Repair Integrity and Functional Outcomes after Arthroscopic Repair of Transtendinous Full-thickness Rotator Cuff Tears Minimum Two-year Follow-up

BACKGROUND: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon. METHODS: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography. RESULTS: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively). CONCLUSIONS: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.

Repair Integrity and Functional Outcomes after Arthroscopic Repair of Transtendinous Full-thickness Rotator Cuff Tears Minimum Two-year Follow-up

BACKGROUND: To evaluate the clinical outcomes and associated repair integrity in patients treated with arthroscopic repair for a transtendinous rotator cuff tear followed by resection of the remnant rotator cuff tendon. METHODS: Between July 2007 and July 2011, we retrospectively reviewed patients who were treated for transtendinous full-thickness tears in the tendinous portion of the rotator cuff by arthroscopic repair. Clinical outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA), the Constant-Murley score, a visual analogue scale (VAS) pain score, and range of motion (ROM). The repair integrity was determined by magnetic resonance imaging or ultrasonography. RESULTS: There were 19 shoulders with transtendinous full-thickness tears in the tendinous portion of the rotator cuff. The ASES, UCLA, Constant-Murley, and VAS pain scores showed significant improvements in function and symptoms (all p<0.001). The active ROM for forward flexion and abduction was also significantly improved (p=0.002 and p<0.001, respectively). The postoperative radiological examination showed cuff integrity without a re-tear in 68.4% of patients. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and re-torn group (p=0.530, p=0.885, and p=0.262, respectively). CONCLUSIONS: Although repair of transtendinous rotator cuff tears followed by resection of the remnant rotator cuff tendon in the footprint has a relatively high re-tear rate, no significant difference was observed in the short-term clinical results between the re-tear and healed groups.

Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: 5-7 Years Result / 대한고관절학회지

PURPOSE: To report the mid- and long-term follow up results of patients who underwent arthroscopic treatment after being diagnosed with femoroacetabular impingement. MATERIALS AND METHODS: 72 consecutive patients diagnosed with femoroacetabular impingement underwent arthroscopic partial labrectomy and femoroplasty(79 cases). In order to evaluate the clinical results, a modified Harris hip score, and VAS and Hip outcome scores were utilized. In addition, the alpha angle and femoral offset were measured radiologically. RESULTS: Based on the clinical results from all consecutive patients, the preoperative mean pain score was 6.0 and 1.7, and 2.1 points on the mid-(2-5 years) and long-term(5-7 years) follow ups, respectively. The mean modified Harris hip score improved from 58.9 points to 81.9 and 79.3 points for the mid-term and long-term follow up groups, respectively. Prior to surgery, the daily activity scale and motor scale results associated with Hip outcome scores were 59.2 and 57.5 points for the mid- and long-term groups, respectively. These scores improved to 84.7 and 84.5, and 81.2 and 79.5 for each group upon the mid- and long-term postoperative follow ups, respectively. Based on the radiological results, the mean alpha angle decreased from 61.2degrees preoperatively to 40.9degrees after surgery, and the mean femoral offset increased from 4.8 mm to 10.0 mm. CONCLUSION: The mid- and long-term clinical and radiological follow ups to evaluate the results of arthroscopic treatment of femoroacetabular impingement revealed satisfactory improvement. This finding further demonstrates that arthroscopy is an effective and safe treatment for cases of femoroacetabular impingement.

Arthroscopic Treatment of Femoroacetabular Impingement in Young Taekwondo Players / 대한정형외과학회잡지

PURPOSE: We wanted to evaluate the clinical results and the radiological and arthroscopic findings of femoroacetabular impingement (FAI) in young Taekwondo players and to investigate the rate of returning-to-play Taekwondo and the recurrence rate. MATERIALS AND METHODS: Twenty Taekwondo players (16 males and, 4 females) who were arthroscopically treated for FAI from September 2003 to July 2008 were retrospectively analyzed. Their mean age was 21.6 years old (range: 17 to 32 years) and the mean follow up was 33.7 months (range: 24 to 71 months). Plain radiographs and 3 dimensional computed tomography were taken in all patients and magnetic resonance arthrography was performed in 11 with suspicious soft tissue lesions. Labral injury, cartilage injury and associated lesions were evaluated by arthroscopy. The preoperative and postoperative visual analogue scale (VAS), the modified Harris hip score (MHHS), the sports frequency score (SFS), and the non-arthritic hip score (NAHS) were compared. We investigated the rate of returning-to-play at postoperative 1 year and at postoperative 2 years and the recurrence rate within 2 years after surgery. RESULTS: There were 10 cam types, 1 pincer type and 9 mixed types. The mean alpha angle improved from 65.8 degrees preoperatively to 43.2 degrees postoperatively (p<0.001). Acetabular labral tears were accompanied in all cases and the most common tear site and type were at 2 o'clock and degenerative tear, respectively. In descending order, the acetabular cartilage injuries were located in the anterosuperior, posteroinferior and anterior portion, respectively. The femoral cartilage injuries were mostly located in the anterosuperior portion. The range of motion at the final follow-up showed improvement in all except abduction (p=0.262). The VAS, MHHS and SFS showed statistically significant improvement (p<0.001). The NAHS was improved, but without statistical significance (p=0.31). The rates of returning-to-play at postoperative 1 year and postoperative 2 years were 85% (17/20) and 75% (15/20), respectively. The recurrence rate within postoperative 2 years was 15% (3/20). CONCLUSION: As screening test for FAI in young Taekwondo players is necessary at the beginning of Taekwondo. Arthroscopic treatment in symptomatic Taekwondo players is an effective procedure that can improve the postoperative exercise frequency and function. Returning-to-play Taekwondo is associated with the clinical improvements and the patients' will.

Ultrasound-guided Femorosciatic Nerve Block by Orthopaedist for Ankle Fracture Operation / 대한족부족관절학회지

PURPOSE: The purpose of this study is to investigate the usefulness of ultrasound-guided femorosciatic nerve block by orthopaedist to operate the fracture around ankle. MATERIALS AND METHODS: Twenty-two patients, who had an operation for fracture around the ankle under a ultrasound-guided femorosciatic nerve block from January to April 2010, were the targets of this study. We measured the time spent for the ultrasound-guided femorosciatic nerve block, the time taken to start the operation after the nerve block, the time taken to deflate the tourniquet because of a tourniquet pain, the time passed until feeling a postoperative pain after the operation, etc. We also studied the complications and satisfaction of the anesthesia. RESULTS: It took 6.2 (3 to 12) minutes for the nerve block, 46.1 (28 to 75) minutes to start the operation, 52.5 (22 to 78) minutes until feeling a tourniquet pain and 11.5 (7.5 to 19) hours until starting to feeing a postoperative pain. There was no complication by anesthesia and 21 people (95.5%) were satisfied with anesthesia by ultrasound-guided femorosciatic nerve block. CONCLUSION: Ultrasound-guided femorosciatic nerve block by orthopaedist in the fracture around ankle reduces anesthetic and nerve injury complication, and leads to high anesthetic success rate. Also it is considered as an effective method to alleviate postoperative pain.