• Clinics in Shoulder and Elbow
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• v.5 no.1
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• pp.47-54
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• 2002

Purpose : We evaluated clinical result of arthroscopic and open Bankart repair in anterior shoulder instability to identify factors iuluencing operative result and prognosis. Materials & Methods . We reviewed 24 patients of anterior shoulder instability treated with arthroscopic Bankart repair in 16 cases and open Bankart repair in 8 cases. Average age was 26 years old and involved in dominant arm in 15 cases. Patients were suffered instability for 3.1 years before operation and mean follow-up was 2 year 9 months ( 1 you 9 months -4year 10 months). Results : Post operative pain was subsided in 2 weeks in arthroscopic surgery and 3 weeks in open surgery. The final range of motion after arthroscopic repair were flekion in 168" , external rotation in 54" , and internal rotation in 79, and after open repair 168" ,49" , and 78 respectively. In arthroscopic surgery,2 cases (13%) were redislocated, and 4 cases(25%) showed mild instability. In open case,1 case (11%) showed mild instability. According to function- al result by Rowe grading scale, satisfactory results were 12case (76%) in arthroscopic repair and 7 cases (88%) in open cases. Conclusions Both arthroscopic or open Bankart could get good results in the treatment of anterior instability of shoulder. In arthroscopic repair, perioperative morbidity was lower than open repair, but it needs careful rehabilitation program to prevent redislocation and to return to sports activity.

• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.60-66
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• 2016

Background: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. Methods: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. Results: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). Conclusions: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.

• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.110-116
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• 2016

Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision.

• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.118-123
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• 2002

Purpose: The purpose was to identify the effectiveness of beach-chair position in the arthroscopic Bankart repair over conventional lateral decubitus position with distal traction. Materials & Methods: 36 arthroscopic Bankart repair through July 2000 to July 2001 was done under beach chair position. All cases were shoulder instability. Male patients were 6 and female were 4 with average age of 25 years. Arthroscopic suture anchor was used in 24 cases and average number was 3. Results: Interscalene block was tried in 29 patients and 1 case was changed to general anesthesia. Arthroscopic examination to identify Bankart lesion and associated pathology was done without difficulty Bankart lesions were easily reduced to anatomic position and placed suture anchor and hooking approprately. After the arthroscopic examination,3 cases were converted to open procedure without any positional change. Conclusion: Under interscalene block, the preparation was more simple and the patient could watch arthroscopic procedure with confidence. There was no hindrance in arthroscopic examination and arthroscopic repair could be dont: in more anatomic position. It can be easily changed to open repair if it needed

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.70-75
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• 2004

Purpose: To evaluate the results of arthroscopic repair of traumatic anterior shoulder instability with glenoid bone defect. Materials and Methods: Nineteen patients who had underwent arthroscopic repair for the shoulder with traumatic anterior instability and glenoid bone defect were retrospectively reviewed. Mean age was 24.6 years(range, 20 to 39) and mean follow-up was 23 months(range, 19 to 55). No glenoid bone defect was greater than 7mm in length and 20% of the glenoid. The results were evaluated according to stability, range of motion and function. Results: All patients obtained excellent-good results according to Rowe scoring system. Two patients(10.5%) had instability. The mean loss of external rotation was 15 degrees (range, 0 to 25). Functionally, 17 patients could participate in preinjured work or sports to the same level with or without mild discomfort. The remained 2 patients who had 25 degree loss of external rotation could not play sports. Conclusion: Though arthroscopic repair is a good treatment for traumatic anterior shoulder instability with small glenoid bone defect, it is possible to cause loss of external rotation

• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.84-89
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• 2016

Background: The purpose of this study was to assess the results of arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Methods: From November 2009 to April 2011, 12 patients underwent arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Patients were followed for an average of 33.9 months. Clinical outcome was evaluated preoperatively and postoperatively using the mean University of California, Los Angeles (UCLA) score and the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging (MRI) was performed postoperatively at an average of 6.5 months. Results: At a mean follow-up of 33.9 months (range, 25 to 42 months), 11 out of 12 patients were satisfied with their procedure. Patients showed significant improvement in their mean modified UCLA score from 15.9 preoperatively to 29.4 postoperatively (p=0.001). The mean KSS score improved from 45.6 preoperatively to 80.5 postoperatively (p=0.002). In MRI studies, 9 out of 12 patients had full incorporation of the graft into the native rotator cuff remnant. To date, there has been no intraoperative or postoperative complication from the graft procedure, such as infection or allograft rejection, in any patient. Conclusions: Arthroscopic bridging repair using a human dermis allograft can be considered as an option in treatment of select cases of massive irreparable rotator cuff tears, resulting in high patient satisfaction.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.50-54
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• 2003

Object: To evaluate the efficiencies of the arthroscopic rotator cuff surgery which is Performed without the traction system in the lateral decubitus position. Methods: Twenty-nine cases of the arthroscopic rotator cuff surgery performed without the traction system in the lateral decubitus position were studied from February, 2002 to January, 2005. We performed a repair using the arthroscopic debridement and the arthroscopic rotator cuff repair, or using the mini-open incision technique after the confirmation of rotator cuff tear, then, the arthroscopic subacromial decompression was performed after the confirmation of subacromial lesions Results: We could easily find the subscapularis tear which was often overlooked in the arthroscopic rotator cuff surgery performed with the traction surgery by the relaxation of the subscapularis, as the arm position was internally rotate about 45 to 70 degrees from abducted position. We found that the operation time was reduced 14 minutes shorter than the operation time of the controlled group which had the surgery with the traction system on the average. We also found that there were no neurovascular complications from all cases. Conclusions: The arthroscopic rotator cuff surgery without traction system in the lateral decubitus position provided the better visual field, easy manipulation of the joint and reducing operation time.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.183-189
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• 2019

Background: Since the establishment of biological augmentation to improve the treatment of rotator cuff tears, it is imperative to explore newer techniques to reduce the retear rate and improve long-term shoulder function after rotator cuff repair. This study was undertaken to determine the consequences of a gel-type atelocollagen injection during arthroscopic rotator cuff repair on clinical outcomes, and evaluate its effect on structural integrity. Methods: Between January 2014 and June 2015, 121 patients with full thickness rotator cuff tears underwent arthroscopic rotator cuff repair. Of these, 61 patients were subjected to arthroscopic rotator cuff repair in combination with an atelocollagen injection (group I), and 60 patients underwent arthroscopic rotator cuff repair alone (group II). The visual analogue scale (VAS) for pain and the Korean Shoulder Society (KSS) scores were evaluated preoperatively and postoperatively. Magnetic resonance imaging (MRI) was performed at 6 months postoperatively, to assess the integrity of the repair. Results: VAS scores were significantly lower in group I than in group II at 3, 7, and 14 days after surgery. KSS scores showed no significant difference between groups in the 24 months period of follow-up. No significant difference was obtained in the healing rate of the rotator cuff tear at 6 months postoperatively (p=0.529). Conclusions: Although a gel-type atelocollagen injection results in reduced pain in patients at 2 weeks after surgery, our study does not substantiate the administration of atelocollagen during rotator cuff repair to improve the clinical outcomes and healing of the rotator cuff.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.334-338
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• 2022

Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.21-21
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• 2007