• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.115-118
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• 2004

Purpose: The purpose of this study is to measure the internal and external rotation of shoulder and compare with normal volunteer and patients diagnosed as SLAP lesion. Materials and Methods: Thirty-eight cases (group 1) who had SLAP lesions at shoulder arthroscopy and fourty young volunteers(group 2) were analyzed retrogradely with medical record, intra-operative arthroscopic photo & video for SLAP lesions and the ROM of shoulder Under the interscalene anesthesia, the range of motion of internal rotation and external rotation were measured on flxed scapula and 90 degree abduction of shoulder, and the same method for group 2. We analyzed the results with two sample T-test and Wisconsin signed ranks test. Results: There was a significant difference between group 1 and group 2 for the ROM of shoulder. (IR; p<0.001,ER; p<0.001).For the group 1, internal and external rotation with the arm abducted 90 averaged 50 and 64 degrees and for the group 2, internal and external rotation averaged 77 and 90 degrees with significant difference(IR; p<0.001,ER; p<0.001).Conclusion: The range of motion of shoulder, especially internal and external rotation significantly decreased in SLAP lesions. Our results suggest that a limited rotational motion of shoulder closely related with SLAP lesion.

• Journal of the Korean Arthroscopy Society
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• v.5 no.1
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• pp.1-6
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• 2001

Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using central one third bone-patellar-tendon bone(BPB) autograft versus quadrupled semitendinos-us(ST) autograft as the medium term review. Materials and Methods : Eighty patients(40 BPBs,40 STs) with isolated ACL injury were available for a mean follow up of 49.4 months(BPB) and 48.8 months(ST). There was no significant difference between the two groups with respect to age and sex. We compare the final results between two groups with respect to subjective Lysholm score, objective laxity including anterior drawer test, Lachman test, pivot shift test, KT-2000 measurements and International Knee Documentation Committee(IKDC) evaluation system. Results : Postoperatively, positive anterior drawer test was found in $22.5\%\;and\;27.5\%$, positive Lachman test was found in $30.0\%$ and $25.0\%$ and positive pivot shift test was found in $15\%\;and\;20\%$ of the ST and BPB group, respectively(p>0.05). Mean side to side difference of KT-2000 at 20 lbs was 2.2 mm for the ST group and 2.1 mm for the BPB group. There was no significant difference between the two groups about Lysholm score(>0.05). Anterior knee pain was knee common in the BPB group. Eighty-three percent of the patients were nearly normal according to the IKDC grade in both groups. Conclusion : We consider that autogenous semitendinosus tendon is a good alternative subsititute in ACL reconstruction together with the bone-patellar tendon-bone autograft.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.22-27
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• 2009

Purpose: To identify the damage of the articular cartilage and analyze the clinical results of the partial medial meniscectomy. Materials and Methods: From January 2001 to December 2004, forty-eight patients in the degenerative arthritis and medial meniscal tear of knee who undertook arthroscopic partial meniscectomy and were able to keep pace with the times follow-up for more than 3 years were enrolled in this study. Six cases were men and 42 were women, and the mean age was 55.7 years (40~78 years). The patients were classified into two groups according to the Outerbridge grade. Grade I and II were classified into group 1 and grade III and IV into group 2. Group 1 included 30 cases and group 2 included 18 cases. The result were analyzed according to the Tapper & Hoover classification and Lysholm knee scoring scale. And we measured the distance of medial joint space in standing anteroposterior (AP) view of both sides at the pre-operative and the last follow-up. Results: According to the Tapper & Hoover classification, 28 cases were excellent, 7 cases good, 8 cases fair, and 5 cases poor. Among group 1, 25 cases were excellent, 2 cases good, 2 cases fair, 1 case poor. However, among group 2, 3 cases were excellent, 5 cases good, 6 cases fair, 4 cases poor. Average Lysholm knee score was improved from 62.4 preoperatively to 94 postoperatively in group 1, and from 58 preoperatively to 77.9 postoperatively in group 2. The joint space narrowing showed no statistically significant difference in both knees standing AP view. Conclusion: The arthroscopic partial meniscectomy for a patient with the degenerative articular cartilage was an effective treatment. However, we could not satisfy the results, in cases of Outerbridge grade III and IV. In grade III and IV, the partial meniscectomy was not aggravated the cartilage damage.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.34-38
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• 2009

Purpose: To evaluate the association of subacromial bursa inflammation with acromial shape and shoulder pain in subacromial impingement syndrome. Materials and Methods: 24 cases with subacromial impingement syndrome were reviewed. Eighteen patines were males and six females(mean age: 58.3 yrs). During arthroscopic operation, the specimens were taken from subacromial bursa with arthroscopic knife($1{\times}1$ cm size). The shape of acromion were classified according to Bigliani grading system. The shoulder pain of patients was graded with visual analog scale (VAS). The grade of inflammation was classified to the pathological three grade system (mild, moderate, severe) by pathohistological 8 factors. Results: Of total 24 cases, 9 cases were the pathological grade I and 15 cases were grade II. None was grade III. In the 9 cases of pathological grade I, 6 cases were the radiologic grade II of acromial shape and 3 cases were grade III. In the 15 cases of pathological grade II, 5 cases were the radiologic grade II and 10 cases were grade III. The VAS was 7 point at pathological grade I and 8 point at grade II. As the statistical analysis, the pathological grade of subacromial bursa was associated with acromial shape (p<0.05), but not associated with pain of patient (p>0.05). Conclusion: Our study suggests that pathological grade of subacromial bursa inflammation was associated with acromial shape. But pathological grade of subacromial bursa inflammation was not associated with shoulder pain of patients.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.39-44
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• 2006

