• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.84-87
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• 1999

The Buford complex is unusual variant of the glenohumeral joint. This complex is distinguished by a cord-like middle glenohumeral ligament that oriented directly form the superior labrum at the base of the biceps tendon and crosses the subscapularis tendon to insert on the humerus. There is no anterior-superior labral tissue present between this attachment and the mid-glenoid notch. This anatomical variation may lead the surgeon to confuse this complex with a sublabral hole, pathologic labral detachment, Bankart lesion or SLAP lesion. We report a case of Buford complex which was found incidentally during the operation of impingement syndrome with stiffness and treated with subacromial decompression only.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.173-182
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• 2019

This study is to report the effectivenes of Meridian-Test (M-test) in 2 cases on shoulder diseases. The M-test was applied to one patient diagnosed with as impingement syndrome and one patient diagnosed with tear of supraspinatus tendon. The changes in numeral rating scale and range of motion were identified to assess the progress of the treatment. After three times treatments, In example 1, the pain decreased from 6 to 0.5 and the range of flexion and abduction increased from $150^{\circ}$ to $180^{\circ}$. In example 2, the pain decreased from 6.5 to 1, and the range of shoulder flexion increased from $120^{\circ}$ to $170^{\circ}$, while the range of abduction increased from $90^{\circ}$ to $170^{\circ}$. Based on the above results, it would be effective to apply M-test to treat shoulder diseases in these two cases.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.219-228
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• 2022

Purpose : The purpose of this study was to suggest a more effective method by comparing the effects of changes in pain intensity, muscle strength, and athletic performance after applying a 6-week eccentric training program (ET-MWM) or concentric training program (CT-MWM) with MWM for high school baseball players with shoulder internal impingement (SII). Methods : A total of 75 participants were randomly assigned to each group and divided into two groups, "ET-MWM group (n=35)" and "CT-MWM group (n=32)" according to the intervention method. Pain intensity, muscle strength (external rotation, internal rotation), and athletic performance were first measured before the intervention, and after the intervention 3 times a week for a total of 6 weeks, both groups were re-measured in the same way. Visual analog scale (VAS) was used for pain intensity, biodex dynamometer for muscle strength (60 °/sec.), and Kerlan-Jobe orthopedic clinic shoulder & elbow score (K-KJOC) for athletic performance. Results : As a result of analyzing the homogeneity of the pre-intervention characteristics and initial measurement variables of the study subjects, there was no significant difference between the two groups in all variable values. Pain intensity (VAS) was significantly reduced in the ET-MWM group than in the CT-MWM group (p<.05). In addition, the maximum muscle strength of external rotation & internal rotation of the shoulder (60 °/sec.) and athletic performance (K-KJOC) were significantly increased in the ET-MWM group than in the CT-MWM group (p<.05). Conclusion : Compared with the CT-MWM training program, the ET-MWM training program reduced shoulder joint pain and further increased the muscle strength required for throwing motion in high school baseball players. As the result showed better athletic performance improvement, the ET-MWM training program can be clinically recommended as a more effective intervention.

• Journal of Korean Foot and Ankle Society
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• v.22 no.1
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• pp.16-20
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• 2018

Purpose: To evaluate the clinical and radiographic results of surgical treatment for patients with sinus tarsi pain due to accessory talar facet impingement. Materials and Methods: Between July 2013 and July 2015, nine patients who underwent surgery for the accessory talar facet impingement were reviewed. The mean follow-up period was 18.6 months (12~36 months), and the mean age was 33.1 years (19~60 years). Previous trauma history, duration of symptom, and types of surgery were analyzed. The clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS). Radiographic results were assessed using Meary's angle, calcaneal pitch angle, heel alignment angle, and heel alignment ratio. Results: All patients had evident trauma history prior to the initial symptom. The mean duration of symptoms was 25.6 months (6~120 months). Four patients received only accessory anterolateral talar facet (AALTF) excision, and four patients received medial sliding calcaneal osteotomy (MSCO). One patient underwent both AALTF excision and MSCO. The AOFAS ankle-hindfoot score was significantly improved from 73 (62~77) preoperatively to 93 (67~100) postoperatively. The VAS score was decreased from 6 (5~7) preoperatively to 1 (0~5) postoperatively. The Meary's angle and calcaneal pitch angle showed no significant difference after surgery. The heel alignment angle and ratio increased from $-3.6^{\circ}$ ($-10^{\circ}{\sim}5^{\circ}$) and 0.22 (-0.15~0.6) preoperatively to $2.8^{\circ}$ ($1^{\circ}{\sim}5^{\circ}$) and 0.42 (0.3~0.6) postoperatively, respectively. Conclusion: If there is persistent sinus tarsi pain in patients with hindfoot valgus, accessory talar facet impingement caused by AALTF could be considered as a cause of chronic sinus tarsi pain.

