• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.109-114
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• 2004

Purpose: To evaluate the clinical results and prove the effectiveness of arthroscopic capsular release in refractory adhesive capsulitis of shoulder. Materials and Methods: We preformed arthroscopic capsular refractory adhesive capsulitis that not responded by stretching execies for above 1 year. 21 cases were followed above 1 year and average follow up 3 years 1 months (1${\sim}$5 years). We checked VAS of pain, ADL of function. UCLA score which were evaluated at preoperation, postoperation 6 months, 1 years and last follow up period, and compared with each other at last follow up. Results: The VAS score improved average preoperative score 8 to average postoperative score1, the ADL score improved average preoperative score 7 to average postoperative score 26, the UCLA score improved average preoperative score 8 to average postoperative score 34. Forward elevation improved average preoperative 75 degrees to average postoperative 175 degrees, external rotatiion at side improved average preoperative 4 degrees to average postoperative 52 degrees, abduction improved average Preoperative 60 degrees to average postoperative 170 degrees, internal rotation at posterior improved preoperative thigh-lumbar 3 spinous process to postoperative 7th thoracic spinous process~9th thoracic spinous process. Conclusion: Arthroscopic capsular release in refractory adhesive capsulitis that non responsive to stretching exercise for above 1 year were effective treatment method.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.92-97
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• 2012

Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.79-86
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• 2012

The conservative treatment for impingement and rotator cuff tear includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection and physiotherapy depending on the purpose to relieve the pain and inflammation, in addition, stretching exercise to recover flexibility and strengthening exercise to recover the function could be used. When these conservative treatments are divided into multiple steps, the first one contains pain relief, modification of daily activity and stretching exercise. Second step includes strengthening exercise of the anterior/posterior cuff and peri-scapular muscles and eventually. The third step includes training program to return to job, housework and hobby activities and maintain. Thus, the key of these step wise approach for the treatment of impingement and rotator cuff tear is exercise program. Understanding of various exercise program and apply to the patients properly is most important for the conservative treatment of impingement and cuff tear.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.155-159
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• 2007

Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.11-17
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• 2024

Background: Rotator cuff tears are often associated with synovitis, but the ability of noninvasive ultrasonography to predict the severity of synovitis remains unclear. We investigated whether ultrasound parameters, namely peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, reflect synovitis severity. Methods: A total of 54 patients undergoing arthroscopic rotator cuff repair were selected. Doppler ultrasound was used to measure peak systolic velocity in the anterior humeral circumflex artery and Doppler activity in the glenohumeral joint and subacromial space, and these values were compared with the intraoperative synovitis score in univariate and multivariate analyses. Results: Univariate analyses revealed that tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the glenohumeral joint were associated with synovitis in the glenohumeral joint (P=0.02, P<0.001, P=0.02, respectively). In the subacromial space, tear size, peak systolic velocity in the anterior humeral circumflex artery, and Doppler activity in the subacromial space were associated with synovitis severity (P=0.02, P<0.001, P=0.02, respectively). Multivariate analyses indicated that tear size and peak systolic velocity in the anterior humeral circumflex artery were independently associated with synovitis scores in both the glenohumeral joint and the subacromial space (all P<0.05). Conclusions: These findings demonstrate that tear size and peak systolic velocity in the anterior humeral circumflex artery, which can both be measured noninvasively, are useful indicators of synovitis severity.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.242-248
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• 2009

Purpose: To evaluate the clinical and radiologic results of the arthroscopic rotator cuff repair for partial articular surface tendon avulsion lesion. Materials and Methods: Twelve patients with symptomatic, partial articular surface tendon avulsion underwent arthroscopic rotator cuff repair between Mar. 2006 and Sep. 2008. The mean follow-up period was 18.3 months(12~36 months), and the mean age at the time of surgery was 46.9-year-old(19~64 years). Three cases had underwent rotator cuff repair after conversion to full-thickness tear and nine cases had transtendon repair with preserving bursal side cuff. Results: The mean VAS during motion was 6.2 before treatment and 2.0 at final follow-up (p<0.001). The passive forward flexion improved from $163.3^{\circ}$ preoperatively to $169.8^{\circ}$ postoperatively (p=0.038). The mean UCLA score improved from 18.4 preoperatively to 30.1 with 2 excellent, 8 good and 2 fair results at final follow-up. The mean KSS improved from 61.8 preoperatively to 76.8 at final follow-up. By examining the postoperative MR images of 5 patients, complete healing was observed in all of them. Conclusion: Arthroscopic rotator cuff repair may be an effective procedure for partial articular surface tendon avulsion in pain relief and improvement of the range of motion. If the remaining bursal side cuff fibers are intact, transtendon repair procedure with preserving the intact bursal layer of the tendon can be considered. If the remaining bursal side cuff fibers are friable or little, completion from partial-thickness to full-thickness tears with subsequent cuff repair can be considered.

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.32-38
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• 2007

Purpose: This study reports the clinical results of the arthroscopic repair of type V SLAP lesion with bio-knotless anchor. Materials and Methods: 10 cases of 10 patients (10 male) were included in this study. The average age was 32.7 years old and the period from the first injury to operation was average 47.2 months. Preoperative Rowe score was average 37.5. Arthroscopic SLAP repair with 1 or 2 bio-knotless anchors were performed and arthroscopic Bankart repair with bio-knotless anchors were performed in all cases; 3 anchors were used in 7 cases and 2 anchors in 3 cases. The average follow up period was 15.7 months. Results: The Rowe score improved to 93 at last follow up period and 8 cases had full range of motion of the shoulder. 2 case had mild limited range of motion of the shoulder (one case; 170 degrees in flexion, 60 degrees in external rotation and T12 level in internal rotation, the other case; 160 degrees in flexion, 45 degrees in external rotation and T12 level in internal rotation.) without any problem in normal activity. Conclusion: Arthroscopic repair with bio-knotless anchor in type V SLAP lesion is one of the good methods because of the good clinical results.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.50-58
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• 2007

Purpose: To report our experience with nine cases of pathologic synovial plica on radiohumeral joint which symptom of painful snapping elbow was improved by arthroscopic resection. Materials and Methods: Between 1999 and 2004, 43 cases of elbow arthroscopy were performed by one surgeon. Eight patients with nine cases showed pathologic synovial plica in conjunction with snapping or posterolateral elbow pain. The mean age of eight patients (man: 7, woman: 1) was 29 years (range $16{\sim}56$ years). All patients had a trial of conservative treatment at least six months (range $6{\sim}16$ months). The diagnosis was confirmed before surgery in six cases and at the time of surgery in three cases. Pain, snapping, and subjective results were evaluated at least 12 months in the average(range $12{\sim}24$). Results: All patients showed a hypertropic lateral synovial plica with local synovitis. Seven of them had an associated lesion of chondromalacia on radial head. One of them was associated with radiocapitellar arthritis and had a wrapping over the radial head. Six patients experienced improved posterolateral pain at the end of study (VAS<1). However, the other two patients had occasional pain with activity. One of them persisted with mechanical symptoms, which was treated with additional arthroscopic procedure. Conclusion: Synovial plica in elbow should be considered as an important entity of common elbow disease, especially when pain in the lateral aspect of the elbow with a snapping sensation during motion is featured in patients. The arthroscopic resection seems to be safe and efficient in the short and long term treatment of plica in the elbow joint.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.61-67
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• 2021

Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.