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견관절 극상건 전층 파열의 관절경적 복원술; 임상적 결과 및 술후 회전근개 상태의 평가
노규철,정국진,김성우,유정한,Noh, Kyu-Cheol,Chung, Kook-Jin,Kim, Sung-Woo,Yoo, Jung-Han 대한정형외과스포츠의학회 2006 대한정형외과스포츠의학회지 Vol.5 No.1
Purpose: The purpose of this study was to evaluate the tendon healing of arthroscopic repair in full-thickness supraspinatus tears. We evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement. Materials and Methods: Thirty consecutive full-thickness supraspinatus tears were repaired arthroscopically in 19 patients with a one row of anchor and 11 patients with two rows of anchors. Patients ranged in age from 51 to 79 years (average 63 years). Average follow-up was 16 month (range, 12 to 28 months). To evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement, we calculate the Constant, ASES, UCLA scores. The 30 patients had either an MR Arthrogram (25 cases) or an MRI (5 cases), performed between 5 months and 20 months (mean 10 months) after surgery. Results: The cuff was healed in 21/30 cases (70%) and partially torn in 3 cases (10%) after the arthroscopic repair of full-thickness supraspinatus tear. Although the supraspinatus tendon was totally torn to the tuberosity in 6 cases(20%) after the arthroscopic repair, the size of the tear was smaller than the initial in 5 cases. The Constant score improved from an average of $55.7{\pm}7.1$ points preoperatively to $77.7{\pm}9.7$ points at the last follow-up (p<0.001), and the average ASES score improved from $39.2{\pm}7.4\;to\;72.4{\pm}12.6$ (p<0.001), and the average UCLA score improved from $17.9{\pm}2.2\;to\;26.8{\pm}5.0$ (p<0.001). Strength of elevation was significantly better $(7.1kgs{\pm}2.4)$ in the shoulders with a healed tendon that in those with an total or partial re-tear tendon $(4.5kgs{\pm}1.0)$ (p<0.05). Factors adversely affecting tendon healing were increasing age, Only 41.7% of the repairs completely healed in patients over 65 years (p<0.05). Conclusion: Arthroscopic repair of isolated full-thickness tear of the supraspinatus leads to completely healing in 70% of the cases. Total or partial re-tear of the repaired rotator cuff is associated with a decreased strength. Older patients had significantly lower healing rates.
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Arthroscopic Treatment of Septic Arthritis of Acromioclavicular Joint
노규철,정국진,Hui Seong Yu,고성혜,유정한 대한정형외과학회 2010 Clinics in Orthopedic Surgery Vol.2 No.3
Septic arthritis requires an early diagnosis and proper treatment to prevent the destruction of articular cartilage and jointcontracture. This paper presents a rare case of septic arthritis of the acromioclavicular joint that was treated with arthroscopicdebridement and resection of the distal clavicle.
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노규철,이재원,유연식,Noh, Kyu-Cheol,Lee, Jae-Won,Yoo, Yon-Sik 대한관절경학회 2011 대한관절경학회지 Vol.15 No.1
Acromioclavicular (AC) joint dislocations are common injuries in active individuals secondary to direct force on the lateral aspect of the adducted shoulder. Complete disruption of the acromioclavicular and coracoclavicular (CC) ligaments may occur, depending on the magnitude of the insulting force. Most of these injuries are successfully treated without surgery. However, for the treatment of cases in which surgical management is warranted, there are more than 100 surgical techniques available without a gold standard technique. We review the anatomy of the acromioclavicular joint, the diagnosis of disorders of this joint, and the different treatment options in this article.
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