• 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.

• Hip & pelvis
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• v.34 no.3
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• pp.177-184
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• 2022

This study aimed to analyse the initial results of five patients with symptomatic osteochondral lesions (OCL) and femoroacetabular impingement (FAI) who were treated successfully with osteochondral autologous transfer (OAT) and femoral neck osteochondroplasty (OCP) through surgical dislocation of the hip. Five patients with FAI and OCL of the femoral head who underwent surgery between 2015-2018 were studied retrospectively. All patients had a grade IV OCL, and the median defect size was 2 cm2 (interquartile range [IQR], 2-2). At the final follow-up, the modified Harris hip score showed a median value of 94 (IQR, 91-95) (P=0.04). Pain evaluation using the visual analogue scale showed a median value of 1 (IQR, 1-2) (P=0.04). Adequate graft union and healthy formation of the chondral surface were observed by magnetic resonance imaging. Although the procedure is demanding, the combination of OAT and femoral neck OCP appears to be an effective alternative in young patients.

• Journal of Korean Medical Science
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• v.33 no.52
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• pp.339.1-339.11
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• 2018

Background: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ${\leq}50years\;old$. Methods: We retrospectively analyzed a consecutive cohort of 150 patients (${\leq}50years\;old$) with chronic hip pain (${\geq}6weeks$), which was not diagnosed or misdiagnosed based on the information provided on the referral form. Results: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. Conclusion: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.4-8
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• 2021

Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs. Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. The steroid group received a mixture of 1 mL of triamcinolone acetonide (40 mg/mL) and 1 mL of lidocaine hydrochloride 2%, while the NSAID group received a mixture of 1 mL of Ketorolac Tromethamine (30 mg/mL) and 1 mL of lidocaine hydrochloride 2%. The patients were assessed before and at 3, 6, and 12 weeks after the procedure. Shoulder scores from visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES), and University of California Los Angeles (UCLA) were used for evaluation. Results: Both groups showed improvements in the clinical outcomes. Overall VAS, ASES, and UCLA scores improved from 6.9, 32.7, and 16.0 before the procedure to 2.0, 1.2, and 1.1; 81.5, 87.6, and 88.5; and 29.7, 31.8, and 32.0 at weeks 3, 6, and 12 weeks after the procedure, respectively. Twenty-six patients (86.7%) in the steroid group and 28 (93.3%) in the NSAID group reported satisfactory treatment outcomes. There were no significant differences in the outcomes between the two groups (p=0.671). Conclusions: Subacromial injection of NSAIDs for rotator cuff tendinitis with shoulder pain had equivalent outcomes with those of steroid injection at the 12-week follow-up.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.2
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• pp.11-19
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• 2018

PURPOSE: The aim of this study was to identify the effects of joint mobilization intervention combined with exercise on range of motion (ROM), pain intensity, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. METHODS: The subjects were 30 adolescent baseball players diagnosed with internal impingement. Ten subjects were randomly assigned to each of 3 groups: Group 1 (exercise only), Group 2 (joint mobilization combined with exercise), and Group 3 (rest-only control group). Three weekly interventions were given for 4 weeks (the control group rested for 4 weeks). The main outcome measures were goniometer, visual analogue scale (VAS), and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), pain intensity (at the moment of throwing), and functional performance were compared among the groups. RESULTS: No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal rotation was significantly increased in Group 2 compared to Groups 1 and 3. Pain intensity was significantly lower in Group 2 than in Group 1 and 3, and functional performance was significantly increased in Group 2 compared to Group 1 and 3. CONCLUSION: An intervention that combined joint mobilization with exercise was more effective than resting or exercise alone for rapid recovery from sports injury and improvement in athletic performance.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 1995.05a
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• pp.12-12
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• 1995