• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.101-102
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• 2007

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.65-72
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• 2007

Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above $90^{\circ}$. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2002.03a
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• pp.109-109
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• 2002

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.5-9
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• 2004

Purpose: To identify associated findings in glenohumeral joint in rotator cuff tear and evaluate its clinical significance, we examined minor and major changes during arthroscopic or mini open repair. Materials & Methods: We reviewed 66 patients of rotator cuff tear treated from March, 2001 to January, 2004. Of 38 cases of small to medium tear, average age was 53 years old and involved in dominant arm in 27 cases. Of 28 cases of large to massive tear, average age was 58 years old and involved in dominant arm in 26 cases. Minor and major associated changes of the glenohumeral joint were evaluated in the tendon of biceps long head, biceps pulley, cartilage of the glenoid and humeral head, labrum and synovium. Results: Minor changes in biceps tendon were in 35% of cases, biceps pulley in 18%, cartilage of humeral head in 27%, cartilage of glenoid in 18%, labrum in 38%, and synovium in 42%. Major changes in biceps tendon were in 6% of cases, biceps pulley in 35%, arthritis of humeral head in 3%, arthritis of glenoid in 2%, labrum in 6%, and synovium in 21 %. Major changes in biceps tendon were 5% in Group I and 7% in Group Ⅱ(p>0.05) and in biceps pulley, 18% and 57% in each (P<0.05). Minor changes of arthritis were prevalent in glenoid cartilage and major changes were more prevalent in humeral head. There were no differences in minor changes of labrum and synovium, but major changes were more prevalent in Group Ⅱ. Conclusion: The prevalence of intraarticular associated changes of rotator cuff tear were 63% in synovium, 54% in labrum, 53% in biceps pulley, 41% in biceps tendon, 30% in humeral head and 20% in glenoid cartilage in order. Major changes of biceps pulley, humeral head, labrum and synovium were more prevalent in Group Ⅱ.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.136-139
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• 2007

Shoulder arthroscopic surgeries are an accepted technique for many shoulder disease and have many advantages over open surgeries. To date, shoulder arthroscopic surgery have been rare complications that compromise patient airway, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. This report presents a case of life-threatening airway obstruction due to extra-articular saline collection during arthroscopic rotator cuff repair. In concluding we should hourly check the patient's neck swelling undergoing shoulder arthroscopic surgery, because anesthetized patients cannot complain of the airway problem may progress until it becomes life-threatening.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.8-12
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• 2006

회전근 개 파열이 왜 통증을 일으키며 어떤 경우 통증을 일으키는가에 대해 아직도 모르는 부분이 많다. 그러나 생 역학적으로 회전근 개 질환을 이해하고 접근하면 순리적으로 풀어져 나가는 부분도 많다. 회전근 개가 파열되었어도 통증이 미약하다면 수술보다는 적극적인 보존적 치료가 원칙이다. 만약 수술을 하는 경우 고식적인 방법으로 충분한 경험을 쌓은 후 관절경술을 시도하여야 한다. 물론 최근 관절경술로 파열된 회전근 개를 봉합하여 주는 것이 선호되고 있으며 치료 결과 역시 관절경술이 더 좋을 수는 있으나 불안정성과 마찬가지로 전례에서 가능한 것도 아니고 만족한 결과를 모든 정형외과 의사가 공히 얻는 것은 아니다. 특히 회전근 개 봉합술은 고도의 관절경술 수기가 요구되는 것이므로 충분한 연마가 요구된다.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.12a
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• pp.31-33
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• 2004

소절개 봉합술은 관혈적 봉합술에 비해 동반된 상완관절와 관절(glenohumeral joint)내의 병변을 확인하고 이에 대한 처치를 시행할 수 있으며, 견봉하 감압술과 함께 동반된 견봉 쇄골 관절의 병변을 치료할 수 있다. 또한 삼각근 기시부에 대한 손상을 최소화하기 때문에 마른 재활과 조기 퇴원을 시행할 수 있는 둥의 장점이 있다. 관절경적 봉합술에 비해서는 수술 술기가 어렵지 않기 때문에 항상 좋은 결과를 기대할 수 있다. 회전근개 파열에 대한 수술을 시행할 때 관절경적 봉합술이 모든 경우에서 관혈적 또는 소절개 봉합술에 비해 좋은 결과를 나타내는 것은 아니다. 환자가 심한 골다공증이 있는 경우, 기술적 문제가 있는 경우, 봉합후 회전근개에 지나친 긴장이 염려될 때는 항상 소절개 봉합술로의 전환을 시도하여야 한다. 소절개 봉합술을 시행한 경우에도 관절경적 봉합술시와 비슷한 좋은 결과를 얻을 수 있고, 치료의 결과는 수술의 종류보다는 정확한 술기 및 술전 환자의 상태에 좌우된다고 하겠다.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.2
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• pp.98-99
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• 2004

