A Correlation Study of Clinical Outcomes by Quantification of Fatty Degeneration of the Subscapularis: Partial vs. Whole Cross-section

BACKGROUND: Fatty degeneration of rotator cuff is a well-known predictor of postoperative outcome. The purpose of this study was to evaluate the clinical features of rotator cuff tears involving subscapularis, and investigate whether fatty degeneration quantified from only the upper subscapularis correlates better with clinical outcomes than quantified from the whole subscapularis. METHODS: We retrospectively analyzed 315 consecutive patients who underwent arthroscopic repair for rotator cuff tears involving subscapularis with a minimum follow-up of 1 year. Preoperative and postoperative visual analogue score for pain, range of motion and functional scores were assessed. Integrity of the repaired tendon was assessed at the 1-year follow-up with either magnetic resonance imaging or ultrasonography. RESULTS: The mean Goutallier grade of whole cross-section was significantly lower than that of upper cross-section (1.59 vs. 1.71, p<0.05), but significantly higher than that of lower cross-section (1.59 vs. 1.01, p<0.05). In analysis of 37 re-tears, the occupancy of severe fatty degeneration in upper cross-section was 86.5%, which was significantly higher than that seen in whole cross-section (56.8%, p<0.05). We calculated the cut-off tear size for prediction of re-tears as 19.0 mm for retraction and 11.0 mm for superior-inferior. The cut-off Goutallier grade was 2.5 for both whole and upper cross-sections, but area under the curve was greater in the upper cross-section than the whole (0.911 vs. 0.807). CONCLUSIONS: As fatty degeneration of upper subscapularis demonstrated a more distinct spectrum than whole subscapularis, we suggest that measuring fatty degeneration of upper subscapularis can be a more useful method to predict clinical prognosis.

Isolated Ruptures of the Infraspinatus: Clinical Characteristics and Outcomes

BACKGROUND: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. METHODS: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. RESULTS: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5–9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0–5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45–77] to 89.3 [range, 81–100], p=0.029), and ASES score (52.3 [range, 30–77] to 90.0 [range, 80–100], p=0.002). There was no healing failure on imaging. CONCLUSIONS: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.

Corrigendum: Isolated Ruptures of the Infraspinatus: Clinical Characteristics and Outcomes

The corresponding author's name and E-mail address have been corrected. This article was corrected online. The authors would like to apologize for any inconvenience cause.

Isolated Ruptures of the Infraspinatus: Clinical Characteristics and Outcomes

BACKGROUND: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. METHODS: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. RESULTS: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5–9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0–5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45–77] to 89.3 [range, 81–100], p=0.029), and ASES score (52.3 [range, 30–77] to 90.0 [range, 80–100], p=0.002). There was no healing failure on imaging. CONCLUSIONS: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.

Corrigendum: Isolated Ruptures of the Infraspinatus: Clinical Characteristics and Outcomes

The corresponding author's name and E-mail address have been corrected. This article was corrected online. The authors would like to apologize for any inconvenience cause.

Evaluation of the Effusion within Biceps Long Head Tendon Sheath Using Ultrasonography

BACKGROUND: Many shoulder diseases are related to glenohumeral joint synovitis and effusion. The purpose of the present study is to detect effusion within the biceps long head tendon sheath as the sign of glenohumeral joint synovitis using ultrasonography, and to evaluate the clinical meaning of effusion within the biceps long head tendon sheath. METHODS: A consecutive series of 569 patients who underwent ultrasonography for shoulder pain were reviewed retrospectively and ultimately, 303 patients were included. The authors evaluated the incidence and amount of the effusion within the biceps long head tendon sheath on the ultrasonographic short axis view. Furthermore, the authors evaluated the correlation between the amount of effusion within the biceps long head tendon sheath and the range of motion and the functional score. RESULTS: The effusion within the biceps long head tendon sheath was detected in 58.42% of the patients studied: 69.23% in adhesive capsulitis, 56.69% in rotator cuff tear, 41.03% in calcific tendinitis, and 33.33% in biceps tendinitis. The average amount of the effusion within the biceps long head tendon sheath was 1.7 +/- 1.6 mm, and it was measured to be the largest in adhesive capsulitis. The amount of effusion within biceps long head tendon sheath showed a moderate to high degree of correlation with the range of motion, and a low degree of correlation with the functional score and visual analogue scale for pain in each type of shoulder disease. CONCLUSIONS: The effusion within the biceps long head tendon sheath is closely related to the range of motion and clinical scores in patients with painful shoulders. Ultrasonographic detection of the effusion within the biceps long head tendon sheath might be a simple and easy method to evaluate shoulder function.

Ganglion of the Cruciate Ligament of the Knee / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical characteristics of ganglia of the cruciate ligament of the knee. MATERIALS AND METHODS: We retrospectively analyzed the clinical symptoms and signs, magnetic resonance findings, arthroscopic findings and operative results of 14 patients. RESULTS: The most common complaint was pain. McMurrays test was negative and instability was not identified. Limitation of motion was observed in 7 cases. In the remaining 7 patients who had no limitation, pain was caused by hyper-flexion or hyper-extension. Most ganglia (11 of 14) arose from the femoral insertion side of the cruciate ligament. Treatment methods were arthroscopic drainage in 11 of the cases and open excision in the remaining cases. Irrespective of treatment methods, all patients gained full range of motion without pain and returned to their preoperative jobs within 3-4 weeks. CONCLUSIONS: When patients complain of limitation of motion or pain on hyper-flexion and/or hyper-extension without trauma, a ganglion of the cruciate ligament should be considered if there is no instability nor negative findings on McMurray's test. Magnetic resonance imaging is diagnostic in confirming the lesion. Arthroscopic drainage of the ganglia is useful in treating the symptomatic patient with ganglia of the knee.

A clinical study on the ectopic pregnancy following laparoscopic tubal sterilization / 대한산부인과학회잡지

No abstract available.

A case of combined pregnancy / 대한산부인과학회잡지

No abstract available.