• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.3-10
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• 2020

Background: The aim of this study was to evaluate clinical experience with arthroscopic debridement for septic arthritis of the shoulder joint and to report on our patient outcomes. Methods: The retrospective analysis included 36 shoulders (male:female, 15:21), contributed by 35 patients (mean age, 63.8 years) treated by arthroscopy for septic arthritis of the shoulder between November 2003 and February 2016. The mean follow-up period was 14.3 months (range, 12-33 months). An additional posterolateral portal and a 70° arthroscope was used to access the posteroinferior glenohumeral (GH) joint and posteroinferior subacromial (SA) space, respectively. Irrigation was performed with a large volume of fluid (25.1±8.1 L). Multiple suction drains (average, 3.3 drains) were inserted into the GH joint and SA space and removed 8.9±4.3 days after surgery. Intravenous antibiotics were administered for 3.9±1.8 weeks after surgery, followed by oral antibiotic treatment for another 3.6±1.9 weeks. Results: Among the 36 shoulders, reoperation was required in two cases (5.6%). The average range of motion achieved was 150.0° for forward flexion and T9 for internal rotation. The mean simple shoulder test score was 7.9±3.6 points. Nineteen shoulders (52.8%) had acupuncture or injection history prior to the infection. Pathogens were identified in 15 shoulders, with Staphylococcus aureus being the most commonly identified pathogen (10/15). Both the GH joint and the SA space were involved in 21 shoulders, while 14 cases involved only the GH joint and one case involved only the SA space. Conclusions: Complete debridement using an additional posterolateral portal and 70° arthroscope, a large volume of irrigation with >20 L of saline, and multiple suction drains may reduce the reoperation rate.

• Clinics in Shoulder and Elbow
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• v.6 no.1
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• pp.55-66
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• 2003

Background: The purpose of this study was to evaluated results of arthroscopic treatment of the traumatic recurrent unidirectional posterior subluxation. Materials and Methods: We treated twenty-seven patients who had traumatic recurrent unidirectional posterior subluxation of the shoulder by arthroscopic labral repair and posterior capsular shift and prospectively evaluated for a mean of thirty-nine months (range,24 to 85 months). Patients who had posteroinferior instability, multidirectional instability, atraumatic onset, or revision cases were excluded. There were twenty-five male and two female patients with the mean age of twenty-one years (range, 14 to 33 years). All patients were involved in sports activity. All had a significant traumatic event prior to the onset of the instability. Stability, motion, three objective measurement (UCLA, ASES, and Rowe scores) and two subjective measurements (pain and function visual analogue scale) were evaluated. Results: The most common finding in magnetic resonance image-arthrogram was separation of the posteroinferior labrum without displacement in 9 patients, In arthroscopic examination, all patients had one or more lesions in the posterior inferior labrum and capsule. The most common finding was incomplete stripping of the posterior inferior labrum (18 patients). The posteroinferior capsule subjectively appeared to be stretched in twenty-two patients. At follow-up, all patients had improved shoulder function and scores(p < 0.01). All patients had stable shoulder by subjectivel and objectivel measurements, except one patient who had recurrent subluxation. All but one patient with postoperative recurrence were able to return to their prior sports activity with little or no limitation. Twenty-four patients were graded as having more than 90％ of shoulder function. Their were twenty-one excellent, five good, and one fair UCLA. scores. Pain sore improved from 4.5 to 0.2 point(p : 0.0001). Mean loss internal rotation was one vertebral level. None had operative complications. Conclusion: In conclusion, treatment outcomes of the traumatic unidirectional recurrent posterior subluxation are consistently reliable with respect to the stability, pain relief, and functional restoration by the arthroscopic posterior capsular shift procedure.

