Kim Sung-Jae;Shin Sang-Jin;Kim Jin-Yong;Rhee Dong-Joo
Journal of the Korean Arthroscopy Society
/
v.4
no.1
/
pp.25-31
/
2000
Introduction : This study compared the clinical results with biceps rerouting fer the isolated posterolateral instability (PLI) and for the PLI combined with PCL injuries. Methods : 21 cases of isolated PLI (group I) and 25 cases of PLI combined with PCL rupture were included in the study. The PLI was reconstructed by modified biceps femoris rerouting technique with PCL reconstructions performed prior to the PLI correction in cases of combined injury The clinical results were reviewed and analyzed. Results : Pre-operatively positive reverse pivot shift test turned negative in 43 cases post-operatively. Increased preoperative external rotation thigh foot angle (ERTFA) showed significant differences between the two groups and all fell within normal limits post-operatively At a mean follow-up of 40.3 months, the average Lysholm knee score and. The Hospital for Special Surgery Knee Ligament Score for group I and group II revealed above 90 points without statistically significant difference between the groups. 3 cases of tenodesis failure developed and re-operation was performed. Discussion and Conclusion : The advantages of modified Clancy technique include reduced surgical damages to the iliotibial band and fixation of the biceps tendon at the isometric position. The modified biceps rerouting technique is recommended for the reconstruction of both isolated and combined PLI except in patients with severe damages at the attachment of biceps tendon.
Objectives : 1. Clinical trial for the efficacy evaluation of Korean acupuncture techniques in treating frozen shoulder. 2. Development of the standard clinical guidelines of the acupuncture treatment for the frozen shoulder. 3. Development of the new clinical protocol for the acupuncture treatments. 4. Verification of the hypothesis that treating at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints. Methods : 1. Research designed as Single blind, Randomized, Sham acupuncture controlled clinical Trial. 2. Assignment of 86 patients to one of three groups treated at nearby acupoints(group A), remote & nearby acupoints(group B), and sham points(group C) respectively. 3. Trial conducted at KIOM CRC of Dunsan oriental medical hospital, Daejeon Univ. 4. Estimation of the recovery rate of the frozen shoulder in subjects aged over 40. 5. Efficacy evaluation using VAS, SPADI, ROM and Improvement rate. Results : 1. There was no significant difference in VAS among the three groups. 2. Pain related scores in SPADI of the group B were significantly lower than those of the group A. 3. There was no significant difference in disability related scores of SPADI among the three groups. 4. External rotation of upper arm in the group B was significantly improved in comparison with that in the group C. 5. Abduction of upper arm in group A was improved with weak statistical significance in comparison with that in the group C. Conclusion : Acupuncture at both the remote and the nearby acupoints according to the meridian theory is effective to improve external rotation of frozen shoulder, and acupuncture at the nearby acupoints is effective to improve adduction of frozen shoulder. However it is not clear that acupuncture treatment at both the remote and the nearby acupoints according to the meridian theory is more effective than treating at only the nearby acupoints in the treatment of frozen shoulder. Since our study was a short term trial, a long term trial for a more precise evaluation of acupuncture treatment for frozen shoulder will be needed in the future.
