• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.110-114
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• 1999

We reviewed the results of arthroscopic surgery in patients with rotator cuff disease. Arthroscopic subacromial decompression(ASD) was performed on 22 patients with rotator cuff disease who had not responded to nonoperative measures. In the patients who had a complete tear of the rotator cuff(four of ten Neer's stage III patients), mini-open repair also was performed. Results were determined by questioning patients about their satisfaction with the outcome of surgery and by functional assessment of the shoulder with the parameters of pain, function, and range of motion according to the UCLA shoulder rating scale. The average follow-up was 21 months. The results were sixteen(72%) excellent, three(14%) good, two(9%) fair, and one(5%) poor. The following variables were analyzed to assess their influence on final outcome; duration of preoperative symptoms, Neer's stage(extent of damage to the cuff), type of acromion. Satisfactory results were achieved in thirteen of fourteen patients(93%) who had duration of preoperative symptoms below one year, and in four of six(67%) above 2 years. And satisfactory results were achieved in eleven of twelve patients(92%) who had Neer's stage II and in eight of ten(80%) stage III and achieved in six of seven patients(86%) who had Bigliani's acromion type I, in nine of eleven(82%) type II, and in four of four(100%) type III. There are multiple factors that may influence the recovery after ASD or the eventual outcome. However, although there is still a controversy about the pathogenesis of rotator cuff disease, We found that arthroscopic subacromial decompression and mini-open repair in patients with rotator cuff disease were well enough documented to be considered a standard treatment.

• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.176-180
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• 2006

Purpose: Although surgical arthroscopic repair of rotator cuff has become much more common as surgeons have developed proficient techniques, it is still technically difficult. The purpose of this study was to evaluate the clinical results and the usefulness of mini-open repair in large and massive size tears. Materials & Methods: From January 2000 to December 2004, sixteen patients were treated with mini-open repair. There were 10 male and 6 female patients with the average age of 62.5 years. The size of tear was massive in 4 cases and large in 12 cases. All tears were repaired with metal anchor sutures. The mean duration of follow-up period was 23 months. Postoperative results were evaluated based on American Shoulder and Elbow Society scoring system. Results: Five patients showed excellent results, five good, and two fair in large tears while one patient showed excellent result, one good, and two fair in massive tears. Poor outcome was not seen during the follow-up period. There was no significant relationship between the patient's age and the size of tear, and postoperative results. However, the relationship between the duration of symptomatic period in preoperation and postoperative results showed significant correlation. Conclusion: Mini-open repair combined with the preservation of deltoid and early rehabilitation is clinically useful in large and massive size rotator cuff tear patients treatment.

• Clinics in Shoulder and Elbow
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• v.11 no.1
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• pp.29-36
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• 2008

Purpose: We wanted to evaluate the relationship between the clinical outcomes and cuff integrity after open rotator cuff repair and we wanted to analyze the causes of rotator cuff retear. Materials and Methods: 78 patients who underwent open rotator cuff repair were enrolled from 2004 to 2006. All the patients were observed for a minimum follow-up of 12 months and they were evaluated by magnetic resonance imaging (MRI). The clinical outcomes were accessed by dividing the patients into the retear group and the intact group. The groups were also compared to analyze the cause of rotator cuff retear according to the preoperative tear size, the symptom duration, and so on. Results: The clinical outcome of the retear group (n=22) was improved significantly after operation (p<0.001, p<0.001), but the muscle power was not improved significantly (p=0.099, p=0.243). More retears were found in the patients who had a larger preoperative tear (p<0.001) and the symptom duration of the retear group was longer (p=0.027). Conclusion: Although there were retear after rotator cuff repair, the clinical outcomes were improved. Yet the muscle power of the supraspinatus and external rotator were not improved significantly. There were more retears for the cases that had a larger preoperative tear size and a longer duration of symptoms.

• Journal of the Korean Orthopaedic Association
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• v.55 no.2
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• pp.103-116
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• 2020

The incidence of rotator cuff tear is increasing rapidly due to the aging of the population and the advancement of radiological diagnosis, and so on. Recently, arthroscopic rotator cuff repair is common way of surgery, and the surgical outcome is comparable to open rotator cuff repair. Arthroscopic repair is one of the minimally invasive procedures itself and may have additional benefits of postoperative pain reduction and early functional recovery. Recently, there has been increasing interest in various methods for improving the functional recovery of patients after arthroscopic shoulder surgery. Various protocols of functional recovery after arthroscopic shoulder surgery are classified by the postoperative period, and they are being studied actively and improved at each stage. On the other hand, there are a range of methods according to the postoperative period, rehabilitation stage, characteristics of individual patients, degree of rotator cuff tear, and underlying disease. Therefore, for functional recovery after arthroscopic rotator cuff repair, it is essential to establish proper regimens for functional recovery.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.4
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• pp.485-492
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• 2014