소절개 봉합술은 관혈적 봉합술에 비해 동반된 관절와 상완 관절(glenohumeral joint) 내의 병변을 확인하고 이에 대한 처치를 시행할 수 있으며, 견봉하 감압술과 함께 동반된 견봉 쇄골 관절의 병변을 치료할 수 있다. 또한 삼각근 기시부에 대한 손상을 최소화하기 때문에 빠른 재활과 조기 퇴원을 시행할 수 있는 등의 장점이 있다 관절경적 봉합술에 비해서는 수술 술기가 어렵지 않기 때문에 항상 좋은 결과를 기대할 수 있다 회전근 개 파열에 대한 수술을 시행할 때 관절경적 봉합술이 모든 경우에서 관혈적 또는 소절개 봉합술에 비해 좋은 결과를 나타내는 것은 아니다. 환자가 심한 골다공증이 있는 경우, 기술적 문제가 있는 경우, 봉합 후 회전근 개에 지나친 긴장이 염려될 때는 항상 소절개 봉합술로의 전환을 시도하여야 한다. 소절개 봉합술을 시행한 경우에도 관절경적 봉합술시와 비슷한 좋은 결과를 얻을 수 있고, 치료의 결과는 수술의 방법보다는 정확한 술기 및 수술 전 환자의 상태에 좌우된다고 하겠다.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.164-164
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• 2008

The beach-chair traction position is designed to allow the use of traction while allowing the surgeon to orient the shoulder in an upright position and convert to an open procedure, if necessary. The patient is placed in the beach-chair position under general anesthesia. A three-point shoulder holder (Arthrex, Naples, Florida) is attached to the rail of the operating table on the same side as the surgeon, whereas it is placed on the side opposite the surgeon in the lateral decubitus position. A shoulder traction and rotation sleeve (Arthrex) are affixed to the arm following the manufacturer's instructions. Positioning the thumb toward the closed side of the sleeve ensures a field for the anterior portion of the rotator cuff and prevents the tendency of the suspension apparatus to place the arm in internal rotation. The arm is maintained in 30 to 40 degree abduction and 30 to 40 degree flexion by controlling the length and height of the bar and the location of the universal clamp. The universal clamp allows multiple planes of adjustment to control abduction and forward movement of the arm. The sleeve is attached to the longitudinal traction cable using a sterile hook, and a lateral strap is secured around the proximal portion of the sleeve to the overhead traction cable to ensure a field for glenohumeral reconstruction. The use of a lateral strap permits ideal shoulder positioning for improved access to the anterior and inferior glenohumeral joint. The lateral strap can be released or removed to widen the subacromial space during subacromial decompression or rotator cuff repair. A 10-lb weight is attached to the longitudinal traction cable for an average-sized person.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.207-214
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• 2009

Purpose: In arthroscopic rotator cuff repairs there are generally weak link in tendon suture interface, arthroscopic rotator cuff repairs can have higher retear rates than open repairs. The purpose of this study was to compare the strength of UU (Ulsan University) suture than open modified MA (Mason-Allen) suture when suture anchored into bone. Materials and Methods: The human supraspinatus tendons were harvested from the shoulder of the cadaver and split in 2 times, producing four tendons per one shoulder, for a total of 24 specimens. Two suture configurations (UU, MA) were randomized and checked on each set of tendons. Specimens were cyclically loaded under force control between 5 and 30 N at 0.25 Hz for fifty cycles. Each specimen was loaded to failure under displacement control at 1 mm/sec. Cyclic elongation, peak to peak displacement, stiffness, ultimate tensile load, mode of failure were checked. Results: No significant difference was found between two suture configuration with respect to peak to peak displacement, cyclic elongation, and stiffness. With regard to ultimate failure load, there were no significant difference statistically between the UU suture and modified MA suture (109.4 N, 110.6 N). The most common mode of failure between both sutures was suture pull-out through the tendon. Conclusion: The UU suture and modified MA suture produced similar biomechanical properties.