• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.166-172
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• 2001

Purpose: To evaluate effectiveness of arthroscopic capsular release combined with manipulation in frozen shoulder. Material and Method: 15 patient who had failed to respond to physical therapy were evaluated, which were treated with arthroscopic capsular release combined with manipulation, from July 1998 to March 2000. Result: At a mean of fifteen months(range, six to twenty four) after the combined procedure, the improvement in the score of Constant and Murley averaged 45 points. The mean improvement in motion was 76 degrees for abduction; 40 degrees and 65 degrees for external rotation in adduction and abduction. Conclusion : Arthroscopic capsular release with manipulation is useful method to treatment the frozen shoulder which was not respond to conservative treatment.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.174-178
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• 2009

Purpose: We introduce arthroscopic assisted core decompression for humeral head osteonecrosis. Operative technique: After diagnostic shoulder arthroscopy is performed using posterior and anterior portal, we make a 2 cm lateral skin incision approximately 3 cm distal to 1/3 of lateral margin of the acromion and place short gray cannula to prevent adjacent soft tissue injury when insert guide pin. Under C-arm fluoroscopic and arthroscopic guidance, 3 to 4 guide pins are inserted toward the necrotic area. Then we perform drilling using 7.0 mm reamer. Conclusion: We believe this technique is a less invasive approach and avoids the complications comparing to deltopectoral approach. Arthroscopic assisted core decompression is an effective procedure in management of early stage of the humeral head osteonecoris.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.135-139
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• 2001

Purpose : Repair of the posterior capsule tear at the time of the operation for the chronic postero-lateral or postero-medial rotary instability has not been reported. We describe the arthroscopic repair of the posterior capsule tear using the posterior trans-septal portal. Method : After conducting basic arthroscopic examination of the knee, postero-medial and postero-lateral portals are secure to make the posterior trans-septal portal, through which the postero-medial and postero-lateral capsule tears are repaired using the suture hook under the arthroscopic guidance. Conclusion : When arthroscopic reconstruction of PCL insufficiency or postero-lateral rotaty instability that accompanies postero-medial or postero-lateral capsular tears. rising the posterior traits-septal portal could ensure better visualization of the capsule and a subsequent more accurate repair of the capsule. Since it significantly lessened instability, it could contribute to an achievement of successful clinical results.

• The Korean Journal of Pain
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• v.33 no.4
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• pp.344-351
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• 2020

Background: The effects of far-infrared radiation (FIR) on the treatment of rotator cuff diseases remains unknown. We evaluated the safety and efficacy of FIR after arthroscopic rotator cuff repair with regard to postoperative pain and healing. Methods: This prospective randomized comparative study included 38 patients who underwent arthroscopic rotator cuff repair due to a medium-sized tear. Patients were randomly divided into the FIR or control group (n = 19 per group). In the FIR group, FIR with an FIR radiator started 1 week postoperatively for 30 minutes per session twice daily. It lasted until abduction brace weaning at 5 weeks postoperatively. We assessed pain using a pain visual analogue scale (pVAS) and measured the range of motion (ROM) of the shoulder at 5 weeks, and 3 and 6 months, postoperatively. The anatomical outcome was evaluated using magnetic resonance imaging at 6 months postoperatively. Results: At 5 weeks postoperatively, the average pVAS score was lower in the FIR group than in the control group (1.5 ± 0.8 vs. 2.7 ± 1.7; P = 0.019). At 3 months postoperatively, the average forward flexion was higher in the FIR group (151.6° ± 15.3° vs. 132.9° ± 27.8°; P = 0.045), but there was no significant difference at 6 months postoperatively. There was no significant difference in healing failure between the groups (P = 0.999). Conclusions: FIR after arthroscopic rotator cuff repair could be an effective and safe procedure to reduce postoperative pain, thereby facilitating rehabilitation and better ROM in the early postoperative period.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.171-175
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• 2004

Purpose: We evaluated the clinical and radiological results of arthroscopic ankle fusion using 2 medial screws which had advantages of less morbidity, early weight-bearing and high union rate. Material and Methods: From April, 2002 to March, 2004, 8 patients who had ankle osteoarthritis were treated by ankle fusion using 2 medial screws under arthroscopy; five patients with post-traumatic osteoarthritis, two with post-infectious arthritis and one with paralytic foot. There were 5 male and 3 female. Average age was 67 years old ranging from 57 to 71 years. We evaluated them clinically preoperative and postoperative using AOFAS score, VAS pain scale and patient's satisfaction. In regard to radiological fusion, we checked them by simple AP, lateral and mortise view. Follow up period was average 11 months (range, $6{\sim}24$ months). Results: All ankles were successfully fused with 2 medial screws under arthroscopy. The mean time of fusion was 10.5 weeks (range, $8{\sim}14$ weeks). Patient's satisfaction checked at 6 months after operation had favorable results (excellent and good 75%). One case had pain on medial malleolar area because of screw's protrusion. Conclusion: Arthroscopic ankle fusion using 2 medial screws was good modality of ankle fusion with less morbidity and early weight-bearing in some cases of ankle arthritis.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.124-128
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• 1998

