The Radiologic and Clinical Changes after Open Complete Repair of Massive Rotator Cuff Tears

PURPOSE: This study evaluated the preoperative and postoperative radiologic findings of patients with complete repairs after massive rotator cuff tears along with the incidence of re-tear and the clinical outcomes. MATERIALS AND METHODS: This study evaluated 33 cases who had open complete repairs for massive rotator cuff tears and these patients were followed up for more than 24 months. The clinical evaluation was performed according to the shoulder joint function test of the American Shoulder and Elbow Surgeons (ASES), and the degree of arthritis related to the massive rotator cuff tears was evaluated using the Hamada classification. RESULTS: The ASES scores improved from 37.6 preoperatively to 85.6 postoperatively. The mean preoperative acromio-humeral interval (AHI) score was 6.5 mm, which increased to 9.3 mm immediately after surgery, and there was a decreased to 6.5 mm noted at the last follow up. The lower radiology stages of arthritis according to the classification showed better preoperative and postoperative results. CONCLUSION: An open complete repair as the surgical treatment for a massive rotator cuff tear showed satisfactory results for pain relief and an improvement in the shoulder joint function though re-tear after surgery.

Radiologic Evaluation of Change of Ankle Joint after Total Knee Arthroplasty / 대한족부족관절학회지

PURPOSE: To evaluate the incidence and describe radiologic pattern of ankle arthritis following change of mechanical loading axis by total knee arthroplasty. MATERIALS AND METHODS: We reviewed radiographs of 419 cases, 243 patients underwent total knee arthroplasy from January 2002 to October 2006 retrospectively. We described radiologic parameters around the ankle joint and measured the amount of change of knee varus or valgus angle by comparing preoperative and postoperative anteroposterior standing lower extremities AP X-rays. We divided cases into two groups, one with radiologically arthritic change of the ankle joint and the other one without any radiologic change after surgery. We compared two groups in each parameters and analyzed statistically (SPSS v13.0). RESULTS: Three hundred eighty one cases were divided into varus group and 38 cases in valgus group. 125 cases were divided into ankle arthritic change-positive subgroup among the varus group and 251 cases were in negative subgroup. The amount of varus angle correction by total knee arthroplasty showed significant difference between two subgroups. There was no significant difference in each parameters between subgroups within 38 valgus cases. CONCLUSION: Ankle arthritis can be aggravated after total knee arthroplasty because of the change of mechanical loading axis onto the ankle joint. Therefore it may be needed to evaluate symptoms and function of ankle joints before performing total knee arthroplasties especially in patients with huge varus deformities of knee joints.

Spinal Mobility and Radiologic Change after Comprehensive Rehabilitative Management of Ankylosing Spondylitis

OBJECTIVE: To investigate the evidence of improvement of spinal mobility and the radiologic change of ankylosing spondylitis with comprehensive rehabilitative management. METHOD: We retrospectively studied spinal mobility index and radiologic changes of the twenty eight patients who had met the modified New York criteria of ankylosing spondylitis. RESULTS: Patients comprised 25 men and 3 women with age ranged from 22 to 63 (mean 44.9) years. With spinal mobility index, including Schober index, lumbar lateral bending, chest expansion, occiput to wall, and finger to floor, all in dices showed improvement after comprehensive rehabilitative management. When we evaluated the correlation between spinal mobility index and radiologic change scored by Bath ankylosing spondylitis radiology index (BASRI), patients with mild radiologic change (BASRI grade 0-2) showed improvement in spinal mobility. Radiologic change from initial visit to after one year showed no statistical difference. CONCLUSION: We found that intensive rehabilitative management increases spinal mobility of the patients with ankylosing spondylitis.

Radiologic Changes after Lumbar Discectomy / 대한정형외과학회잡지

Open discectomy is one of usual treatment for herniated intervertebral disc. We may expect the reduction of height of intervertebral disc due to decreased volume by partial resection of herniated disc. But the effect of decreased height of intervertebral disc space to posterior joint and spinal canal has not been identified, and the correlation between the amount of reduced height and the changes of range of motion has been undetermined. Thus, we analyzed radiologic changes of disc height and segmental motion by the flexion-extension view in 20 patients who had undergone discetomy for prolapsed intervertebral disc from June 1989 to January 1991 who could be followed up for 3 years or more. As a result, lumbar discetomy associates with 1) significant decrement of disc height (average 14%), 2) decreased disc motion of involved segment without hypermobility (average 34%), 3) hypermobility of adjacent segment, 4) and posterior facet overriding consistent with recurred low back pain.