• Title/Summary/Keyword: Small-sized and medium-sized tear

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New Method and Clinical Results of Arthroscopic Mattress-Locking Suture for Small and Medium sized Rotator Cuff Tear (관절경적 매트리스 잠김 봉합술을 이용한 회전근 개 소범위 및 중범위 파열의 새로운 치료방법과 해부학적인 결과)

  • Ko, Sang-Hun;Park, Hang-Chang;Lee, Chae-Chil;Kim, Sang-Woo;Lee, Seon-Ho;Cha, Jeo-Ryung
    • Clinics in Shoulder and Elbow
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    • v.14 no.2
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    • pp.229-235
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    • 2011
  • Purpose: To compare the clinical and radiological result of arthroscopic Mattress Locking suture repair to that of a Simple suture repair with small and medium-sized rotator cuff tears. Materials and Methods: Among 92 patients who were followed up after arthroscopic repair in patients with small and medium-sized rotator cuff tear from April 2007 to October 2010, 27 patients who took Arthroscopic Mattress Locking suture were set as group I and 65 patients who took Simple suture were set as Group II. The average age of patients were 58 years old and average follow-up period was 30 months. For analysis, VAS, ASES and KSS were used to analyze the range of joint movement and pain. And, for the image result, MRI performed after operation were evaluated. Results: The average VAS, KSS, UCLA score and ASES prior to surgery improved in the last follow-up (p<0.001), while was no difference in two groups (p>0.001). In MRI follow-up examination, the 2 cases (7.41%) of group 1 showed increased rupture lesions with improved symptoms. And the 12 cases (18.47%) of group 2 showed increased rupture lesions with improved symptoms. Retears in the group I were significant less than the group II (p<0.001). Conclusion: Comparing patients with small and medium-sized rotator cuff tear who took arthroscopic mattress locking suture repair to those who took simple suture repair after over one year follow up period, the clinical result showed no significant difference between two groups. However, Mattress Locking suture repair showed excellent radiological result compared to simple suture repair when comparing rerupture.

Comparison of Arthroscopic versus Mini Open Repair in Rotator Cuff Tear (회전근 개 파열에 대한 관절경적 봉합술과 소 절개 봉합술의 비교)

  • Park, Ji-Kang;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Im, Se-Hyuk
    • 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.

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Postoperative clinical outcomes and radiological healing according to deep and superficial layer detachment in first facet involving subscapularis tendon tear

  • Kim, Jung-Han;Min, Young-Kyoung;Park, Man-Jun;Huh, Jung-Wook;Park, Jun-Ho
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.93-100
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    • 2022
  • Background: Subscapularis tendon insertion at the first facet has separate layers (deep and superficial). The purpose of this study is to evaluate postoperative clinical outcomes and radiological healing according to each layer of detachment in the first facet involving subscapularis tendon tear. Methods: Eighty-three patients who underwent arthroscopic repair due to First facet involving the scapularis tendon tear accompanying small to medium sized posterosuperior cuff tear were classified into three groups (group A: deep layer partial detachment, group B: deep layer complete detachment, but no superficial layer detachment, and group C: deep layer and superficial layer complete detachment). Subscapularis tendon healing was evaluated using computed tomography arthrogram and clinical result was evaluated using American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant score and University of California Los Angeles (UCLA) shoulder score. Results: Retear rate of the subscapularis tendon was 2.2%, 18.2%, and 33.3% in group A, group B, and group C, respectively. These rates showed statistically significant difference among the three groups, which were classified by deep and superficial layer detachment in the first facet (p=0.003). Group A showed significant difference in subscapularis tendon healing compared with group B and group C (p=0.018 and p<0.001, respectively), but there was no statistical difference between group B and group C (p=0.292). Regarding clinical outcomes, there was no significant difference among three groups in ASES and UCLA score at final follow-up (p=0.070 and p=0.106, respectively). Conclusions: Complete detachment of deep layer may be related with retear occurrence regardless with detachment of superficial layer, but clinical outcome may not be related with each layer detachment in the first facet involving subscapularis tendon tear.

Anterior Dislocation of the Shoulder with Rotator Cuff tear Over the 5th Decades of Age (40대 이후 발생한 견관절 탈구와 회전근 개 파열)

  • Moon, Young-Lae;Lee, Sang-Hong;Kim, Jeoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.131-135
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    • 2002
  • Object : To evaluate the prognostic factors of the rotator cuff tear after anterior dislocation of the shoulder over the 5th decades of age. Methods : We evaluated twelve patients who had rotator cuff tears combined with primary anterior dislocation of the glenohumeral joint between May 1995 and October 1998. Their age were ranged from 42 to 67-years-old. Two of them were initially presumed to have an injury of the axillary nerve and associated with avulsion fracture of the greater tuberosity. Among twelve patients who had rotator cuff tears, 8 cases had massive, 3 cases had medium and one case had a small sized tear. Results : All the tears of the rotator cuff were repaired and the results were obtained by UCLA shoulder rating scale. Ten cases of them revealed more than good results except for 2 cases who had been unhappy triad of the shoulder injury. Conclusions : In the case of anterior dislocation of shoulder, it is necessary to check the injury of rotator cuff and axillary nerve in the middle age group. If these injuries are combined, proper rotator cuff repair and axillary nerve rehabilitation program would be asked for better results.

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The Results of Arthroscopic Double-Row Rotator Cuff Repairs with Combined Knot-tying and Knotless Suture Anchors (매듭 결속과 비매듭 봉합나사를 이용한 관절경적 이열 회전근개 봉합술의 결과)

  • Ku, Jung-Hoei;Lee, Choon-Key;Cho, Hyung-Lae;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.172-179
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    • 2008
  • Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

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