• 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.

• Journal of Acupuncture Research
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• 제37권1호
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• pp.49-58
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• 2020

Background: This study aimed to investigate the clinical effectiveness of treatment of Korean medicine on superior labrum anterior to posterior (SLAP) lesions. Methods: A total of 55 inpatients diagnosed with SLAP lesions by magnetic resonance imaging, were investigated from May 1^st, 2014 to May 31^st, 2019 at Haeundae Jaseng Hospital of Korean Medicine. The patients were sorted by gender, age, causing factor, illness duration, period of hospitalization, SLAP lesion type, complications, and treatments. Treatments included acupuncture, pharmacopuncture, Chuna therapy, herbal treatment, and physiotherapy. After treatment, the Numeric Rating Scale, Shoulder Pain and Disability Index, and European Quality of Life 5-Dimension questionnaire were used to evaluate treatment effect. Results: There were more males than females in this study (1:0.83). Patients were more likely to be in their 50s (38.18%), have an unknown etiology (70.91%), and be in the subacute disease stage (41.82%). According to the SLAP lesion type, most of the inpatients had Type 2 lesions (69.09%). For inpatients diagnosed with SLAP lesions, the mean shoulder numeric rating scale score decreased from 5.55 ± 0.90, to 4.07 ± 1.18 (p < 0.001), the mean Shoulder Pain and Disability Index score decreased from 50.35 ± 18.36, to 39.90 ± 19.34 (p < 0.001), and the mean European quality of life 5-dimension index increased from 0.70 ± 0.16, to 0.75 ± 0.13 (p < 0.01) after treatment. Conclusion: Treatment of Korean medicine effectively decreased pain and increased the quality of life of the patients with SLAP lesions in this study.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.68-76
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• 2017

Background: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a "knot-ache". This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. Methods: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. Results: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. Conclusions: The knots of suture anchor maybe a possible etiology of the pain, which we termed a "knot-ache". Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, "knot-ache". Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

• Clinics in Shoulder and Elbow
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• 제11권1호
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• pp.6-12
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• 2008

관절경 수술 및 MRI가 보편적으로 쓰이면서 SLAP (superior labrum from anterior to posterior) 병변은 최근 많이 진단되고 있으며 수술 역시 널리 시행되고 있다. 그러나 임상적으로 SLAP 병변을 진단 내리기는 힘들어 이를 진단하기 위한 다양한 이학적 검사법이 소개되고 있으나 그 민감도와 특이도에 이견이 많아 확진 검사로 쓰이기는 힘들다. 하지만 임상적으로 SLAP 병변이 의심되는 경우 이학적 검사가 SLAP 진단 과정에 도움이 되는 것은 사실이며, 다른 정밀검사를 하도록 도와줄 수 있고 수술 전 계획을 수립하는데도 도움을 준다. 따라서 자세한 병력과 함께 정확한 이학적 검사법을 알고 시행하는 것이 SLAP 병변의 진단과 치료에 중요하다고 할 수 있다. 이 종설에서는 현재 보고된 SLAP 병변의 이학적 검사법들을 나열하여 원문 기술(original descriptions)과 통계학적 분석에 기술하여 어떠한 검사법이 있으며 어떻게 검사를 시행 해야 되며 그 검사 결과를 어떻게 판정해야 되는지를 알아보고자 한다.

• 한방재활의학과학회지
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• 제28권1호
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• pp.185-193
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• 2018

The purpose of this study is to report the improved case of superior labrum from anterior to posterior tear patient treated with Shinbaro pharmacopuncture and motion style acupuncture treatment. We used Shinbaro pharmacopucture, motion style acupuncture treatment and other korean medicine treatment for this patient. This case is measured and assessed by visual analogue scale (VAS), shoulder range of motion (ROM) and shoulder physical examination (Neer test, O'Brien test). After treatment, VAS decreased and the patient showed improvement of range of motion. Also physical examination of shoulder was improved. Shinbaro pharmacopuncture and motion style acupuncture treatment are thought to be helpful to relieve pain and recover function on shoulder joints, although further study is needed.

