• Title, Summary, Keyword: Shoulder surgery

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The Incidence of Venous Thromboembolism Following Shoulder Surgery: A Pilot Study

  • Cho, Chul-Hyun;Jang, Hyung-Gyu;Park, Ui-Jun;Kim, Hyoung Tae
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.18-23
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    • 2017
  • Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

Comparison of Shoulder Range of Motion, Pain, Function, Scapular Position Between Breast Cancer Surgery and Shoulder Surgery Female Patients (유방암 절제술과 견관절 수술을 한 여성의 견관절 관절가동범위, 통증수준, 기능수준, 견갑골의 자세 비교)

  • Lee, Min-Ji;Kim, Suhn-Yeop;Shim, Jae-Kwang
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.9-18
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    • 2015
  • This study aimed to compare the characteristics of breast cancer surgery and shoulder surgery patients on the shoulder range of motion (ROM), degree of pain and dysfunction, and scapular position. This study was carried out with a total of 90 women: a breast cancer surgery group (BS, $n_1=30$), a shoulder surgery group (SS, $n_2=30$) and a control group ($n_3=30$). Shoulder ROM, the Quadruple Visual Analogue Scale (QVAS), the Shoulder Pain and Disability Index (SPADI), and the Scapular Index (SI) were used to assess shoulder function. Statistical analyses were performed using a one-way analysis of variance, crosstab test, and independent sample t-test. Post-hoc testing was carried out with Bonferroni test. There were significant differences in shoulder ROM when the BS and the SS were compared with the control group. However, there was no significant difference in ROM between the BS and SS. Furthermore, there was a significant difference in shoulder pain between both surgery groups, and there was greater shoulder dysfunction in the SS than in the BS. There was also a significant difference in upper extremity posture when the BS and the SS were compared to the control group. Finally, there was no significant difference in upper extremity posture between the BS and the SS. This study compared shoulder ROM, pain, dysfunction, and upper extremity postures between the BS and SS. While there were no significant differences in shoulder ROM, pain, and upper extremity posture between both surgery groups, the level of dysfunction was found to be significantly different. Therefore, health professionals managing for breast cancer surgery or shoulder surgery patients should consider these outcomes.

Risk Factors for Recurrence of Anterior Shoulder Instability after Arthroscopic Surgery with Suture Anchors

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Chae, Seung-Bum;Lee, Jae-Keun;Kim, Dong-Young
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.78-83
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    • 2016
  • Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

Neuropathic Arthropathy of the Shoulder Associated with Cervical Syringomyelia: A Case Report

  • Park, Jaehyun;Im, Taekang;Moon, Jinsun;Lee, Yongbeom
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.261-265
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    • 2015
  • Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition.

Rapidly Progressive Osteonecrosis of the Humeral Head after Arthroscopic Bankart and Rotator Cuff Repair in a 66-Year Old Woman: A Case Report

  • Cho, Hyun IK;Cho, Hyung Lae;Hwang, Tae Hyok;Wang, Tae Hyun;Cho, Hong
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.167-171
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    • 2015
  • Humeral head chondrolysis has been widely reported as a devastating complication after arthroscopic shoulder surgery; however little is known about post-arthroscopic humeral head osteonecrosis. We experienced a 66-year-old female patient with rapidly progressive osteonecrosis of the humeral head only seven months after arthroscopic Bankart and rotator cuff repair. The patient had no systemic risk factors for osteonecrosis. A satisfactory result was achieved with reverse total shoulder arthroplasty for severe humeral head destruction and an irreparable massive rotator cuff tear. Shoulder surgeons should be aware of such severe complication, perform routine radiographs, and pay close attention to the presence of constant pain or loss of motion after arthroscopic shoulder surgery.

Arthroscopic Treatment for Calcific Tendinitis of Origin of Long Head of Triceps

  • Kim, Woo;Song, Byung Wook;Rhie, Tae-Yon;Kwon, Jieun
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.245-248
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    • 2016
  • A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.

Intraarticular Finding and Clinical Result of Arthroscopic Diagnosis after Manual Manipulation in the Frozen Shoulder (동결견에서 수동 조작 후 관절경 검사시 보인 관절내 소견 및 임상 결과)

  • Moon Young Lae;Park Joon Kwang;Kim Chan Sang
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.33-38
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    • 2000
  • Objectives: The purpose of this study was to grading the severity of intra-articular lesions and evaluate the effects of arthroscopic surgery after manipulation of the resistant frozen shoulder. Materials and Methods : Forty-eight cases from 44 subjects, median age of 53, who underwent arthroscopic surgery after manipulation with minimum follow-up of 12 months were chosen. The UCLA shoulder rating scale was applied, and average scale was 18.2 points. Results: Twelve cases out of our series showed as rotator cuff tear which could produce secondary frozen shoulder. In postoperative follow up, 34 subjects complained of no pain or noctalgia, 5 showed mild degree of pain, 8 with mild degree of remained limited range of motion, and only 1 with no improvement. When viewed with UCLA shoulder rating scale, the most improved aspect was pain, and satisfaction of patient was following. And final average scale was 31.9 points. Conclusion: Our study revealed that arthroscopic surgery after manipulation showed favorably high final scale and patient's satisfaction. Therefore, we recommend this modality for treatment of resistant frozen shoulder in a point of view that the diagnosis and treatment can be done simultaneously.

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