• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.18-25
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• 2024

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107°(±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.15-21
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• 2018

Background: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well. Methods: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM. Results: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], -0.255 [p=0.077], 0.068 [p=0.642], and -0.188 [p=0.196], respectively). Conclusions: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.

• Physical Therapy Korea
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• v.2 no.2
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• pp.46-55
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• 1995

The purpose of this study was to assess the concurrent validity and reliability of goniometric measurement of joint motion. Subjects were 40 healthy university students. Measurements were performed by 4 inexperienced physical therapy students. Four different instruments were used and three readings were taken with each instrument in random order making a total of 12 readings for flexion of the right elbow of each subject. Goniometers used were 1. universal 2. fluid-based goniometer/inclinometer 3. digital LCD goniometer 4. electronic goniometer/torsiometer. The results were as follows: Concurrent validity was highest (r= .94) with the universal and digital LCD tools. Interrater reliability (Pearson Product Moment Correlation) was good for each tool. Interrater reliability calculated by ICC(2,1) was highest (.96) with the tensiometer and lowest (.78) with the digital LCD goniometer. Intrarater reliability calculated by ICC was excellent (${\geq}.90$) for all instruments. These results show that concurrent validity, intrarater and interrater reliability are very good in the used of all four types of goniometers/inclinometer/tensiometer, even with inexperienced raters. These results confirm the almost universal reliance on hand held goniometers for joint measurement by physical therapists as being a reliable practice. Further research should be done clinically with actual patients.

• The Research Journal of the Costume Culture
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• v.25 no.3
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• pp.301-314
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• 2017

This study focused on the movement adaptability of $19^{th}$ century classical opera stage costumes. Researchers focused on a basic $19^{th}$ century women's jacket. The study analyzed movement adaptability using ROM (range-of-motion) tests of the upper limb flexion and abduction postures. It developed two research garments to mimic basic $19^{th}$ century style jackets with or without gussets at the axilla. The ROM experiment identified the gusset size as 11cm in length. Experimental postures included upper limb flexion and abduction. The study measured subjective comfort at 8 postures. These postures included the flexion and abduction of the arms and torso. Subjects also evaluated the subjective comfort of the rotation posture of the torso. Researchers evaluated the similarities between research garments' silhouettes and the $19^{th}$ century women's jacket. The study used a 3D virtual fitting system to evaluate fit, and specialists further analyzed fit with photographs and 3D virtual graphics. The results are as follows. The silhouettes of both research garments were similar to the silhouettes of the $19^{th}$ century western women's jacket. The jacket with axilla gusset had a better fit than the basic style jacket. The basic style jacket without the axilla gusset showed limited movement adaptability at the shoulder joint and it caused discomfort at the axilla and elbow. The 3D virtual fit test was not a suitable method for analyzing silhouette similarity.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.131-135
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• 2007

We report an isolated anterior dislocation of the radial head in a 23-year-old man after a fall on the outstretched arm. At the time of the injury, the patient's elbow was in a position of mild flexion and pronation which was suddenly further pronated as he fell down. The radial head was incarcerated by the lateral portion of brachialis muscle, and annular ligament was interposed between capitellum and radial head. Open reduction was performed. During 12 months follow-up, reduction of radial head was well maintained without a limitation of range of motion.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.40-46
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• 2012

Purpose: This study evaluated the clinical outcome of arthroscopic debridement of anterior compartment and mini-open resection of posterior osteophyte for the treatment of primary osteoarthritis of the elbow. Materials and Methods: Between March 2003 and Feburary 2010, 19 cases who were performed arthroscopic debridement of anterior compartment and resection of posterior osteophyte through mini-open procedure for refractory osteoarthritis of the elbow were enrolled. Average follow-up period was 19 months. Mean age was 49 years old. Clinical results were evaluated by the scoring system of Andrew-Carson Rating Scale (ACRS) and Mayo Elbow Performance Score (MEPS). Results: In the range of motion, flexion contracture was improved from $28.7^{\circ}$ preoperatively to $17.9^{\circ}$ postoperatively, further flexion was improved from $105.1^{\circ}$ to $121.8^{\circ}$. In the scoring system of MEPS, score was improved from 51.1 points preoperatively to 87.9 points in last follow up, 3 cases had in excellent result, 13 good and 3 fair. According to the scoring system of ACRS, score was improved from 92.9 points to 168.2 points, 3 excellent, 14 good and 2 fair. Except one case, all cases returned to preoperative ordinary daily living activity and their own job. Conclusion: For the treatment of refractory osteoarthritis of the elbow, arthroscopic debridement of the anterior compartment and mini-open resection of posterior osteophyte would be helpful on pain relief and functional recovery of the elbow. But this procedure was required long term follow-up in aspect of recurrence of osteophytes and progress of arthritis of the elbow.

