• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.339-346
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• 2022

Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

• Journal of Veterinary Clinics
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• v.33 no.3
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• pp.172-175
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• 2016

An 11-month-old, 19.5 kg, intact male Border collie was referred with intermittent left forelimb lameness to the Gyeongsang Animal Medical Center. The symptom was first discovered about 6 months ago, and it has gotten worse for the last 10 days with non-weight bearing on the left forelimb. During the physical examination, the patient showed painful reaction when the left shoulder was abducted. On radiographic assessment, a radiolucent line and some osteophytes were found in both humeral heads. Based on patient's clinical signs and radiographic findings, osteochondritis dissecans (OCD) was very suspicious. So, we decided to perform an arthroscopic surgery on left shoulder for definitive diagnosis and treatment because the right forelimb revealed no clinical signs. During arthroscopic technique, we found a large OCD flap on the caudo-central area of humeral head, and observed severe synovitis over a wide range on posterior area of the articular capsule. The large OCD flap was removed by a grasping forceps, and many joint mice were removed either. Curettage was performed using a curette on the articular surface until hemorrhage occurred, and articular capsule flushed with a lactated-ringer's solution. The patient was discharged on the same day without any specific abnormal status. Antibiotic, anti-inflammatory and analgesic drugs were administered. Mild lameness on left forelimb was observed in 2 weeks after surgery, but after 4 weeks, the patient showed complete normal gait without any lameness. Although surgical removal of OCD flap with arthroscopic was previously reported, We would like note that a large OCD flap can also be removed by arthroscopic surgery in this report.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.117-125
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• 2017

Background: To compare the clinical outcomes of arthroscopic capsular release in patients with and without inferior capsular release for shoulder stiffness. Methods: Between January 2010 and December 2015, 39 patients who underwent arthroscopic capsular release for shoulder stiffness were enrolled and randomized into two groups. In group I, 19 patients underwent arthroscopic capsular release of the rotator interval and anterior capsule. In group II, 20 patients underwent arthroscopic capsular release of the anterior to inferior capsule, including the rotator interval. The American Shoulder and Elbow Surgeons score, Constant scoring system, Simple Shoulder Test, visual analogue scale for pain, and range of motion (ROM) were used for evaluation before surgery, at 3, 6, and 12 months after surgery and on the last follow-up. Results: Preoperative demographic data revealed no significant differences (p>0.05). The average follow-up was 16.07 months. Both groups showed significantly increased ROM at the last follow-up compared with preoperative (p<0.05). At the last follow-up, no statistical differences were found (p>0.05) between groups I and II in functional scores and ROM (forward flexion, p=0.91; side external rotation, p=0.17; abduction external rotation, p=0.72; internal rotation, p=0.61). But we found that group II gained more flexion compared to group I at 3 months and 6 months (p<0.05) after the surgery. Conclusions: Both techniques of capsular release are effective for stiffness shoulder. However, the extended inferior capsular release shows superiority in forward flexion over anterior capsular release alone during 6 months of follows-up (level of evidence: Level I, therapeutic randomized controlled trial).

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.155-158
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• 1999

Recently arthroscopic procedure was introduced into an effective method when chronic gouty arthritis associated with acute inflammation is unresponsive to conservative treatment. The purpose of this study is to cvaluate the efficacy of tophi excision during this procedure. We tried to excise tophi which were known as one of causative materials of acute inflammation as much as possible. We report one case of chronic tophaceous gouty arthritis of the right knee which was satisfactorily treated without recurrence during more than one year after this arthroscopic procedure.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.159-163
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• 1998

We reviewed the cases of 35 knees of 34 patients who had arthroscopic debridement for degenerative osteoarthritis of the knee. The patients were followed up for an average of 29 months (range: 13 months to 45 months). The mean age of the patients at operation was 54 years (range: 44 years to 75 years). At the time of follow up, the patients were evaluated using the nine-point scale by Baumgaertner et al. We divided the knee into 4 stages according to the classification system by Jackson et al. Satisfactory results were achieved in 80%(stage I), 75%(stage II), 55.6%(stage III) and 25%(stage IV) of the patients. Arthroscopic debridement is of significant value in the earlier stages of degenerative osteoarthritis (stage I and II) for the symptom relief as a simple procedure with rare complication as well as in the later stages(stage III and IV) as a time buying procedure before the total knee arthroplasty.