Purpose: The object of this study is to compare the Insall-Salvati ratio and Carton index between the patients who have an anterior cruciate ligament (ACL) tear and the patients who have no ACL tear. Materials and Methods: The study group included 114 patients who had an ACL tear and received arthroscopic reconstruction. The group I was acute ACL tear group, within 3 weeks after injury. The group II was chronic ACL tear group who had MRI was done after 3 weeks from injury. The group III was normal control group. We measured the Insall-Salvati ratio and Carton index on Magnetic Resonance Images (MRI) for all patients. Results: The Insall-Salvati ratio of control group was $1.02{\pm}0.12$ and Carton index of control group was $1.14{\pm}0.16$. The ACL-tear study group was $0.91{\pm}0.12\;and\;0.89{\pm}0.20$ respectively. The Insall-Salvati ratio and Caton index in ACL tear group was significantly less than those of control group. There were no significant differences in comparing with acute and chronic ACL tear group. Conclusion: Our study show that patella baja has an association with ACL tears, therefore in patients with an ACL tear who had patella baja, ideal graft for reconstruction was seriously considered.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.123-130
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• 2008

Os acromiale is the rare shoulder disease and its treatment is controversial. Despite conservative treatments for 6 months include medication, exercise, physical therapy and subacromial steroid injections, operative treatment for uncontrolled symptomatic Os acromiale is considered the treatment of choice. Operative treatment includes excision, arthroscopic or open reduction and internal fixation with a bone graft. Open reduction with tension band wiring and a bone graft is now the preferred treatment. We experienced 8 patients with symptomatic Os acromiale from March, 2001 to March, 2006. The average patient's age was 45 years and the man and women ratio were 2: 6. All 8 cases of symptomatic Os acromiale of the mesoacromion were treated with open reduction and internal fixation using tension-band wiring. The preoperative ASES($47.3\pm24.4$) and UCLA ($16.6\pm5.8$)scores were improved to $88.8\pm7.3$ and $31.5\pm1.9$, respectively, at the 2 year follow up. The overall UCLA score showed 1 excellent result and 7 good results. We think that symptomatic Os acromiale is a specific disease entity, and open reduction and internal fixation using tension-band wiring with K-wire is a good treatment modality.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.89-94
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• 2009

Purpose: The purpose of this study was to evaluate the factors affecting the treatment results of medial meniscus posterior horn tear. Materials and Methods: Forty seven patients who had been performed the arthroscopic surgery for medial meniscus posterior horn tear were enrolled in this study. We analyzed the clinical outcomes with Lysholm score and Tegner activity score in accordance with the factors such as patients' age, tibiofemoral angle, uptake in bone scintigraphy, surgical methods and patterns of meniscal tears, respectively. Results: The patients' age didn't affect to the results, but the preoperative tibiofemoral angle over valgus $4^{\circ}$ and the preoperative normal uptake in scintigraphic assessment showed a positive influence on the clinical outcomes. The partial meniscectomy and repair in surgical methods had no statistically significance. In addition, the pattern of meniscal tear did not have an effect on the clinical results. Conclusion: We can conclude that many factors should be considered to get satisfactory results. Among them, preoperative bone scintigraphy may be a good assessment factor for the postoperative prognosis, reflecting the condition of meniscal tear and the periarticular bone and soft tissue.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.180-184
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• 2008

Purpose: This study evaluated the differences in associated shoulder lesions on complete rotator cuff tear patients regarding ages and gender. Materials and Methods: Between June 2003 and March 2006, 109 patients (59 males, 50 females) who received arthroscopic shoulder surgery for their complete rotator cuff tear were selected and their associated shoulder lesions were analyzed. Ages were between 24 years, the youngest, and 75 years, the oldest. Groups by age were under 59 years group and over 60 years group, and associated lesions of patients to be analyzed were Acromioclavicular arthritis, SLAP(shoulder labrum anterior and posterior) lesion, and biceps tendinitis, and statistic analysis were performed by Khai-square method. Results: For acromioclavicular joint arthritis, over 60 years old group showed higher association rate compared to under 59 years young group, and for SLAP lesions, under 59 years young group showed higher association rate compared to over 60 years old group only in men. Conclusion: For diagnosis and treatment of complete rotator cuff tear patient, associated shoulder lesions in different ages should be considered, especially associations of SLAP lesions in young male patients, and acromioclavicular joint arthritis in old age patients should be verified.

• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.574-578
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• 2019

For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.