• The Korean Journal of Applied Statistics
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• v.26 no.6
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• pp.873-887
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• 2013

The axis of rotation in biomechanics is a major tool to investigate joint function; therefore, many methods to estimate the axis of rotation have been developed. However, there exist several problems to describe, estimate, and test the axis statistically. The axis is directional data(axial data) and it should not be analyzed with traditional statistics. A proper comparative method should be considered to compare axis estimating methods for the same given data ANOVA (analysis of variance) is a frequently used statistical method to compare treatment means in experimental designs. In case of the axial data response assumed to come from Watson distribution, there are a few ANOVA method options. This study constructed ANOVA models for within-subjects designs of axial data. Two models (one within-subjects factor and two within-subjects factors crossed design) were considered. The empirical data used in this study were instantaneous axes of rotation of flexion/extension at the knee joint and the flexion/extension and pronation/supination at the elbow joint. The results of this study can be further applied to the various analysis of experimental designs.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.1
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• pp.1-6
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• 2017

Purpose: The purpose of this study was to explore the influence of a sling suspension exercise with abdominal drawing-in maneuver (ADIM) on the thickness of abdominal muscles. Method: Twenty healthy young women volunteered for this study, and they were randomly assigned to either the control group or experimental group. Subjects of both groups performed the ADIM in standard method. And subjects of the experimental group underwent a structured sling exercises additionally, which consists of bridging exercise on supine, elbow support and trunk control exercise on prone, and trunk flexion exercises. The exercises were performed thirty minutes per day, 3 times a week for a 4-week period. Thickness of abdominal muscles (transverse abdominis; TrA, internal obliques; IO and external obliques; EO) was measured by using real-time ultrasonography. Results: After the intervention, subjects of the experimental group appeared to be significantly increased for the thickness of the TrA (p<.05). However, significant difference weren't found for the IO and EO (p>.05). Conclusion: These findings suggest that sling suspension exercise with the ADIM may be favorably used to augment trunk stabilizing effort by increasing TrA thickness. Further studies need in this field.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.1
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• pp.9-19
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• 2010

Purpose : To identify whether isometric shoulder horizontal extension (ISHE) exercise could sufficiently activate the lumbar multifidus muscle, and to determine appropriate exercise intensity to increase muscle strength. Methods : Twenty healthy volunteers (10 males and 10 females) participated in this study. ISHE exercises on the dominant side were performed with $90^{\circ}$ shoulder abduction held in $90^{\circ}$ elbow flexion so that their arms were in the horizontal plane. Electromyographic (EMG) measurements of multifidus activation were performed in standing and supine positions, and were taken under four strength conditions: 75%, 50% and 25% of maximum shoulder horizontal extension strength, and maximum strength. Results : The EMG activations of both lumbar multifidus increased significantly with ISHE exercises of larger % strength (p<.05). In their multifidus EMG data measured in standing and supine positions, men differed significantly in their 75%, 50% and 25% strength for both sides (p<.05), and women differed significantly in their 75%, 50% and 25% strength on their 5th lumbar vertebrae's left side, but 75% only for their 5th lumbar vertebrae's right side (p<.05). The EMG data of 5th lumbar vertebrae's left and 5th lumbar vertebrae's right sides appeared to differ significantly at all strength levels for men while standing, but only at the 25% level for women in the supine position (p<.05). These findings indicate that ISHE exercises can be considered a beneficial method to enhance the multifidus strength. Conclusion : This study provides useful information for further study in this field.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.47-52
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• 2010

Purpose: To evaluate shoulder stability, clinical, and functional results more than 6 months after utilizing the 'Remplissage' technique, consisting of an arthroscopic posterior capsulodesis and infraspinatus tenodesis, to fill Hill-Sachs lesions. Materials and Methods: Seven patients were followed-up more than 6 months after the 'Remplissage' procedures performed in our hospital from August 2008 to August 2009. The mean age of the patients was 28.6 years and the mean follow-up time was 10 months. Evaluations included ROM, ASES score, KSSI score, ROWE score, and postoperative MRI. Results: In a functional evaluation of the patients with an average postoperative time of 10 months, the ASES score improved from 51.4 preoperatively to 76.8 postoperatively, the KSSI score improved from 46.5 preoperatively to 76 postoperatively, and the ROWE score improved from 43.5 preoperatively to 76.3 postoperatively. After an average postoperative time of 10 months, the range of motion was nearly normal (>170 degrees in further flexion, and >45 degrees in external rotation). Conclusion: In recurrent shoulder instabilities with large Hill-Sachs lesions, the 'Remplissage' technique resulted in good outcomes in terms of shoulder stability, clinical, and functional results after postoperative times of more than 6 months.