• Journal of Korean Foot and Ankle Society
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• v.2 no.2
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• pp.82-87
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• 1998

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. And so the goals of operative treatment for ankle fractures are to obtain an anatomical reduction that is maintained by stable fixation, resulting in a healed fracture and recovery of normal function. The 64 patients who had ankle fractures were treated by arthroscopic reduction(20 cases) and open reduction (43 cases) in Konkuk university hospital from February 1991 to October 1997 and the results were analyzed in clinical and radiological aspects. The following results were obtained. According to the criteria of Meyer, arthroscopic assisted reduction group had good or excellent results in 18 cases (90%) and open reduction group good or excellent in 35 cases (83%). The difference of the results was not significant statistically, but arthroscopic assisted reduction technique has several advantages over open technique; the best assessment of articular surface, lower wound problem, postoperatively faster rate of rehabilitation and minor discomfort.

• Clinics in Shoulder and Elbow
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• v.16 no.2
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• pp.153-162
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• 2013

The arthroscopic bony procedures during rotator cuff repair include acromioplasty, distal clavicle resection, footprint preparation and coracoplasty. The indication of each bony procedure is based on the theoretical reasons, and various types of surgical techniques are available. The purpose of this review article is to review the backgrounds of the indication and surgical techniques in the arthroscopic bony procedures during rotator cuff repair.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2008.03a
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• pp.170-170
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• 2008

Synovial chondromatosis is an uncommon condition, and the involvement of the shoulder joint is rare. A 15 year old female patient presented to author's institution for right shoulder pain. We checked the plain radiographs and MRI. And they showed that a diagnosis of synovial chondromatosis in the shoulder, and they also demonstrated that the disease involved the bicipital tendon sheath as well as glenohumeral joint. We removed all loose bodies with total synovectomy by arthroscopic procedure, and a mini-open procedure for the lesions of biceps tendon sheath. Arthroscopic treatment affords excellent visualization of the shoulder joint with less morbidity. However, with current arthroscopic techniques, it is difficult to manage the synovial chondromatosis of biceps tendon in bicipital groove. The authors suggest that the complete elimination of synovial chondromatosis involving shoulder requires a mini-open procedure for the lesions of biceps tendon sheath in addition to the arthroscopic resection of the affected synovium and loose body removal in the glenohumeral joint.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.136-139
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• 2007

Shoulder arthroscopic surgeries are an accepted technique for many shoulder disease and have many advantages over open surgeries. To date, shoulder arthroscopic surgery have been rare complications that compromise patient airway, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. This report presents a case of life-threatening airway obstruction due to extra-articular saline collection during arthroscopic rotator cuff repair. In concluding we should hourly check the patient's neck swelling undergoing shoulder arthroscopic surgery, because anesthetized patients cannot complain of the airway problem may progress until it becomes life-threatening.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.63-67
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• 2009

We report the case of a 21-year-old man with acute septic arthritis of the knee after meniscal allograft transplantation, which was successfully treated with repeated arthroscopic debridement and irrigations. Our procedures included arthroscopic debridement and irrigation with 10L normal saline, repeated arthroscopic irrigations (5 times), and intravenous antibiotics. Our decision to repeat the debridement was based on clinical and laboratory results. The significance of this case is that early aggressive arthroscopic debridement and repeated irrigations as part of a treatment protocol of acute septic arthritis after meniscal allograft transplantation can be an effective treatment option in selected cases.