• Clinics in Shoulder and Elbow
• /
• v.25 no.4
• /
• pp.339-346
• /
• 2022

Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

• Clinics in Shoulder and Elbow
• /
• v.26 no.3
• /
• pp.323-329
• /
• 2023

Rotator cuff tear is a common shoulder injury that compromises both function and quality of life. Despite the prevalence of the injury and advancements in repair techniques, a significant percentage of these repairs fail. This review aims to explore the multifactorial reasons behind this failure, including the degenerative nature of the rotator cuff tendon, inherent and extrinsic factors, and the role of hypoxia in tissue degeneration. Additionally, it elucidates potential strategies for improving healing outcomes.

• Journal of the Korean Arthroscopy Society
• /
• v.16 no.1
• /
• pp.92-97
• /
• 2012

Purpose: The reparability of rotator cuff tears is very important to establish the indication of the surgical treatment of rotator cuff tears. We reviewed the factors that effect to reparability of rotator cuff tears, and considered about the surgical indication of rotator cuff tears. Materials and Methods: The reparability was considered by the surgical reparability and the postoperative healing potentials of rotator cuff. The natural history of rotator cuff tear gives us the information to make decision about the surgical treatment or the conservative treatment. Results: There are 3 general categories of factors that help predict the healing potential of a rotator cuff tear. These include surgical technique, biology, and environmental issues. Surgeon can control the surgical technique by himself. The control of biology comes from careful operative indications by age, acute trauma history, chronicity, and tear size. And the control of environmental factor can give better outcomes by cessation of smoking and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: A better understanding of the natural history and the reparability of rotator cuff tear will help us to estabilish the indication of surgical treatement of rotoator cuff tears, and lead to satisfactory clinical outcomes.

• Journal of Acupuncture Research
• /
• v.29 no.6
• /
• pp.119-125
• /
• 2012

Objectives : Rotator cuff tear is a common disease that causes shoulder pain and disability. Sometimes surgical treatment is demanded and appropriate rehabilitation is also needed to provide functional recovery. This report is intended to estimate the effect of oriental treatment for the patients in rotator cuff surgery rehabilitation period. Methods : From 29th October, 2012 to 13th November, 2012, One male patient who received rotator cuff surgery was treated with acupuncture, pharmacopuncture and herbal medication. NRS and ROM were evaluated to demonstrate the effect of treatment. Results : The patient showed the improvement in shoulder pain and ROM. Conclusion : Oriental treatments such as acupuncture, pharmacopuncture, herbal medication can be effective for relieving pain and increasing ROM in rotator cuff surgery rehabilitation period.

• Clinics in Shoulder and Elbow
• /
• v.19 no.2
• /
• pp.84-89
• /
• 2016

Background: The purpose of this study was to assess the results of arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Methods: From November 2009 to April 2011, 12 patients underwent arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Patients were followed for an average of 33.9 months. Clinical outcome was evaluated preoperatively and postoperatively using the mean University of California, Los Angeles (UCLA) score and the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging (MRI) was performed postoperatively at an average of 6.5 months. Results: At a mean follow-up of 33.9 months (range, 25 to 42 months), 11 out of 12 patients were satisfied with their procedure. Patients showed significant improvement in their mean modified UCLA score from 15.9 preoperatively to 29.4 postoperatively (p=0.001). The mean KSS score improved from 45.6 preoperatively to 80.5 postoperatively (p=0.002). In MRI studies, 9 out of 12 patients had full incorporation of the graft into the native rotator cuff remnant. To date, there has been no intraoperative or postoperative complication from the graft procedure, such as infection or allograft rejection, in any patient. Conclusions: Arthroscopic bridging repair using a human dermis allograft can be considered as an option in treatment of select cases of massive irreparable rotator cuff tears, resulting in high patient satisfaction.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.3 no.2
• /
• pp.93-97
• /
• 2004

Continued research needs to be devoted to understanding the natural history of rotator cuff tears. Recent studies have shown progression of tear, symptomatic flare-ups and irreversible change in rotator cuffs managed nonsurgically. These data allow the grouping of patients with rotator cuff tears into three categories based on risk-benefit ratios. Nonsurgical care should be maximized for patients with impingement symptoms only, with partial-thickness tears, with chronic tears, and for the elderly patients. The proper selection of candidates for nonsurgical management should lead to the high success rate quoted by multiple authors. Even though conservative treatment is necessary, early surgery should be considered for tears that are acute, small or medium, associated with shoulder loss of function, or occur in a younger patient. Prolonged nonsurgical care in these patients risks tear propagation and irreversible changes to the cuff, which may complicate rotator cuff repair.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.33 no.4
• /
• pp.233-238
• /
• 2019

