• Clinics in Shoulder and Elbow
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• 제17권4호
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• pp.185-189
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• 2014

We report a case of intramuscular hemangioma in the subscapularis muscle and the resulting impairment of shoulder function in an adult patient. A nineteen-year-old female complained of shoulder pain and the development of a mass in the absence of previous trauma. Physical examinations, including lift-off and belly-press tests, showed abnormality. X-ray showed multiple calcifications in the front of the scapula. Magnetic resonance imaging showed a soft-tissue mass occupying almost the entire intramuscular portion of the subscapularis muscle. An arthroscopic examination excluded the possibility of a joint invasion, after which the entire mass was successfully removed by open excision. The displacement of the subscapularis by the mass was relieved after the surgery. Pathological diagnosis of the tissue confirmed a cavernous hemangioma. Both shoulder pain and function was improved after operation. There was no evidence of recurrence even at the 2-year follow-up. Rare forms of hemangioma adjacent to the shoulder joint could be successfully managed with surgical excision. Differential diagnosis, such as synovial chondromatosis, pigmented villo-nodular synovitis, and malignant sarcoma, should also be considered.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.3-10
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• 2020

Background: The aim of this study was to evaluate clinical experience with arthroscopic debridement for septic arthritis of the shoulder joint and to report on our patient outcomes. Methods: The retrospective analysis included 36 shoulders (male:female, 15:21), contributed by 35 patients (mean age, 63.8 years) treated by arthroscopy for septic arthritis of the shoulder between November 2003 and February 2016. The mean follow-up period was 14.3 months (range, 12-33 months). An additional posterolateral portal and a 70° arthroscope was used to access the posteroinferior glenohumeral (GH) joint and posteroinferior subacromial (SA) space, respectively. Irrigation was performed with a large volume of fluid (25.1±8.1 L). Multiple suction drains (average, 3.3 drains) were inserted into the GH joint and SA space and removed 8.9±4.3 days after surgery. Intravenous antibiotics were administered for 3.9±1.8 weeks after surgery, followed by oral antibiotic treatment for another 3.6±1.9 weeks. Results: Among the 36 shoulders, reoperation was required in two cases (5.6%). The average range of motion achieved was 150.0° for forward flexion and T9 for internal rotation. The mean simple shoulder test score was 7.9±3.6 points. Nineteen shoulders (52.8%) had acupuncture or injection history prior to the infection. Pathogens were identified in 15 shoulders, with Staphylococcus aureus being the most commonly identified pathogen (10/15). Both the GH joint and the SA space were involved in 21 shoulders, while 14 cases involved only the GH joint and one case involved only the SA space. Conclusions: Complete debridement using an additional posterolateral portal and 70° arthroscope, a large volume of irrigation with >20 L of saline, and multiple suction drains may reduce the reoperation rate.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.40-45
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• 1998

Multidirectional instability of the shoulder joint is an unusual entity which is not yet well understood. Traditionally recommended treatment is non-operative, but recently arthroscopic treatment has been performed. This is a retrospective review of 20 patients who had multidirectional instability, who had been treated with arthroscopic capsular shift(7 cases), and arthroscopic treatment using Ho:YAG laser(l3 cases) at Department of Orthopaedic Surgery, Chungnam National University Hospital from July, 1988to February, 1997. Results of this study were as follows: 1. In five patients who were treated with arthroscopic anterior capsular shift only, all cases had redislocation of the shoulder joint. But there was no redislocation in two patients who were treated with arthroscopic anterior and posterior capsular shift. 2. ln three patients who were treated with laser-assisted capsular shift only, all cases had redislocation of the shoulder joint. But there was only one redislocation in ten patients treated with laser-assisted capsular shrinkage and capsular plication. Ho: Y AG laser has been found to be a safe and efficacious adjunct to many arthroscopic shoulder procedures. We had satisfactory results by combining a transglenoid capsular shift with laser-assisted capsular shrinkage. Arthroscopic laser-assisted capsular shrinkage and capsular plication is a one of recommendable treatment options in multidirectional instability of the shoulder joint.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2003년도 연수강좌
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• pp.11-26
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• 2003

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1997년도 학술대회
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• pp.49-49
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• 1997

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.110-116
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• 2005

Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.21-21
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• 2009

There are some patients who have traumatic anterior shoulder instability due to minor injuries like overhead activities. The purpose of this study was to clarify characteristic features of traumatic anterior shoulder instability due to minor injuries. According to the mechanism of injury in an initial dislocation, 83 shoulders that underwent the stabilizing surgery for traumatic anterior shoulder instability were divided into two groups. Traumatic group included patients who suffered from a fall or a direct injury. Minor injury group included patients who suffered from the other injury like overhead activity. General joint laxity, range of motion and laxity under anesthesia, and intraarticular findings were compared between two groups. The morphology of superior and middle glenohumeral ligaments, Bankart lesion, Hill-Sachs lesion, and partial articular surface tendon avulsion lesion were observed in arthroscopy. Minor injury group consisted of 19 shoulders with 8 males, 11 females and the mean age of 22.5 years. Traumatic group consisted of 64 shoulders with 52 males, 7 females and the mean age of 24.3 years. Female in minor injury group was significantly more than that in traumatic group. There was no difference in general joint laxity and intraarticular findings between two groups. Range of external rotation in injured side in minor injury group was significantly more than that in traumatic group. Inferior laxity in both sides in minor injury group was more than that in traumatic group. In conclusion, the traumatic anterior shoulder instability due to minor injuries might incline to occur the shoulder in female and with inferior laxity of shoulder.

• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.245-248
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• 2016

A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.

• Clinics in Shoulder and Elbow
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• 제18권1호
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• pp.47-51
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• 2015

Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.19-29
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• 2017

Background: Patients after rotator cuff (RC) surgery experienced pain, weakness and limited of motion of the shoulder. Physical therapists have used heat therapy, electrotherapy, range of motion (ROM) exercise and other methods to treat patients after RC surgery. In addition, functional taping is also used to support joint movement and to increase shoulder joint stability. Objects: The purpose of this study was to determine the initial effects of functional taping using non-elastic tape on pain, strength and ROM of the shoulder following RC surgery. Methods: Forty-eight patients with who underwent RC surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, $n_1=25$) and a control group (CG, $n_2=23$). First, non-allergic tape was applied to the shoulder to prevent skin irritation. The EG applied functional taping using non-elastic tape and the CG applied sham taping using elastic tape. Assessment tools included the shoulder pain and disability index for functional activity score, visual analog scale for level of pain, shoulder muscle strength, hand grip strength and ROM testing. Results: Pain score in the both group significantly decreased (p<.05), and change in pain score of in the EG increased significantly than in the CG (p<.05). Shoulder strength and ROM in the both group significantly increased (p<.05). Especially external rotation and extension of the shoulder ROM in the EG increased significantly more than in the CG (p<.05), but the rate of change in the two groups showed no significant difference. Conclusion: These results suggest that functional taping using non-elastic tape was initially effective in decreasing pain score level in patients with RC surgery.