• Clinics in Shoulder and Elbow
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• 제7권1호
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• pp.10-13
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• 2004

Superior labrum anterior to posterior (SLAP) lesions of the shoulder has recently been a popular issue to shoulder surgeons. Now we are correlating many shoulder symptoms to this SLAP lesion. A 45 year-old female patient injured her shoulder when her arm sleeve was entrapped in moving automobile door. A forceful pull of the arm in external and abduction position was suspected. She complained continuous shoulder pain with limited range of motion for 2 months. Magnetic resonance image showed possible SLAP lesion but no definite diagnosis were made prior to the operation. Arthroscopic evaluation revealed SLAP type Ⅱ lesion with concomitant avulsion of the superior glenoid cartilage. In addition anterior labrocapsular tear was seen from 7 to 9 o'clock of anterior glenoid. The SLAP lesion and the anterior capsulolabral lesion were repaired properly to the glenoid. We report a case of glenoid-cartilage avulsion type of SLAP Ⅱwith anterior labrocapsular lesion.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1997년도 학술대회
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• pp.164-166
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• 1997

MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex(LOLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalis in image interpretation related to evaluation of the LOLC. MR Arthrogram of 56 shoulders in 41 asymptomatic young, active volunteers were prospectively reviewed to evaluate the labral shapes. capsular insertions and images which may mimic the lesions of glenohumoral instability. The anterior and posterior parts of the labra. respectively. varied in shape: triangular$(72\%,\; 36\%)$. round $(13\%,\; 35\%)$. cleaved$(8\%,\; 1\%)$. notched$(2\%,\; 0\%)$. flat$(5\%,\; 24\%)$ and absent$(0\%,\; 4\%)$. The anterior and posterior capsular insertions. respectively. varied in sites: Mosely and Oevergaard type I$(82\%,\;62\%)$, type II$(13\%,\; 3\%)$ and type III $(5\%,\; 2\%)$. A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum$(29\%)$ and middle glenohumoral ligament in proximity to anterior labrum $(5\%)$ simulated a labral tear. Joint fluid interposed in the central. superior portion of the sublabral sulci$(25\%)$ simulated a SLAP lesion. Synovial fold$(38\%)$ in axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral capsular - ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.80-83
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• 2009

목적: 삼중 관절와 순 병변(triple labral lesion)은 전방, 후방, 상방 관절와 순의 파열이 동시에 발생한 경우를 말한다. 문헌 보고가 드물어서, 수상 기전과 증상에 대하여 아직 정립되지는 않았다. 대상 및 방법: 본 저자들은, 교통 사고 후 우측 견관절의 동통과 능동적 외전 장애를 보인 39세 남자에서 삼중 관절와 순 병변을 경험하였다. 내원 시에 관절와 상완 관절의 불안정에 대한 증상을 호소하지는 않았다. 흡수성 봉합 나사못과 봉합 갈고리를 사용하여 관절와 순에 대한 봉합술을 시행하였다. 결과: 수술 후 18개월 추시에서, 능동적 운동범위는 정상으로 호전되었으며 일상 생활 중에는 어려움이 없었다.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.155-162
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• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.244-249
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• 2010

목적: 본 연구는 제 2형 SLAP 병변에서 외상의 유무에 따른 손상기전의 차이 및 임상 결과의 차이를 비교하고자 한다. 대상 및 방법: 2007년 1월부터 2009년 5월까지 제 2형 SLAP 단독 병변으로 수술을 시행한 27예를 대상으로 하였다. 제 2형 SLAP 병변의 분류는 Burkhart에 의한 분류법을 이용하여 병변이 전상방부에 위치하면 제 1형, 후상방부는 제 2형, 전후방 복합 병변은 제 3형으로 분류하였다. 치료 결과는 술 전, 술 후의 UCLA 점수와 KSS 점수를 사용하여 측정하였다. 결과: 총 27예 중 외상군은 16예, 비외상군은 11예였다. 제 2형 SLAP 병변의 형태는 외상군에서 제 1형은 12예, 제 2형은 2예 그리고 제 3형은 2예였다(p=0.013). 비외상군에서는 제 1형 2예, 제 2형 6예, 제 3형 3예였다 (p=0.026). 즉 외상군에서는 전방 병변이 더 많이 발생하였고 (p<0.05), 비외상군에서는 후방 병변이 더 많이 발생한 것으로 추정할 수 있다 (p<0.05). 외상군에서 UCLA 점수 및 KSS 점수는 술 전 평균 18점 (14~23점), 48점 (32~76점)에서 술 후 32점 (28~33), 86점 (71~92점)이었다. 비외상군에서는 UCLA 점수 및 KSS 점수는 술 전 평균 21점 (18~25점), 58점 (41~68점)에서 술 후 29점 (26~31점), 81점 (68~89점)이었다. 임상결과에 있어서 두 군 사이의 통계학적으로 유의한 차이를 보이지 않았다 (p=0.317, 0.405). 결론: 본 연구에서 제 2형 SLAP 병변의 형태가 외상 기전에 따라 차이가 있음을 관절경 소견을 통해 확인할 수 있었다. 따라서 제 2형 SLAP 병변에 대한 수술적 치료를 고려할 때 외상 유무를 파악하여야 할 것이다.