Rotator Cuff Repair Without Bony Trough / 대한정형외과학회잡지

Surgical repair has been widely accepted for full thickness tear of the rotator cuff. In traditional method, hony trough on the greater tuberosity of the humerus has heen used for tendon to hone suture. Recently, there have been some suggestions that hony trough would not he essential for repairing the rotator cuff. Purpose of this study was to investigate the clinical result of rotator cuff repair without bony trough. We evaIuated the clinical results of 23 operative repairs of the full-thickness tear of the rotator cuff, using modified ASES scoring system, at an average of l4 months postoperatively. For these cases, all the tendon to hone sutures were done without makin bony trough. There were 3 cases of small tear. 14 case of medium tear, 1 case of large tear and 5 cases of massive tear. Mini-open repairs with arthroscopic acromioplaslies were used for 9 cases with small or medium sized tear. Open acromioplasties and repairs were done for 14 cases. Nine cases were rated excellent (39%), and twelve cases showed good results (52%). Two cases showed fair results (9%). Averagc increase of score was 40 (ranee, 18 to 78). There were no complications or deteriorations of function. No patient needed additional surgery. Repair without hony trough is more simple and easier than the traditional method making bony trough. There would he possibility of less tension to the tendons and preserving more natural course of tendons. The authors believe that this method provides larger contact surface between the tendon and hone. The repairing method without hony trough is considered to he a safe and efficient method for the full thickness tear of the rotator cuff. This technique can he useful not only for ordinary open repair, but also for mini-open repair.

Functional Knee Braces for Control of Hyperextension

The functional knee hrace has been used to provide or to assist knee stahility in the anterior cruciate ligament (ACL) deficient knee, Nowadays, it is more indicated in the postoperative care of ACL injury to protect the reconstructed or repaired ligament, but eontroversies still exist regarding the effectiveness and the selection of an appropriate model. For successful application, it must restrict the knee motion within the range of certain arc, especially hyperextension, during weight bearing together with convenience and comfort.. The six commercial functional knee braces, which were introduced in Korea, were ehecked to detect the angle discrepancy between angle of brace and knee joint motion. The purpose of this study was to guide correct application of the functional knee brace in preventing hyperextension of the knee joint. Each brace was grouped into small, medium and large by size, and fixed with the arc of motion 30 to 90. The brace was applied to 3 healthy volunteers whose size was just fit mth the brace size small, rnedium and large, respectively. True lateral X-ray of the knee joint was taken in active flexion and extension state under the fluoroscopic control and measured the lateral intershaft angle of femur and tibia. Average angle discrepancy between the brace and the intershaft ang]e of femur and tibia in active extension was 22 and 3 in acTive flexion. In active extension at 30, angle discrepancy of Denzo brace was the large:st recording 26, that of Sentry hrace was the smallest recording 17. In active flexion at 90', angle discrcyancy of Sentry hrace was the largest recording 13, that of ACL brace (custom made modified Sentry brace) was the smallest recording 2. There was no statistically significant difference of the angle discrepancy among each size of brace. This study suggests that, at least 20 of angle discrepancy must be considered in appling the knee brace for prevention of hyperextension of the knee joint and careful selection of the brace, which may be affected by the design of hrace and the soft tissue compliance, is mandatory.