile through orthodontic and/or orthognathic surgery treatments.

• Journal of Korean Foot and Ankle Society
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• v.17 no.2
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• pp.115-120
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• 2013

Purpose: Calcaneal lengthening osteotomy is one option for the treatment of symptomatic flexible flatfoot in adults. The aim of the study was to evaluate the short term clinical and radiologic results and analyze its complications. Materials and Methods: Twelve feet who had undergone calcaneal lengthening osteotomy without flexor digitorum longus transfer between December 2009 and July 2011 were included. The mean age was 40.6 years (23~75 years). The mean followup was 17.3 months (13~25 months). Clinical outcome were assessed using American Orthopadics Foot ans Ankle Society (AOFAS) score and visual analogue scale (VAS) for pain. Four radiologic parameters were measured from weightbearing radiographs to evaluate the difference between preoperatively and postoperatively measures. To analyze the complications, calcaneocuboid joint subluxation and degenerative change were measured postoperatively. Results: The mean AOFAS score improved from 55.3 points preoperatively to 82.2 points at lastest follow-up (p=0.000). The mean VAS improved from 6.3 points preoperatively to 3.2 points postoperatively (p=0.002).All radiologic parameters, the mean talonavicular coverage angle on AP view, the mean talo-1st metatarsal angle on AP and lateral view and the mean calcaneal pitch angle, significantly improved after calcaneal lengthening osteotomy. Nine feets (75%) were shown the degenerative change in the calcaneocuboid joint at latest follow-up radiographs. Conclusion: Calcaneal lengthening osteotomy for the symptomatic flexible flatfoot in adults produced significant improvement in clinical and radiologic parameters, but calcaneocuboid joint osteoarthritis occurred postoperatively remained a major problem.

• Archives of Reconstructive Microsurgery
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• v.19 no.1
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• pp.7-11
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• 2010

Interpostion arthroplasty with allograft has been known as a useful option for the shoulder arthropathy, but it has a limitation to immune response. We performed the pectoralis major muscle transfer for shoulder arthropathy. From January 2007 to December 2007, we performed the pectoralis major muscle transfer in 2 patients. They were 1 man and 1 woman, and the mean age of the patients was 70 years (range, 65 to 75). The average follow-up after surgery was 13 months (range, 12 to 14). We analyzed the clinical results by the American Shoulder and Elbow Surgeons (ASES) Score, and evaluated the pain by Visual Analogue Scale. The level of pain reduced from a preoperative average of 10 to a postoperative average of 1. The ASES scores increased from a preoperative mean of 9 to a postoperative mean of 58. These results indicated that interposition arthroplasty with the pectoralis major muscle transfer is a reliable treatment method for the shoulder arthropathy improving shoulder pain, and patient satisfaction.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.77-83
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• 2017

Background: Although there have been multiple reports on surgical outcomes of superior labral anterior to posterior (SLAP) lesions in overhead athletes, only a few reports exist in the literature about the results of nonoperative treatment in elite (collegiate or professional) overhead athletes. To determine the clinical outcomes of nonoperative treatment of SLAP lesions in elite overhead athletes. Methods: Between January 2006 and December 2011, 69 patients were selected. Initial arthroscopic SLAP repair was performed in 19 patients and of the 50 patients who underwent nonsurgical treatment, such as range of motion gain and periscapular muscle strengthening, 14 patients were converted to surgical treatment; 5 patients were lost to follow-up. Medical records of 31 elite overhead athletes who underwent nonsurgical treatment were retrospectively reviewed. Four clinical outcome measures were used: visual analogue scale (VAS) for pain, VAS for satisfaction, American Shoulder and Elbow Surgeons (ASES) score, and subjective feeling of recovery. Results: The average follow-up period was 35.9 months (range, 24-62 months). The VAS for pain decreased from 6.5 to 2.2 (p<0.01) and VAS for satisfaction was 7.6. The ASES score increased from 54.1 to 85.9 (p<0.01). The overall average value of subjective feeling of recovery was 72%. Twenty-three out of 31 elite athletes (74.2%) returned to play after rehabilitation; these 23 athletes performed at the same or higher levels after rehabilitation. Conclusions: Nonsurgical treatment in elite overhead athletes with SLAP lesion should be considered as a treatment option.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.84-89
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• 2017

Background: Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department. Methods: Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and postneedling size and shape of the calcific deposits were compared between the two groups. Results: We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator. Conclusions: Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

• Journal of the Korean housing association
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• v.19 no.2
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• pp.1-10
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• 2008

The purpose of this research is to compare residents' movement and activities in SH apartment in Yangcheon-Gu, Seoul (SH apartment) and PHA apartment in St. Paul, Minnesota (PHA apartment) in order to improve the quality of rental housing environment. This study had surveyed 418 residents of SH apartments in Korea and used the secondary data gathered from 1,462 residents of PHA apartments in the United States. The results of this study are as follows: The criteria of Korean residents in SH apartments when choosing their residences are lower rent payment and shorter waiting time. They seemed to have no other options than public rental housing. On the contrary, American residents in PHA apartment had more option to choose from. Therefore, Korea needs to offer more variety types of residents that can be lead to better satisfaction of low income classes. Most of the SH apartments residents has lived for long-term, in the average of more than 6 years, and wanted to live continually at their current dwelling. PHA residents showed similar tendency. However, long term residency may lead to permanent occupation of the public rental apartment by the same family. Hence, a system which can provide equal residency opportunities to all low-income classes need to be developed. Residents of SH apartment were satisfied with the personal activities but were not satisfied with group activities among residents or regarding resident meetings. However, residents of PHA apartments were more satisfied with their management because there is more in-housing-complex activity programs. Therefore, more activity program for a resident should be developed after analysing programs of different apartments and current conditions in Korea. There were some noticeable divergences among residents, based on their age, term of residence and physical, emotional and mental problem, when evaluating in-housing-complex's programs. Thus, these factors are also need to be considered when planning and examining evaluation about the management of rental apartments.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.144-149
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• 2006

Purpose: To evaluate the clinical characteristics and the functional results of the osteochondral lesions of the talus (OLT) treated with arthroscopic osteochondroplasty. Materials and Methods: The study was based on 25 cases (25 feet) of osteochondral lesion of talus that were treated with arthroscopic osteochondroplasty from May 1997 to June 2005 with at least 1 year follow-up. Follow-up period was average 21.8 months. The average age was 37.2 years old. Male patients were 22 while female were 3. Postoperative evaluation was performed with American Orthopedic Foot and Ankle Society (AOFAS) Functional score, patient satisfaction and complications. Results: Ninety-two percent of patients had trauma history. Seventy-two percent of the lesions were located at the medial dome. As for the cartilage classification, 56% were fibrillation/fissure lesions while 44% were flap tears. Visual analogue scale (VAS) pain score improved from 6.8 points to 2.2 points, and AOFAS score improved from 71.3 points to 87.3 points. Eighty-eight percent of the patients were satisfied with the surgery and average period of returning to previous job was 6.5 weeks. Conclusion: We concluded that the arthroscopic osteochondroplasty is a viable surgical option for the osteochondral lesion of the talus.