• The Korean Journal of Pain
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• v.33 no.4
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• pp.344-351
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• 2020

Background: The effects of far-infrared radiation (FIR) on the treatment of rotator cuff diseases remains unknown. We evaluated the safety and efficacy of FIR after arthroscopic rotator cuff repair with regard to postoperative pain and healing. Methods: This prospective randomized comparative study included 38 patients who underwent arthroscopic rotator cuff repair due to a medium-sized tear. Patients were randomly divided into the FIR or control group (n = 19 per group). In the FIR group, FIR with an FIR radiator started 1 week postoperatively for 30 minutes per session twice daily. It lasted until abduction brace weaning at 5 weeks postoperatively. We assessed pain using a pain visual analogue scale (pVAS) and measured the range of motion (ROM) of the shoulder at 5 weeks, and 3 and 6 months, postoperatively. The anatomical outcome was evaluated using magnetic resonance imaging at 6 months postoperatively. Results: At 5 weeks postoperatively, the average pVAS score was lower in the FIR group than in the control group (1.5 ± 0.8 vs. 2.7 ± 1.7; P = 0.019). At 3 months postoperatively, the average forward flexion was higher in the FIR group (151.6° ± 15.3° vs. 132.9° ± 27.8°; P = 0.045), but there was no significant difference at 6 months postoperatively. There was no significant difference in healing failure between the groups (P = 0.999). Conclusions: FIR after arthroscopic rotator cuff repair could be an effective and safe procedure to reduce postoperative pain, thereby facilitating rehabilitation and better ROM in the early postoperative period.

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.211-216
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• 2015

Background: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. Methods: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. Results: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. Conclusions: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.

• Journal of the Korean Society of Radiology
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• v.7 no.3
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• pp.191-198
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• 2013

We verified reason of pain by rotator cuff disease using shoulder sonography and found a correlation between shoulder pain and stress. To find out the accuracy of sonographic prediction of rotator cuff disease among the patients with shoulder pain we surveyed 184 patients in S hospital in Seoul Korea between January to October 2012. These patients were previously diagnosed with the torn rotator cuff, adhesive capsulitis and impingement syndrom with shoulder pain. In most times, the rotator cuff disease was diagnosed among the physical workers who use shoulder excessively and also in the women in their 50~60 years of age(144 patients, 78.3%). There were significant correlation between rotator cuff disease and the stress of pain, between sonographic prediction and pain(p<.05). There were significance between shoulder pain and stress in daily life according to result for survey of BEPSI-K(p<.05).

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.132-140
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• 2010

Purpose: Surgical treatment of massive rotator cuff tear is challenging and there are various surgical options. The purpose of this article is to describe arthroplasty for the treatment of massive rotator cuff tear. Materials and Methods: We reviewed all publications that focused on and/or mentioned arthroplasty as a treatment option for massive rotator cuff tear. Results: Arthroplasty can be used as primary treatment and represents a salvage option for irreparable rotator cuff tear. Hemi-arthroplasty can provide satisfactory results by Neer's limited goals criteria in patients with intact coracoacromial arch. In addition, reverse total shoulder arthroplasty can be a salvage option for pain relief and restoration of active flexion in elderly patients with pseudoparalysis. Conclusion: In patients with massive rotator cuff tear, proper selection of arthroplasty can provide pain relief and restoration of functional range of motion in shoulder joints.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.42-49
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• 2006

Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.

• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.20-26
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• 2006

Purpose: To evaluate the usefulness and functional results of open repair of massive rotator cuff tears combined with or without the tenoplasty of biceps long head. Materials and Methods: From March 2003 to August 2004, we evaluated 18 cases of the patient treated with open repair of massive rotator cuff tears. The mean age was 56 years and mean follow-up period was 15 months. We performed open repair of massive rotator cuff tears by tendon to bone repair, but in irrepairable 4 cases for tendon to bone repair performed open repair combined with tenoplasty of biceps long head. The functional results were assessed using the Constant score, the parameters of which were pain, dialy activity, mobility, strength and satisfaction. Results: The functional results were excellent in 4 cases, good in 8 cases, fair in 3 cases and poor in 3 cases. And the results of open repair combined with tenoplasty of biceps long head were good in 2 cases and fair in 2 cases. Re-repair was done in 1 case for re-rupture. And the functional result of this case was fair. The 3 poor cases were suspected re-rupture, the factor of which old age and weakened rotator cuff. It was impossible to do re-repair. Conclusion: The open repair combined with or without tenoplasty of biceps long head is a useful and effective method for massive rotator cuff tear.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.93-98
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• 1999

Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

• 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.

• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.30-36
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• 2018

Background: The Korean Shoulder Scoring System (KSS) is a reliable and valid procedure for discriminative assessment of the clinical status of patients with rotator cuff tears. This study evaluates the correlation between the preoperative KSS and factors in patients with rotator cuff tears. Methods: From November 2009 to June 2016, 970 patients who underwent arthroscopic rotator cuff repair were retrospectively evaluated. A total of 490 patients met the study criteria. Preoperative factors included age, sex, symptom duration, mediolateral (ML) and anteroposterior (AP) tear size, acromiohumeral distance (AHD), tangent sign, tendon involvement (type I, supraspinatus; type II, supraspinatus and subscapularis; type III, supraspinatus and infraspinatus; type IV, all 3 tendons), fatty infiltration of rotator cuff muscles (group I, Goutallier stages 0 and 1; group II, Goutallier stages 2, 3, and 4), and KSS. Results: Old age, ML tear size, and AP tear size negatively correlated with the preoperative KSS (p<0.001). AHD showed a positive correlation with the preoperative KSS (p<0.001). A significantly inferior preoperative KSS was found in females and type III tendon involvement (p<0.001). For supraspinatus and infraspinatus, the preoperative KSS of group II fatty infiltration showed a significantly lower score than group I fatty infiltration (p<0.05). Conclusions: A relatively lower preoperative KSS was associated with old age, large tear size, narrow AHD, female, type III tendon involvement, and group II fatty infiltration of the supraspinatus and infraspinatus. Our study indicates that preoperative KSS can be a good measurement for the preoperative status of patients with rotator cuff tears.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.119-125
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• 2009

The primary purposes of revision repair for a failed rotator cuff repair are a relief of pain and functional improvement. Therefore, revision repair is most proper in patients with the functional deficit accompanied with the shoulder weakness as well as the persistent pain. The important factor that is considered in revision repair is a quality of torn cuff. Especially, Care must be taken to ensure that the revision repair is possible, considering the size of tendon defect, atrophy of the muscle, fatty infiltration and extent of the retraction of tendon. Revision repair of a failed rotator cuff repair is more difficult, and the functional results are less satisfactory than those of primary repair, because excessive bursal scarring and tendon retraction may be exhibited, a large or massive tear is often detected, tear has usually been present for a long time, and a quality of muscle-tendon may be poor. So, we discuss our experiences related to revision repair after a failed cuff repair that has been recently introduced through the articles.