• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.30-36
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• 2018

Background: The Korean Shoulder Scoring System (KSS) is a reliable and valid procedure for discriminative assessment of the clinical status of patients with rotator cuff tears. This study evaluates the correlation between the preoperative KSS and factors in patients with rotator cuff tears. Methods: From November 2009 to June 2016, 970 patients who underwent arthroscopic rotator cuff repair were retrospectively evaluated. A total of 490 patients met the study criteria. Preoperative factors included age, sex, symptom duration, mediolateral (ML) and anteroposterior (AP) tear size, acromiohumeral distance (AHD), tangent sign, tendon involvement (type I, supraspinatus; type II, supraspinatus and subscapularis; type III, supraspinatus and infraspinatus; type IV, all 3 tendons), fatty infiltration of rotator cuff muscles (group I, Goutallier stages 0 and 1; group II, Goutallier stages 2, 3, and 4), and KSS. Results: Old age, ML tear size, and AP tear size negatively correlated with the preoperative KSS (p<0.001). AHD showed a positive correlation with the preoperative KSS (p<0.001). A significantly inferior preoperative KSS was found in females and type III tendon involvement (p<0.001). For supraspinatus and infraspinatus, the preoperative KSS of group II fatty infiltration showed a significantly lower score than group I fatty infiltration (p<0.05). Conclusions: A relatively lower preoperative KSS was associated with old age, large tear size, narrow AHD, female, type III tendon involvement, and group II fatty infiltration of the supraspinatus and infraspinatus. Our study indicates that preoperative KSS can be a good measurement for the preoperative status of patients with rotator cuff tears.

• Korean Journal of Acupuncture
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• v.40 no.1
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• pp.18-24
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• 2023

A 53-year-old woman with right shoulder pain after falling down presented at our outpatient department after conventional treatment that had little effect. She was treated with integrative Korean Medicine treatment as an outpatient from February 2, 2022 to July 4, 2022. Based on Magnetic Resonance Imaging (MRI) findings, the patient was diagnosed with a right rotator cuff tear. With 39 treatment sessions, Numeric Rating Scale (NRS) score decreased and showed improvement in assessment. On May 6, MRI was retaken to show restoration of the supraspinatus tendon tear. The patient felt almost no pain on July 4, declaring the end of treatment. This successful case suggests that integrative Korean Medicine treatment might be an attractive alternative for severe rotator cuff tears.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.50-57
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• 2006

Purpose: The purpose of this study was to evaluate the tendon healing of arthroscopic repair in full-thickness supraspinatus tears. We evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement. Materials and Methods: Thirty consecutive full-thickness supraspinatus tears were repaired arthroscopically in 19 patients with a one row of anchor and 11 patients with two rows of anchors. Patients ranged in age from 51 to 79 years (average 63 years). Average follow-up was 16 month (range, 12 to 28 months). To evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement, we calculate the Constant, ASES, UCLA scores. The 30 patients had either an MR Arthrogram (25 cases) or an MRI (5 cases), performed between 5 months and 20 months (mean 10 months) after surgery. Results: The cuff was healed in 21/30 cases (70%) and partially torn in 3 cases (10%) after the arthroscopic repair of full-thickness supraspinatus tear. Although the supraspinatus tendon was totally torn to the tuberosity in 6 cases(20%) after the arthroscopic repair, the size of the tear was smaller than the initial in 5 cases. The Constant score improved from an average of $55.7{\pm}7.1$ points preoperatively to $77.7{\pm}9.7$ points at the last follow-up (p<0.001), and the average ASES score improved from $39.2{\pm}7.4\;to\;72.4{\pm}12.6$ (p<0.001), and the average UCLA score improved from $17.9{\pm}2.2\;to\;26.8{\pm}5.0$ (p<0.001). Strength of elevation was significantly better $(7.1kgs{\pm}2.4)$ in the shoulders with a healed tendon that in those with an total or partial re-tear tendon $(4.5kgs{\pm}1.0)$ (p<0.05). Factors adversely affecting tendon healing were increasing age, Only 41.7% of the repairs completely healed in patients over 65 years (p<0.05). Conclusion: Arthroscopic repair of isolated full-thickness tear of the supraspinatus leads to completely healing in 70% of the cases. Total or partial re-tear of the repaired rotator cuff is associated with a decreased strength. Older patients had significantly lower healing rates.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.130-136
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• 2016

