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Articles by H. S. Gong
Total Records ( 3 ) for H. S. Gong
  J. H Oh , H. K Lee , J. Y Kim , S. H Kim and H. S. Gong
  Background

Although arthroscopic glenoid labrum repair using the BioKnotless anchor is common, the benefits and efficacy have not been fully evaluated.

Hypothesis

BioKnotless suture anchor is a clinically and radiologically suitable material for arthroscopic labral repair.

Study Design

Case series; Level of evidence, 4.

Methods

Ninety-seven patients underwent arthroscopic glenoid labrum repair with BioKnotless anchor between July 2004 and December 2005. Thirty-seven patients had traumatic anterior instability and 60 patients had an isolated superior labrum, anterior-posterior (SLAP) lesion. The mean age at surgery was 36.0 years (range, 15–66); the average follow-up was 34.1 months (range, 24–54). Clinical outcomes were evaluated using range of motion and various functional evaluation scores including sports activity. Pain and patient satisfaction were measured using a visual analog scale (VAS). Computed tomography arthrography was conducted in 73 patients at least 1 year after surgery for radiologic evaluation.

Results

In patients with instability, the Western Ontario Shoulder Instability index and Rowe score improved from 53.2 to 85.9 and from 68.7 to 92.7, respectively. Return to normal recreation and sports were possible in 30 patients (81.1%); the mean satisfaction VAS was 9.2. There was 1 postoperative dislocation, and the apprehension test was positive in 1 case. Postoperative range of motion including external rotation was not different. In patients with a SLAP lesion, the American Shoulder and Elbow Surgeons score and Constant score improved from 67.3 to 96.0 and 79.1 to 96.8, respectively. Pain VAS decreased from 6.0 to 0.4, and the mean satisfaction VAS was 9.4. Return to normal recreation and sports were possible in 50 patients (83.3%). All labra were found to have firmly healed to bony glenoid rim without anchor-related osteolysis in postoperative CT arthrography.

Conclusion

Clinically and radiologically, the BioKnotless anchor appears to be an acceptable alternative for arthroscopic labrum repair, and a suitable material allowing the avoidance of certain troublesome drawbacks of the conventional knot-tying suture anchor.

  J. H Oh , S. H Kim , J. Y Kang , C. H Oh and H. S. Gong
  Background

There are numerous reports on the outcome of rotator cuff repair according to age. However, the results are conflicting and driven by univariate analysis, which is not free of confounding factors.

Hypothesis

Age does not affect the anatomical and functional outcomes of rotator cuff repair.

Study design

Case series; Level of evidence, 4.

Materials and Methods

Eighty-one men and 96 women underwent rotator cuff repair at one institution and received computed tomography arthrography and functional evaluations at least 1 year after surgery. Various structural and clinical features according to age were evaluated. The correlation was assessed between age and outcomes, with adjustment for the preoperative score.

Results

Patient mean age was 60.0 ± 8.7 years. The mean ages were higher in women, nonsmokers, and those with positive paradoxical abduction, lower level of sports activity, the presence of biceps injury, higher fatty degeneration in cuff muscles, inferior isokinetic muscle performance, bigger tear size, more retraction of tear, and symptomatic acromioclavicular arthritis. For the integrity of the repair, the mean age was higher in the retear group (31.1%) than in the intact group (68.9%)—that is, 63.7 ± 7.5 and 58.4 ± 8.7 years, respectively (P <.001). Only the Constant score exhibited a positive correlation with age after adjustment (P = .009). Univariate regression analysis revealed that a 0.313-point increment of Constant score could be expected for each year of age.

Conclusion

On univariate analysis, older age was related with poor postoperative integrity and better functional improvement in Constant score. Multivariate regression revealed that age was not an independent determinant for anatomical or functional outcome whereas the tear retraction and fatty degeneration of the infraspinatus were independent factors for the integrity of repair and the presence of the paradoxical abduction and abduction torque of the unaffected shoulder for the Constant score.

  J. H Oh , S. H Kim , K. H Kim , C. H Oh and H. S. Gong
 

Background: Most patients experience a significant reduction in pain after rotator cuff repair. However, there is currently no method to predict the level of pain reduction that each patient will experience. This report explores the usefulness of the modified impingement test for prognosis in cases of rotator cuff repair.

Hypothesis: The amount of pain reduction after injection of lidocaine into the subacromial space preoperatively correlates with the level of pain reduction after rotator cuff repair.

Study Design: Cohort study (prognosis); Level of evidence, 2.

Methods: Preoperatively, a visual analog scale for pain was measured in 153 patients (59 males and 94 females) with a rotator cuff tear before and after injection of lidocaine into the subacromial space. Subsequently, rotator cuff repair was performed. At least 1 year after surgery, the visual analog scale for pain and satisfaction, Constant score, Simple Shoulder Test, American Shoulder and Elbow Surgeons (ASES) score, and University of California, Los Angeles shoulder rating scale were evaluated. Correlation analyses were performed between the change in visual analog scale after the modified impingement test and after surgery.

Results: The amount of pain reduction after the modified impingement test was significantly related to improvement of pain postoperatively (P < .001), as measured using the visual analog scale for pain. The change in ASES score was also related to the amount of pain reduction after the modified impingement test (P = .001); however, the other tests showed no statistical significance (P > .05). Univariate regression analysis revealed that a 0.621-unit reduction in postoperative pain on the visual analog scale could be expected for each 1 unit (on a scale of 10) reduction in pain after lidocaine injection preoperatively.

Conclusion: The amount of pain reduction after the modified impingement test preoperatively correlated with the improvement of pain after rotator cuff repair. This simple preoperative test could help patients understand the subjective level of pain reduction that they may experience after rotator cuff repair.

 
 
 
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