From Feb. 1996 to Feb. 1997. among sixty-four patients of anterior cruciate ligament(ACL) reconstruction using multi-stranded hamstring tendon and EndoButton fixation, twenty-five patients of volunteer, 15 men and 10 women, from 16 to 50 years of age(mean 27.6 years) underwent arthroscopic evaluation. Arthroscopic evaluation was routinely performed one year after surgery along with an examination of stability. The purpose of this study was to arthroscopically evaluate the morphological changes that occurred in hamstring tendon autograft one year after ACL reconstruction. Both of the tendon graft and the adjacent fibrous tissues were observed for gross appearance and physical properties with probing and response to passive anterior translation. Biopsy samples were taken from the surrounding fibrous tissue and the tendon graft. Grossly, we found a well-defined ligamentous structure with good tension tested with a probe. A common finding was that the reconstructed ligaments were embedded in a layer of the synovium, and blood vessels could be seen on the anterior surface of the ligament. The biopsy tissue was placed in formalin solution and subjected to histological preparation by hematoxylin and eosin staining method. The hamstring tendon graft appeared histologically normal under light microscopic finding. There were a few vessels located between existing collagen bundles, and the vessels had an orderly pattern. The surrounding fibrous tissue envelope was covered with synovium. We pleased with preliminary findings in our evaluation.

• Clinics in Shoulder and Elbow
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• v.20 no.1
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• pp.10-17
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• 2017

Background: The purpose is to determine the efficacy of additional intravenous patient-controlled analgesia (IV-PCA) by comparing the analgesic effects between interscalene block (ISB) combined with IV-PCA and single ISB after arthroscopic shoulder surgery. Methods: A total of 213 patients who underwent arthroscopic shoulder surgery were divided into two groups based on the type of perioperative anesthesia. The single ISB group included 100 patients, while the IV-PCA group included 113 patients. The visual analogue scale for pain (VAS pain) scores were assessed at 12, 24, and 48 hours postoperatively in accordance with shoulder pathology. Postoperative narcotics-related complications and consumption of additional non-steroidal anti-inflammatory drugs between the two groups were compared. Results: VAS pain showed no significant difference between the two groups at most points of the postoperative timeline, regardless of shoulder pathology, except in patients with rotator cuff repair at postoperative 24 hours. Although the IV-PCA group showed a statistically lower VAS pain score than the ISB group at postoperative 24 hours (p=0.04), the difference in the VAS pain score was only 9.0 mm in patients with rotator cuff repair. Narcotics-related complications were observed more frequently in the IV-PCA group than in the ISB group for patients with rotator cuff repair. Conclusions: Additional IV-PCA demonstrated no booster effect for immediate pain control in patients undergoing arthroscopic shoulder surgery with preoperative single ISB. Furthermore, patients with IV-PCA experienced greater narcotics-related complications.

• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.190-194
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• 2019

Background: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation. Methods: Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suturebridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery. Results: No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0-88.0; delayed: 66.9-91.0; p<0.001) and the UCLA shoulder score (early: 20.3-32.3; delayed: 20.4-32.4; p<0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6-15 months; average, 10.4 months). Conclusions: Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.

• Clinics in Shoulder and Elbow
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• v.23 no.4
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• pp.169-177
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• 2020

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 57 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Surgeons score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection. Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics. Conclusions: MUA alone can yield similar clinical outcomes to ACR in refractory FS.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.172-177
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• 2021

Background: This study aimed to evaluate the response rate to arthroscopic release treatment in adhesive capsulitis of the shoulder (ACS) for patients with refractory to conservative treatment. Methods: In this retrospective study, 51 patients (age mean, 49.1±5.6 years) with unilateral adherent capsule underwent arthroscopic releasing surgery for the shoulder capsule. Etiologies of the ACS in 30 patients were idiopathic: 10 patients were affected after surgery and 11 patients following trauma. The patients were evaluated in terms of shoulder function, satisfaction rate, pain intensity, and joint range of motion (ROM) based on a Constant score, a Simple Shoulder Test, the visual analog scale, and four movements, respectively. Results: The mean Constant score before surgery was 48.2±3.5 and reached 74.4±6 and 77.0±6.3 at 6 months and the final follow-up, respectively (p<0.001). The mean scores of pain intensity, a Simple Shoulder Test, and ROM showed significant improvement at all follow-ups (p<0.001). Sex, age, and diabetes did not have any significant effect on patient recovery. However, patients who experienced ACS after surgery had poorer results than others at all follow-up points. Conclusions: Arthroscopic releasing surgery of the shoulder in patients with ACS refractory to conservative treatment produces rare complications and an effective injury response. It seems that patients suffering ACS following surgery have a weaker response to the treatment.