The aim of this study was to investigate the effect of Korean medicine treatments on pain reduction and functional improvement of patients after rotator cuff surgery. We studied 10 patients who had admitted to Dunsan Korean Medical hospital after have being diagnosed as rotator cuff tear and got a surgery at other hospital from April 30, 2014 to April 30, 2019. This study was conducted as retrospective study which analyzes patient's medical records. Statistical analysis was performed using the IBM SPSS statistics 24 program. We used Numeric Rating Scale to evaluate pain reduction, Range of Motion to evaluate shoulder functional improvement and Five-point likert scale to evaluate the patient's satisfaction. The result showed that Korean medicine treatments statistically significantly reduced pain on the patients after rotator cuff surgery. Although there were improvement of Range of Motion, it wasn't statistically significant. In conclusion, we found that the Korean medicine treatments showed a positive effect on pain reduction of patients after rotator cuff surgery and got a high satisfaction.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.16 no.1
• /
• pp.1-11
• /
• 2021

Objectives This study aimed to evaluate the efficacy of Chuna manual therapy(CMT) in the treatment of rotator cuff disorder. Methods We searched th following nine online databases without language restriction (MEDLINE/PubMed, Cochrane library, Ebscohost, CNKI, RISS, NDSL, KMBASE, and KISS) to identify randomized controlled trials (RCTs) that used CMT in the treatment of rotator cuff disorder. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Results Four RCTs were included. in the meta-analysis. CMT resulted in a significant reduction in symptoms in these trials. However, there was a high risk of bias in the RCTs. Conclusions We reviewed RCTs that studied the effects of CMT for rotator cuff disorder. While the studies indicate that CMT has favorable effects on rotator cuff disorder. But the risk of bias for most of the studies was high. Therefore, high-quality studies are required to make further conclusions.

• Clinics in Shoulder and Elbow
• /
• v.9 no.2
• /
• pp.181-188
• /
• 2006

Purpose: To evaluate the integrity of repair & technical tip in use of Massive Cuff Stitch at arthroscopic repair of rotator cuff tear. Materials and Methods: Twenthy-nine cases of arthroscopically repaired full thickness tear of rotator cuffs which are medium sized were evaluated. Between December 2004 to September 2005 we have studied, the average age 53($42{\sim}69$) years old, mean follow-up was 15($12{\sim}21$) months. We analyzed the results statistically by paired t-test. The integrity of repair were verified by follow up MRI which were checked 11 cases and ultrasound which were checked 10 cases. Results: VAS of pain improved preoperative average 7.1 to postoperative 0.9, ADL improved 11.2 to 25.6 respectively, UCLA improved 13.7 to 32.9(all, P<0.05). 89.7% showed excellent & good results at the final follow-up. The satisfied rate was 93.1%(27 cases). There was re-rupture of the repaired rotator cuff in one case out of 11 cases which were checked by MRI, and in one case out of 10 cases which were checked by ultrasound, and there was one case of thinning of cuff which were checked by ultrasound. Conclusion: The use of Massive Cuff Stitch in arthroscopic repair of rotator cuff tear have been reduced technical failure. It will be good surgical technique which maintain the integrity of repairs.

• Clinics in Shoulder and Elbow
• /
• v.1 no.2
• /
• pp.250-255
• /
• 1998

Purpose of the study was to analyze the supraspinatus outlet image of sagittal MRI in rotator cuff disease. We analyzed the sagittal views of the shoulder MRI of 78 cases without cuff tear. The cases were divided into 51 cases of rotator cuff disease group and 27 cases of control group. Six parameters of acromial tilt, coracoacromial ligament angle, length and height of coracoacromial triangle, length of acromial side of the baseline and distance of intrusion of the humeral head were compared for each group. The distance of intrusion of the humeral head was the most significantly different one, 0.52cm for rotator cuff disease group and 0.15cm for control group. Intrusion of the humeral head to the supraspinatus outlet space from the bottom may be a contributing factor developing rotator cuff disease. The intrusion may precede to tearing of the rotator cuff.