Analysis of the Change in Fatty Degeneration of the Rotator Cuff and Its Influence on the Outcome of Rotator Cuff Repair / 대한정형외과학회잡지

PURPOSE: To analyze the changes in fatty degeneration of the rotator cuff after its repair as well as the effect of fatty degeneration on the functional and anatomical outcomes. MATERIALS AND METHODS: The medical records of 107 patients (mean age=58.7 years), who had undergone a repair of rotator cuff tears, were reviewed. The mean follow-up period was 16 months. The following parameters were evaluated: the functional outcomes, including the American shoulder and elbow surgeons (ASES) score, Constant score and muscle power; preoperative and postoperative fatty degeneration of the rotator cuffs, including supraspinatus, infraspinatus and subscapularis; and the cuff integrity. RESULTS: Both the ASES and Constant scores were improved significantly postoperatively. The re-tear rate was 19.6%. The overall rate of satisfactory results was 88.8%. Fatty degeneration progressed in 25 cases (22.4%) and regressed in three (2.8%). More progression was observed in older (p=0.016) and re-tear (p=0.011) patients. The ASES score had a significant relationship with the preoperative fatty degeneration of the supraspinatus and the infraspinatus, whereas the Constant score was associated with the fatty degeneration of all three muscles. CONCLUSION: Greater progression of fatty degeneration was observed in older and re-tear patients. The functional outcomes were better in the less severe fatty degeneration group.

Clinical Outcome and Causative Factor in Patients of Structural Failure after Rotator Cuff Repair

PURPOSE: We wanted to evaluate the relationship between the clinical outcomes and cuff integrity after open rotator cuff repair and we wanted to analyze the causes of rotator cuff retear. MATERIALS AND METHODS: 78 patients who underwent open rotator cuff repair were enrolled from 2004 to 2006. All the patients were observed for a minimum follow-up of 12 months and they were evaluated by magnetic resonance imaging (MRI). The clinical outcomes were accessed by dividing the patients into the retear group and the intact group. The groups were also compared to analyze the cause of rotator cuff retear according to the preoperative tear size, the symptom duration, and so on. RESULTS: The clinical outcome of the retear group (n=22) was improved significantly after operation (p<0.001, p<0.001), but the muscle power was not improved significantly (p=0.099, p=0.243). More retears were found in the patients who had a larger preoperative tear (p<0.001) and the symptom duration of the retear group was longer (p=0.027). CONCLUSION: Although there were retear after rotator cuff repair, the clinical outcomes were improved. Yet the muscle power of the supraspinatus and external rotator were not improved significantly. There were more retears for the cases that had a larger preoperative tear size and a longer duration of symptoms.

Percutaneous Vertebroplasty in the Treatment of Osteoporotic Compression Fracture (99 Patients, 171 Vertebral Bodies)

PURPOSE: This study was designed to compare the clinical and radiologic outcome of the patients who underwent percutaneous vertebroplasty among the groups based on follow-up period and BMD. MATERIALS AND METHODS: A total of 99 patients (171 vertebral bodies) underwent percutaneous vertebroplasty from January 2001 to September 2003. The patients were divided into 3 groups by follow-up periods, and also divided into 2 groups by BMD. We investigated the difference of radiologic and clinical effects among the groups. Radiologic findings was assessed as vertebral height restoration rate and rate of reduction loss by measurement of the height of vertebral body. The clinical outcomes were graded into 5. The statistical analysis was done using Chi-squire test and Independent-samples T test. RESULTS: Among the groups divided by follow-up period, there was no statistically significant difference of clinical and radiologic results except the rate of reduction loss between group I and group III (p>0.05). Between the groups divided by BMD, there was no statistically significant difference of clinical and radiologic results. CONCLUSION: Percutaneous vertebroplasty with bone cement for the osteoporotic compression fracture is an efficient procedure and considered as technique producing pleasurable clinical and radiologic results regardless of follow up-period and BMD.

Long term outcome of Vertebroplasty in the Treatment of Osteoporotic Compression Fracture / 대한척추외과학회지

STUDY DESIGN: A retrospective study. OBJECTIVES: The purpose of this study was to assess the clinical features and functional outcomes of patients having undergone percutaneous vertebroplasty, with bone cement, for an osteoporotic compression fracture. SUMMARY OF LITERATURE REVIEW: The clinical result of percutaneous vertebroplasty is good and satisfactory. Percutaneous vertebroplasty is a useful treatment for an osteoporotic compression fracture of the vertebral body. MATERIALS AND METHODS: Among 83 patients who underwent percutaneous vertebroplasty, with bone cement, between January 2000 and June 2001, 47 patients(79 vertebral bodies), followed-up for more than 3 years were selected; the mean follow-up period was 42.6 months. We compared the postoperative clinical and radiological findings immediately and at the 1, 2 and 3-year follow-ups. The clinical outcomes were graded as excellent, good, fair, low and poor. The height of vertebral body, the leakage of bone cement and adjacent vertebral body fracture were also assessed. Statistical analyses were performed using Chisquared and Student t-tests. RESULTS: The immediate postoperative clinical results were either excellent or good in 45 patients(95.7%). The last follow-up showed excellent or good results in 42 patients(89.4%). There was no statistically significance in connection with the follow-up duration (P>0.05). The heights of the vertebral bodies on plain radiographs were 78.0% immediately postoperation, and 76.5% at the last follow-ups, with no statistically significant difference in the heights of the vertebral bodies on follow-up. Cement leakage was noted in 29(35.4%) out of the 79 vertebral bodies. In 4 patients(7 vertebrae), an additional compression fracture of adjacent vertebral bodies was found CONCLUSION: Percutaneous vertebroplasty with bone cement is considered as a safe and promising technique for an osteoporotic compression fracture of the vertebral body.