• 대한정형외과학회지
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• 제54권2호
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• pp.91-99
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• 2019

대부분의 환자는 관절경적 회전근 개 봉합술 후 통증이 완화되고 기능적 호전을 보이지만 일부 환자는 수술 후에도 증상이 지속된다. 재파열은 생물학적, 기술적, 외상적 요인이 복합적으로 작용하여 발생한다. 회전근 개 봉합술 후 재파열이 지속되는 통증의 원인일 수도 원인이 아닐 수도 있다. 따라서 이런 환자들의 평가 및 치료는 난해하여 철저한 문진, 이학적 검사, 적절한 영상 검사를 통해서 통증의 원인에 대한 분석이 이루어져야 한다. 재봉합술의 시행 여부는 환자의 나이, 기능적 요구도 회전근 개의 상태, 수술 전 관절 운동 범위, 삼각근의 상태, 관절과 상완 관절의 관절염의 유무에 따라 결정되어야 한다. 성공적인 재봉합술은 술기뿐만 아니라 수술 전 환자 교육 또한 중요하다.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.135-140
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• 2021

Background: We hypothesized in this study that the characteristics of retear cases vary according to surgeon volume and that surgical outcomes differ between primary and revision arthroscopic rotator cuff repair (revisional ARCR). Methods: Surgeons performing more than 12 rotator cuff repairs (RCRs) per year were defined as high-volume surgeons, and those performing fewer than 12 RCRs were considered low-volume surgeons. Of the 47 patients who underwent revisional ARCR at our clinic enrolled in this study, 21 cases were treated by high-volume surgeons and 26 cases by low-volume surgeons. In all cases, the interval between primary surgery and revisional ARCR, degree of "acromial scuffing," number of anchors, RCR technique, retear pattern, fatty infiltration, retear size, operating time, and clinical outcome were recorded. Results: During primary surgery, significantly more lateral anchors (p=0.004) were used, and the rate of use of the double-row repair technique was significantly higher (p<0.001) in the high- versus low-volume surgeon group. Moreover, the "cut-through pattern" was observed significantly more frequently among the cases treated by high- versus low-volume surgeons (p=0.008). The clinical outcomes after revisional ARCR were not different between the two groups. Conclusions: Double-row repair during primary surgery and the cut-through pattern during revisional ARCR were more frequent in the high- versus low-volume surgeon groups. However, no differences in retear site or size, fatty infiltration grade, or outcomes were observed between the groups.