• Korean Journal of Applied Biomechanics
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• v.16 no.4
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• pp.49-59
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• 2006

The purpose of this study was to investigate the relations between the segments of the body, the three dimensional anatomical angle according to sweep shot in ice hockey. The subjects of this study were five professional ice hockey players. The reflective makers were attached on anatomical boundary line of body. For the movement analysis three dimensional cinematographical method(APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVIEW 6.1 graphical programming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and ice hockey stick were defined. 1. In three dimensional linear velocity of blade the Y axis showed maximum linear velocity almost impact, the X axis(horizontal direction) and the Z axis(vertical direction) maximum linear velocity of blade did not show at impact but after impact this will resulted influence upon hitting puck. 2. The resultant linear velocity of each segment of right arm showed maximum resultant linear velocity at impact. It could be suggest that the right arm swing patterns is kind of push-like movement. therefore the upper arm is the most important role in the right arm swing. 3. The three dimensional anatomical angular displacement of trunk in flexion-extension showed flexion all around the wrist shot. The angular displacement of trunk in internal-external rotation showed internal rotation angle at the backswing top and and increased the angle after the impact. while there is no significant adduction-abduction. 4. The three dimensional anatomical angular displacement of trunk showed most important role in wrist shot. and is follwed by shoulder joints, in addition the movement of elbow/wrist joints showed least to the shot. this study result showed upperlimb of left is more important role than upperlimb of right.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.7
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• pp.134-141
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• 2009

Recently, many researchers have tried to develop wearable robots for various fields such as medical and military purposes. We have been studying robotic exoskeletons to assist the motion of persons who have problems with their muscle function in daily activities and rehabilitation. The upper-limb motions (shoulder, elbow and wrist motion) are especially important for such persons to perform daily activities. Generally for shoulder motion 300F is needed to describe its motion(extension/flexion, abduction/adduction, internal/external rotation) but we have used a redundant actuator thus making a 4 DOF system. In this paper, we proposed the mechanism design of the exoskeleton which consists of 4-DOF for shoulder and 1-DOF for elbow robotic exoskeleton to assist upper-limb motion. Then we compared the new mechanism design and prototype mechanism design. Here we also analyze the proposed system kinematically to find out and to avoid the singular point. This research will ensure that the proposed wearable robot system make human's motion more powerfully and more easily.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.17-26
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• 2002

Purpose: This study was conducted to evaluate the effects of aerobic dance on physical functionnings of women with mastectomy. The study was single group pre- & post-test time series design. The aerobic dance program was performed three times a week for eight weeks, 45${\sim}$60 minutes per session. Method: The research variables used in the study were the period(seconds) of exercise that was taken for target heart rate, activity systolic pressure, range of motion of shoulder joint in affected side, and flexibility for physical functionnings. The data were analyzed with repeated measure ANOVA and Bonferroni multiple comparisons. Results: Over the period of aerobic dance, the degree of all the research variables were changed significantly, and also differed significantly every 2 to 4 weeks. The period(seconds) of exercise that was taken for target heart rate (p <.000), systolic pressure in exercise(p =.019), range of motions of shoulder joint on the affected side(flexion, abduction, over-adduction, over-extension, external & internal rotation), and flexibility(sit & reach, back & reach) (p= .003; p=.001; p(.001; p<.001; p= .014; p<.001; p=.036; p<.001) were differed significantly respectively. Conclusion: The results suggest that the aerobic dance program for women with mastectomy can improve and recover cardiopulmonary endurance and ROM of shoulder joint and that the period of exercise had to be performed over six to eight weeks and three times a week at least.

• Clinics in Shoulder and Elbow
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• v.18 no.1
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• pp.36-42
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• 2015

Background: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. Methods: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged ${\geq}40years$. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. Results: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. Conclusions: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.280-285
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• 2010

Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.