Park, Se-Jin;Jeong, Hwa-Jae;Shin, Hun-Kyu;Seo, Dong-Seok;Choi, Young-Min;Kim, Eugene
Journal of Korean Foot and Ankle Society
/
v.18
no.1
/
pp.29-35
/
2014
Purpose: The purpose of this study is to compare the radiologic and clinical results of syndesmotic screw fixation and posterior malleolar fixation for syndesmotic injury in Lauge-Hansen classification pronation-external rotation (PER) stage IV ankle fractures with posterior malleolus fracture. Materials and Methods: We designed a retrospective study that included patients with Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture. Of 723 patients who underwent ankle fracture surgery from March 2005 to November 2012, 29 were included in this study. In this study, syndesmotic injury was treated with syndesmotic screw fixation or posterior malleolus fixation. There were 15 cases of syndesmotic screw fixation and 14 cases of posterior malleolar fixation. We compared the radiologic and clinical results at one year postoperatively. Posterior malleolus fragment size on a pre-operative computed tomographic image, and tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, and Takakura classification on a postoperative one year followup radiograph were used for comparison of the radiologic results. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society score, visual analogue scale score, and patient subjective satisfaction score. Results: Posterior malleolar fragment size was $12.62%{\pm}3.01%$ of the joint space in the syndesmotic screw fixation group and $27.04%{\pm}4.34%$ in the posterior malleolar fixation group. A statistical difference was observed between the two groups. However, other results, including tibiofibular overlap, medial clear space, articular step-off, Kellgren-Lawrence grade, Takakura classification, and clinical scores showed no statistical difference. Conclusion: In the Lauge-Hansen classification PER stage IV ankle fracture with posterior malleolus fracture, if the posterior malleolus fracture can be reduced anatomically and fixated rigidly, syndesmotic screw fixation, which can cause several complications, is usually not required for achievement of a satisfactory syndesmotic stability; this would be a recommendable option for treatment of syndesmotic injury.
The purpose of this study was to investigate the biomechanical alterations in the punching motion of 10 elderly women after 12 weeks of taekwonaerobics training. Seven infrared cameras(Qualisys MCU-240) and 2 force platforms(Kistler-9286AA) were used to acquire raw data. The results were as follows. First, the minimum joint angles of the lower limbs had a statistically significant difference between both the dorsiflexion/plantar flexion(1eft, $p=0.001^*$) and the inversion/eversion(both, $p=0.009^*$, $p=0.04^*$) from the ankle angle. There were differences in abduction/adduction(left, $p=0.04^*$) from the knee angle, as well as internal/external rotation(both, $p=0.07^*$, $p=0.02^*$) from the hip angle. Second, the maximum resultant joint moments of the lower limbs had statistically significant differences in the inversion/eversion moment from the ankle joint(both, $p=0.05^*$, $p=0.05^*$), the abduction/adduction moment(left, $p=0.08^*$) from the knee joint, and the internal/external rotation moment(right, $p=0.09^*$) from the hip joint. Third, the maximum resultant joint powers of the lower limbs had a statistically significant difference both in flexion/extension joint powers(both, $p=0.05^*$, $p=0.01^*$) and in abduction/adduction(both, $p=0.02^*$, $p=0.00^*$) from the hip joint, as well as abduction/adduction(left, $p=0.00^*$) from the knee joint, In conclusion, the elderly women were somewhat changed after 12 weeks of taekwonaerobics training.
This study aimed to identify the difference of scapular movements between tennis players with and without shoulder impingement syndrome(SIS) and to verify the effect of kinesiology taping applied to scapular. A total of 15 players were categorized in SIS group(n=7) and control(CON) group(n=8). The scapular movements evaluated using 3-dimensional motion analysis in the 5 events of the flat first serve before and after the application of taping. The male of SIS group(-7.31±1.19° and -5.28±1.08°, respectively) had tilted scapular more anteriorly compared to CON group(-0.98±5.38° and -0.44±3.52°, respectively) at the maximally humeral external rotation and the impact(Z=-2.309, p=.021 and Z=-2.309, p=.021, respectively). The scapular(-8.11±2.57°) of female in SIS group tilted more anteriorly than that of CON(-0.97±3.31°) group at the maximally humeral external rotation(Z=-2.121, p=.034). But the scapular movements had no statistical differences between before and after the application of taping.