PURPOSE: This study aimed to examine the pain, range of motion (ROM), upper extremity task performance, and functional levels of patients after rotator cuff repair according to the timing of a closed chain exercise thereby presenting basic data for an effective rehabilitation program. METHODS: The intervention was applied three times per week, one hour per day, for four weeks to 40 participants, 78 of whom had undergone rotator cuff repair. The participants were divided into four groups and assigned to usual general physical therapy and an open chain exercise. Group I consisted of the open chain exercise only. The closed chain exercise was applied to group II after the 4 times, group III after the 7 times, group IV after the 10 times. Measurement were used ROM, visual analogue scale (VAS), box and block test (BBT), and shoulder pain and disability index (SPADI). A one-way analysis of variance was conducted to test differences. RESULTS: There were significant differences in the internal/external rotation between group I and group II. The VAS significantly differed between group II and group I, group III, and group IV. The BBT results of group II and group I were significantly different compared to those of group IV. The SPADI significantly differed between group II and group I and between group II and group IV. CONCLUSION: The closed chain exercise was effective for patients following rotator cuff repair from the second week after active exercise was prescribed, verifying its applicability in rehabilitation programs.

• Clinics in Shoulder and Elbow
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• v.5 no.2
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• pp.88-97
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• 2002

The purpose of this study was to compare the outcomes between arthroscopir repair and mini-open repair of medium and large rotator cuff tears in which arthroscopic repair was technically unsuccessful. We evaluated 76 patients of full-thickness rotator cuff tears, among them 42 patients had all-arthroscopic and 34 patients had mini-open salvage repairs. Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 males and 37 females with mean age of 56 years (range,42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared with regard to the UCLA and ASES shoulder rating scale s. Shoulder scores improved in all ratings in both groups (p > 0.05). Overall, sixty-six patients showed excellent or gr)of and ten patients showed fair or poor scores by the UCLA scale. Seventy-two patients satisfactorily returned to prior activity. Four showed unsatisfactory return. The range of motion, strength, and patient's satisfaction were improved postoperatively. There were no difference in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (p > 0.05). However, Patients with larger size tear showed lower shoulder scores and less predictive recovery of the strength and function (p < 0.05). Postoperative pain was not different with respect to the size of the tear (p : 0.251). Arthroscopic repair of medium and large full-thickness rotator cuff tears had iln equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini- open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.

• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.135-137
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• 2009

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.222-228
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• 2011

Purpose: To compare the mid-term clinical results of arthroscopic and open repair for large to massive rotator cuff tear. Materials and Methods: We retrospectively reviewed 48 patients who underwent either arthroscopic or open repair for large to massive rotator cuff tear. 28 patients underwent arthroscopic repair and 20 patients had open repair. The clinical outcome for the 2 groups was evaluated using range of motion, Visual Analogue Scale (VAS) for pain and function, American Shoulder and Elbow Society (ASES) score and Korean Shoulder Scoring System (KSS) score. Results: The range of motion, VAS for pain and function and ASES score was improved significantly in both groups at the final follow-up visit compared with preoperative values. However, there were no significant differences between the two groups statistically (p>0.05). There were no significant differences between the two groups statistically at the final follow-up KSS score (p>0.05) either. Conclusion: We could obtain improved mid-term clinical outcomes in both arthroscopic repair and open repair without any statistically significant differences between the two groups.

• 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.

• Clinics in Shoulder and Elbow
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• v.13 no.1
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• pp.86-91
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• 2010

Purpose: To introduce mini-open rotator cuff repair using the anterolateral approach and evaluate its clinical outcomes and effectiveness. Materials and Methods: 59 consecutive cases of rotator cuff tearing which were treated with mini-open repair utilizing the anterolateral approach were evaluated. The population comprised 39 men and 20 women, with an average age of 56.6 years. An average follow-up time period was 26 months. Clinical outcomes were analyzed based on VAS, ADL, and ASES scores. Results: The average respective VAS, ADL, and ASES scores improved from 7.04, 12.37, and 35.32 preoperatively to 1.02, 27.20, and 90.08 postoperatively (p=0.000). There were 41 excellent, 11 good, 2 fair, and 5 poor results. There were satisfactory results in 52 cases (88.1%). There were no statistically significant differences between the final ASES scores and age, sex, duration of symptoms, tear size, and preoperative stiffness (p>0.05). Conclusion: Mini-open rotator cuff repair using the anterolateral approach effective in providing better visualization.