• Korean Journal of Applied Biomechanics
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• v.17 no.4
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• pp.169-179
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• 2007

The purpose of this study was to investigate the relations between the segments of the body and to qualitatively analyze coordination pattern of joints and segments during Sweep Shot movement in Ice Hockey, by utilizing coordination variables was angle vs. angle plots. By the utilization the three dimensional anatomical angle cinematography, the angles of individual joint and segment according to sweep shot in ice hockey. The subjects of this study were five professional ice hockey players. The reflective makers were attached on anatomical boundary line of body. For the movement analysis three dimensional cinematographical method(APAS) was used and for the calculation of the kinematic variables a self developed program was used with the LabVIEW 6.1 graphical programming(Johnson, 1999) program. By using Eular's equations the three dimensional anatomical Cardan angles of the joint and ice hockey stick were defined. The three dimensional anatomical angular displacement and coordination pattern of trunk and Upper limb(shoulder-elbow, elbow-wrist linked system) showed important role of sweep shot in ice hockey. As the result of this paper, for the successful movement of sweep shot in ice hockey, it is most important role of coordination pattern of trunk-shoulder, shoulder-elbow and elbow-wrist. specially turnk movememt as a proximal segment. Coordination pattern of Upper Limb(upperarm-forearm-hand) of Sweep Shot movement in Ice Hockey that utilizes coordination variables seems to be one of useful research direction to understand basic control mechanisms of Ice hockey sweep shooting linked system skill. this study result showed flexion-extension, adduction-abduction and internal-external rotation of trunk are important role of power and shooting direction coordination pattern of upper Limb of Sweep Shot movement in Ice Hockey.

• Journal of Chest Surgery
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• v.27 no.12
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• pp.1008-1014
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• 1994

Increased interest in alternative approach to thoractomy has developed because of the considerable morbidity associated with the standard posterolateral thoracotomy[ST]. Muscle sparing thoracotomy is appeared as excellent alternative because of less postoperative pain and morbidity than standard posterolateral one. Vertical axillary muscle sparing thoracotomy[VM] is the newly revised modified muscle sparing thoracotomy that overcomes the disadvantages of previous lateral muscle sparing thoracotomy such as seroma, cosmetic problems, and need of subcutaneous drains. We conducted a prospective study of 45 consecutive patients to compare postoperative pain, muscle strength of serratus anterior and latissimus dorsi, and range of motion of the shoulder girdle between ST and VM group. There were no difference in preoperative status, surgical procedure, morbidity, mortality and hospital stay between two groups. But there were significant less postoperative narcotics requirements, more preserved latissimus dorsi and serratus anterior muscle strength, nd larger range of motion of shoulder girdle [ especially flexion and internal rotation in VM group. The opening time was prolonged[p<0.01] but closing time was less in VM group [p<0.01]. The sum of opening and closing time was not different in two group. The length of incision line was shorter in VM group. The vertical skin incision was concealed by the upper arm.In conclusion vertical axillary muscle sparing thoracotomy is good alternative for various intrathoracic procedures with less postoperative pain, well preserved muscle strength,increased range of motion of the shoulder girdle and impressive cosmetic outcome.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.3-9
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• 2017

Background: Many hyaluronic acid (HA)-based anti-adhesive agents have been commercialized for clinical use in the pharmaceutical market. But their efficacy in arthroscopic rotator cuff repairs remains elusive. To determine their efficacy, we performed a comparative analysis of the effects of two hyaluronate/carboxymethylcellulose (CMC)-based anti-adhesive agents, Protescal and Guardix. Methods: We recruited a total of 256 patients who had received an arthroscopic rotator cuff repair at our hospital between January 2014 and March 2015. Among them, 96 patients fulfilled the study's selection criteria and were enrolled as the final population sample. Thirty patients who had received a postoperative injection of Protescal were allocated into Group A. Another 30 patients who had received a postoperative injection of Guardix were allocated into Group B. As controls, 36 patients who did not receive any injection were allocated into Group C. The patients included in this study were aged between 19 and 75 years. For the clinical assessment, we measured the following clinical parameters-the visual analogue scale for pain (PVAS), the American Shoulder and Elbow Surgeons (ASES) score, and the constant score, as well as passive range of motions (ROMs)-at three time-points (preoperatively, 2-month postoperatively, and 6-month postoperatively). Results: We found that Group A compared to Group B tended to show a swifter recovery in passive anterior elevation and in internal rotation by the 2-month postoperative follow-up, but the differences were not statistically significant. Conclusions: We found that the effects of HA/CMC-based injections were minimal after arthroscopic rotator cuff repairs.