Statement of problem: In order to increase preload with reducing the friction coefficient, abutment screws coated with pure gold and Teflon as dry lubricant coatings have been introduced. But the reported data indicate that if screw repeated tightening and loosening cycle, an efficiency of increasing preload was decreased by screw surface wearing off. Purpose: This study was to evaluate the influence of tungsten carbide/carbon coating, which has superior hardness and frictional wear resistance, on the preload of abutment screws and the stability of coating surface after repeated closures. Material and method: The rotational values of abutment screws and the compressive forces between abutment and fixture were measured in implant systems with three different joint connections, one external butt joint and two internal cones. Moreover the stability and the alteration of coating surface were examined by comparison of the compressive force and the removable torque values during 10 consecutive trials, observation with scanning electron microscope and analyzed the elemental composition with energy dispersive x-ray spectroscopy Results and conclusion: 1. Application of coating resulted in significant increase of compressive force in all implant systems(P<.05). The increasing rate of compressive force by coating in external butt joint was gloater than those in internal cones (P<.05). 2. Coated screw showed the significant additional rotation compared to non-coated screw in all implant systems (P<.05). There were no significant differences in the increasing rate of rotation among implant systems (P>.05). 3. Removable torque values were greater with non-coated screw than that with coated screw (P<.05). 4. Coated screw showed insignificant variations in the compressive forces during 10 consecutive trials(P>.05) 5. After repeated trials, the surface layer of coated screw was maintained relatively well. However surface wearing and irregular titanium fragments were found in non-coated screw.
Park Jin-Young;Lim Soo-Taek;Yoo Moon-Jib;Lyu Suk-Joo
Journal of Korean Orthopaedic Sports Medicine
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v.1
no.1
/
pp.102-107
/
2002
Purpose: The aim of this retrospective study were to report the short-term results of inferior capsular shift procedure using splitting subscapularis and capsule for the patients who had shoulder instability and were apt to recur after arthroscopic stabilization procedure. Materials & Methods : Fifteen cases of instability of the shoulder were included with an average follow-up of 2 years (range: 1$\~$3 years). There were 13 men and 2 women with an average age of 27years. Multidirectional instability was found in 4 cases, voluntary instability in 3 cases, bony Bankarte lesion in 2 cases and 6 cases were contact sportmen. Thirteen shoulders underwent the inferior capsular shifts and Bankart repairs and 2 shoulders without Bankart lesion underwent the inferior capsular shift only. Average 19 mm of shift (range: 10$\~$25 mm) was done. Results : Fourteen patients showed good and excellent results with one subluxation and one positive apprehension test. Postoperative ranges of motions did not change in forward elevation, external rotation at side and external rotation at 90$^{\circ}$ abduction (p>0.05). Conclusion : Inferior capsular shift procedure using splitting subscapularis and capsule can be helpful in shoulder instability patients who were high-risk group of recurrence with arthroscopic procedure.
Objective: To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods: MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results: In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion: MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful.
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.
Purpose: The purpose of this study is to check the range of motion of shoulder and inverstigate the frequencies and patterns of partial thickness rotator cuff tear in SLAP lesions. Materials and Methods: Forty-six patients, forty-seven cases who had SLAP lesions at shoulder arthroscopy were analyzed spectively using the medical records, intra-operative arthroscopic photo & video for SLAP lesions and rotator cuff articular side partial tear. Under the interscalene anesthesia, the range of notion of foreward elevation, internal rotation and external rotation was measured on fixed scapula and 90 degree abduction of the shoulder. Results: The rang of Motion are 150 degree on foreward elevation, 65.5 degree on external rotation, 61.7 degree on internal rotation. By Snyder's classification, type ll SLAP lesion is noted in 24 cases (five cases in type 1, one case in type IV). Rotator cuff articular side partial tear is noted in 24 cases ( one case in type I, 22 cases in type II, one case in type IV SLAP). All the rotator cuff articular side partial thickness tear were located in the anterior part of the supraspinatus. Conclusion: The rotator cuff partial thickness tear is mostly noted on the articular side and frequently found in the relatively more unstable type of SLAP lesions. So we consider that SLAP lesion may be a one of the causes for partial tear of the rotator cuff articular side.
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