• 제목/요약/키워드: Superior labrum anterior and posterior

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상부 관절와 및 관절와 순의 해부학적 분석 (Anatomical Analysis of Superior Glenoid and Glenoid Labrum)

  • 최남용;송현석;윤형문;최승균
    • 대한관절경학회지
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    • 제14권2호
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    • pp.102-106
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    • 2010
  • 목적: 상부 관절와에 부착하는 관절와 순에 발생한 병변에 대한 봉합술 후의 결과가 모든 예에서 만족스러운 것은 아니다. 본 저자들은 상부 관절와 순의 치료에 도움이 되는 해부학적인 정보를 얻고자 견관절 자기 공명 영상 검사를 분석하고, 상부 관절와 순이 부착하는 부위의 관절와의 해부학적인 형태 및 부착 양상을 알아보고자 하였다. 대상 및 방법: 본원에서 견관절 자기 공명 영상 검사를 시행한 108예에서 관상면 영상을 분석하였다. 평균 연령은 52세(17~71세)였으며, 남자는 55예였고 여자는 53예였다. 일반적으로 상부 관절와 순 파열에서 봉합하게 되는 영역인, 이두건 장두의 관절와 부착 부위의 후방 2개 영상에서 관절와 순의 부착 부위의 길이 및 상외측 관절와의 단면 각도를 측정하였다. 결과: 상부 관절와 순의 관절와 전방 부착 부위의 내-외측 길이는 평균 $9.78{\pm}1.64\;mm$였다. 남자는 평균 $10.1{\pm}1.61\;mm$, 여자는 평균 $9.43{\pm}1.6\;mm$였다. 상외측 관절와의 각도는 평균 $89.6{\pm}7.6$도였다. 결론: 관상면에서의 상부 관절와 순의 부착 부위는 후방이 전방보다 짧다. 상외측 관절와의 각도는 후방이 전방보다 작았다.

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Arthroscopic Treatment of a Type II Superior Labrum Anterior to Posterior (SLAP) Lesion Combined with a Bankart Lesion: Comparative Study between Debridement and Repair of Type II SLAP Lesion by the Status of Lesion

  • Lee, Sung Hyun;Joo, Min Su;Lim, Kyeong Hoon;Kim, Jeong Woo
    • Clinics in Shoulder and Elbow
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    • 제21권1호
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    • pp.37-41
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    • 2018
  • Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

후방 Bankart 병변을 동반한 후방 II형 SLAP 병변 - 증례보고 - (Posterior type II SLAP Lesion Combined with Posterior Bankart Lesion - A Case Report -)

  • 천상진;윤명수;김휘택;서정탁
    • 대한관절경학회지
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    • 제12권2호
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    • pp.134-138
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    • 2008
  • 견관절 상완순 전후방(SLAP: Superior labrum anterior to posterior) 병변은 상부 관절와순 단독 손상으로 발견되기도 하고, 견관절 재발성 탈구 환자에서 전하방 관절와순의 파열, 즉 Bankart 병변의 연장으로 상부 관절와순까지 파열이 진행된 동반 손상으로 발생하기도 하며, 드물게 후방 Bankart 병변을 동반하는 경우도 있다. 여러 가지 병변과 동반된 SLAP 병변이 보고되어 왔으나 그 중 후방 Bankart 병변과 동반하여 발생한 후방 II형 SLAP 병변에 대한 보고는 미미하고 그 병변에 대한 관절경적 복원술 시 봉합 나사(suture anchor)의 삽입과 봉합에 주의할 점이 있다. 저자들은 투구 동작과 같은 흔한 손상 기전이 아닌 팔을 뻗친 상태에서 넘어지면서 발생한 외상으로 야기된 본 증례에 대해 관절경적 복원술을 시행하여 만족할 만한 결과를 얻었기에 보고하는 바이다.

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A Comparison between Arthroscopic Biceps Tenodesis and Arthroscopic Repair in Isolated Type 2 Superior Labrum Anterior and Posterior Lesions

  • Hong, Kyung-Jin;Kim, Doo-Sup;Shin, Ji-Su;Kang, Sang-Kyu
    • Clinics in Shoulder and Elbow
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    • 제20권1호
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    • pp.24-29
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    • 2017
  • Background: The purpose of this study was to compare the clinical outcome in patients aged less than 55 years who underwent arthroscopic tenodesis and arthroscopic repair for type 2 superior labrum anterior and posterior (SLAP) lesions. Methods: Between April 2008 and December 2014, surgery was performed on a total of 45 patients with isolated type 2 SLAP lesions. Arthroscopic repair was performed in 22 patients and arthroscopic tenodesis was performed in 23 patients. In both groups, the clinical outcomes at follow-ups were evaluated using the University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and visual analogue scale (VAS) score. Results: In both groups, the VAS scores for pain had improved significantly throughout the postoperative follow-up period. The VAS score showed a statistically significant difference at postoperative 3 and 6 months (p<0.05); however, there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). In both groups, the functional outcome was statistically improved postoperatively. In a comparison of the UCLA and ASES scores between the two groups, there was a statistically significant difference at postoperative 3 and 6 months (p<0.05), but there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). Conclusions: Based on the results of this and other studies, patients with isolated type 2 SLAP lesions showed better short-term clinical outcome with tenodesis than with repair. However, there was no difference between the two groups at the final follow-up.