Background: A novel technique for the repair of tears of the upper subscapularis tendon-intraarticular knotless fixation-has been introduced recently. The purpose of this study was to evaluate the clinical and structural outcomes of arthroscopic intraarticular knotless fixation for the treatment of upper subscapularis tendon tears. Methods: We retrospectively analyzed the clinical and radiological outcomes of 27 patients who underwent arthroscopic intraarticular knotless fixation for upper subscapularis tendon tears. Finally, a total of 10 patients who could participate in at least a 6 month follow-up of magnetic resonance imaging evaluation and in a least 1-year follow-up on an outpatient basis were enrolled in our study. The mean age at the time of operation was 60.7 years, and the mean duration of follow-up was 14.7 months. Two patients had concomitant tears of the supraspinatus tendon and 8 patients had concomitant tears of the supraspinatus and the infraspinatus tendons. Results: The clinical and radiological outcomes improved after the patients had undertaken arthroscopic intraarticular knotless fixation. The mean visual analogue scale score for pain during motion improved from 6.7 preoperatively to 1.4 at the final follow-up (p<0.001). The mean Constant score improved from 59.3 preoperatively to 79.6 at the final follow-up, and the mean the University of California at Los Angeles score, from 21.7 to 30.2, respectively (p<0.001 and p<0.001). The upper subscapularis tendon tear was healed in every patient except one (90%), for the patient had suffered from a postoperative trauma that resulted in a retear. Conclusions: We found that arthroscopic intraarticular knotless fixation gives good clinical and structural outcomes for the repair of upper subscapularis tendon tears. Arthroscopic intraarticular knotless fixation provided such a reliable and efficient restoration of the subscapularis tendon footprint that we anticipate it will become a widely-used procedure for upper subscapularis tendon tears.

• Proceedings of the Korean Society of Radiological Science
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• 1992.10a
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• pp.117-118
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• 1992

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1998.03a
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• pp.41-42
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• 1998

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1366-1387
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• 2021

The interpretation of MRI of partial-thickness rotator cuff tears can be challenging. This review describes the anatomic considerations for diagnosing partial-thickness tears, especially supraspinatus and infraspinatus tendon and summarizes the classification of partial-thickness rotator cuff tears, as well as provides an overview on partial-thickness tears with delamination.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.23-29
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• 2004

It has been reported that rotator cuff tear have good response to arthroscopic or open repair even if the range being so wide. However, the majority of this literature regarding the diagnosis and treatment of tear focused on lesion of the supraspinatus and infraspinatus tendons. But involvement of the subscapularis tendon with rotator cuff tear should be thought to be less common and poorer to open operative repair. Furthermore, some europian author have stated that the rotator cuff tear including the subscapularis tendon are sufficiently distinct in their clinical presentation and prognosis as to merit separate consideration of their diagnosis and treatment. The purpose of this study is to evaluate result of arthroscopic or open repair in patient with rotator cuff tear that include the subscapularis tendon. Of the 128 rotator cuff repairs performed from 1998 through 2003, 12 had a tear that include the subscapularis tendon in combination with the supraspinatus (8 cases) and infraspinatus (4 cases). Mean duration of symptoms before surgical treatment was 6 months (range 3 to 12 months). All 12 patient demonstrated a positive lift off sign. Shoulder function was assessed using the Constant- Murley score, which ranges from 30 to 58. Pain was assessed using a linear visual analogue scale range from 0 to 10. Postoperative Constant score range from 40 to 64 (average 47.8). Pain score improved from 5.5 to 8.5, but there are postoperative pain improvement on nothing in 5 patient. The overall result for 12 patient were satisfy in 2, fair in 5 and dissatisfy in 5: Therefore satisfactory result were noted only in 16 % of this overall group. In conclusion, we have failed to make good result in patient with rotator cuff tear that included the subscapularis tendon. At the result, outcome after surgical repair of this type of rotator tear is comparatively inferior to the result of operative repair of rotator cuff not involved the subscapularis tendon.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2000.03a
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• pp.8-9
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• 2000

• Clinics in Shoulder and Elbow
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• v.22 no.2
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• pp.70-78
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• 2019

Background: This study evaluated postoperative changes in the supraspinatus from time-zero to 6 months, using magnetic resonance imaging (MRI). We hypothesized that restoration of the musculotendinous unit of the rotator cuff by tendon repair immediately improves the rotator cuff muscle status, and maintains it months after surgery. Methods: Totally, 76 patients (29 men, 47 women) with rotator cuff tears involving the supraspinatus tendon who underwent arthroscopic rotator cuff repairs were examined. MRI evaluation showed complete repair with intact integrity of the torn tendon at both time-zero and at 6 months follow-up. All patients underwent standardized MRI at our institution preoperatively, at 1 or 2 days postoperative, and at 6 months after surgery. Supraspinatus muscular (SSP) atrophy (Thomazeau grade) and fatty infiltrations (Goutallier stage) were evaluated by MRI. The cross-sectional area of SSP in the fossa was also measured. Results: As determined by MRI, the cross-sectional area of SSP significantly decreased 11.41% from time-zero (immediate repair) to 6 months post-surgery, whereas the Goutallier stage and Thomazeau grade showed no significant changes (p<0.01). Furthermore, compared to the preoperative MRI, the postoperative MRI at 6 months showed a no statistically significant increase of 8.03% in the cross-sectional area. In addition, morphological improvements were observed in patients with high grade Goutallier and Thomazeau at time-zero, whereas morphology of patients with low grade factors were almost similar to before surgery. Conclusions: Our results indicate that cross-sectional area of the initial repair appears to decrease after a few months postoperatively, possibly due to medial retraction or strained muscle.