Age-related Outcome of Arthroscopic Repair of Isolated Type II Superior Labral Anterior to Posterior Lesions

  • Kwon, Jieun;Kim, Yeun Ho;Yeom, Tae Sung;Oh, Joo Han
    • Clinics in Shoulder and Elbow
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    • 제18권1호
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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.

직접 자기공명 견관절 조영술 상에서 상부 관절순의 크기: 상부 관절순 전후방 파열과의 관계 (Superior Labral Dimension of the Glenohumeral Joint on Direct MR Arthrography (MRA): Relationship with Presence of SLAP (Superior Labrum Anterior to Posterior) Lesion)

  • 임태성;최정아;오주한
    • Investigative Magnetic Resonance Imaging
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    • 제18권3호
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    • pp.193-199
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    • 2014
  • 목적: 직접 자기공명 견관절 조영술에서 측정한 상부 관절순의 크기와 상부 관절순 전후방 파열과의 관계를 평가하고자 함. 대상과 방법: 만성적인 견관절 통증 또는 불안정성으로 직접 자기공명 견관절 조영술을 시행하고 견관절 관절경 수술을 받은 296명의 환자 (300개의 견관절) 이 연구 대상이 되었다. 모든 환자에서 관절경 수술 기록이 검토되었으며 자기공명영상이 두 명의 영상의학과 의사에 의해 분석되었다. 상부 관절순은 T1 강조 관상면 영상에서 상완 이두근 장두가 사라지고 상부 관절순이 가장 커보이는 단면에서 측정되었다. 역삼각형 모양의 상부 관절순에 대하여 밑변과 높이가 측정되었고 관절경 수술 상에서 상부 관절순 전후방 파열을 가진 군과 그렇지 않은 군 사이에 통계적으로 유의한 차이가 있는지 비교하였다. 결과: 17명의 환자는 낮은 영상의 질 때문에 연구에서 제외되었고 총 279명의 환자 (283개의 견관절) 중 122명(43.1%)의 환자에서 상부 관절순 전후방 파열이 있었고 161명 (56.9%)의 환자에서는 없었다. T1 강조 관상면 영상에서 측정된 상부 관절순의 밑변/높이의 평균값은 상부 관절순 전후방 파열을 가진 군과 안 가진 군에서 측정자 1의 경우 8.8 mm / 5.2 mm, 8.5 mm / 4.9 mm 였고 측정자 2의 경우 8.2 mm / 4.9 mm, 8.1 mm / 4.5 mm 그리고 8.0 mm / 4.8 mm, 7.6 mm / 4.3 mm 였다. 상부 관절순 전후방 파열 환자군에서 상부 관절순 높이의 평균이 그렇지 않은 군보다 통계적으로 유의하게 컸다. 결론: 직접 자기공명 견관절 조영술 T1 강조 관상면 영상에서 측정한 상부 관절순의 높이는 상부 관절순 전후방 파열 환자군에서 그렇지 않은 군보다 통계적으로 유의하게 컸으며 이것은 상부 관절순이 관절와를 많이 덮는 경우 상부 관절순 전후방 파열의 소인이 될 가능성을 제시한다.

제2형 상부관절와순파열로 진단받은 사회인 야구선수에 대한 보존적 치료 치험 1례 (A Case Report of Conservative Treatment for the Amatuer Baseball Player diagnosis with type 2 Superior labral anterior posterior lesion)

  • 진은석;염선규;김석;이진혁
    • 척추신경추나의학회지
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    • 제5권2호
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    • pp.151-158
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    • 2010
  • Objective : SLAP is rupture of biceps brachii muscle tendon and it's origin, posterior side of superior labral to anterior glenoid fossa. Snapping and Pain, instability are its typical symptoms. SLAP is physical damage so surgeons use arthroscopy. In point of surgeons view, a conservative medicine is not effective for lesion of labrum. So In this article, we report a result of conservative treatment for the amatuer baseball player diagnosis with type 2 superior labral anterior posterior lesion. Methods : In this case, patient played amatuer baseball for 2 years, had diagnosis with type 2 Superior labral anterior posterior lesion by MRI after right shoulder Injury. OS recommened arthroscopy surgery. But he receive conservative Korean medicin treatment in Korean medicine hospital, including Atx, BV, herbal acupunture and rehabilitation excersise. Results : After 6 months, in the end of continuous conservative treatment and rehabilitation excersise, patient can play baseball normally, and felt a little pain. But In physical examination, he still has a some abnormal signs. Conclusion : A Conservative treatment for an amatuer baseball player diagnosis with SLAP type 2 was effective in restore of fuctional activities, but usefulness of this treatment needs more study.

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