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Articles by J. H Oh
Total Records ( 6 ) for J. H Oh
  S. J Lee , C. W Kim , K. J Lee , J. W Choe , S. E Kim , J. H Oh and Y. S. Park
  Background

S100B is a biomarker that reflects injury to the central nervous system. As the spine is an integral part of the spinal cord, a study was undertaken to investigate whether serum S100B levels are associated with acute spinal fracture without head injury.

Methods

The study population consisted of 32 consecutive patients aged ≥18 years in whom the emergency physicians suspected spinal fractures. All the patients underwent CT scans to establish the diagnosis of spinal fracture. MRI was then performed on all the patients to determine the presence of spinal cord injury.

Results

Serum S100B levels were higher in the spinal fracture group than in the non-spinal fracture group, and 19 of the 20 patients in the spinal fracture group (95%) had an S100B level >0.12 µg/l, whereas all 12 of the non-spinal fracture group had an S100B level ≤0.12 µg/l. The S100B level in patients with epidural encroachment of the spinal cord was significantly higher (0.22–4.58 µg/l; mean 2.45 µg/l; 95% CI 0.95 to 3.94) than in those without epidural encroachment (0.114–2.87 µg/l; mean 0.80 µg/l; 95% CI 0.24 to 1.37) (p=0.037). Plain radiography revealed no definite abnormal findings in half of the patients with spinal fracture.

Conclusions

Serum S100B levels are raised in all patients with acute spinal fracture without head injury. Spinal fracture may therefore be one of the extracerebral sources of S100B. Serum S100B levels may be an effective tool for excluding subtle spinal fractures with no clear radiographic findings.

  J. H Oh , K. H Jo , W. S Kim , H. S Gong , S. G Han and Y. H. Kim
  Background

Various shoulder outcome instruments have been used despite lack of information on their measurement properties; reliability, responsiveness, and validity; and correlation with health-related quality of life.

Hypothesis

Most shoulder outcome instruments have poor correlation with Short Form–36, a general measure of health-related quality of life, and with each other.

Study Design

Cohort study (diagnosis); Level of evidence, 2.

Methods

A consecutive group of 285 patients who had undergone shoulder surgery completed several shoulder outcome instruments—Short Form–36; University of California, Los Angeles shoulder score; American Shoulder and Elbow Surgeons shoulder evaluation form; Constant score; Simple Shoulder Test; Western Ontario Shoulder Instability Index; and the rating sheet for Bankart repair (Rowe score)—preoperatively and at 3, 6, 9, and 12 months postoperatively. Internal consistency, standardized response mean, effect size, and Pearson correlation were used to evaluate reliability, responsiveness, and validity.

Results

The American Shoulder and Elbow Surgeons form, Simple Shoulder Test, and Western Ontario Shoulder Instability Index displayed good internal consistency. The University of California, Los Angeles shoulder score and American Shoulder and Elbow Surgeons form exhibited good responsiveness, whereas Short Form–36 showed the least responsiveness. Pearson correlation coefficients between the shoulder outcome instruments and Short Form–36 were less than excellent (r < .60). Pearson correlation coefficients between the outcome instruments were generally low except for the Constant score and University of California, Los Angeles shoulder score (r = .673, P < .01).

Conclusion

There was no single shoulder outcome instrument that was superior to the others in terms of the measurement properties. Most of the tested shoulder outcome instruments did not reflect health-related quality of life well and poorly correlated with each other. This meant that the comparison of a given surgical result with different outcome instruments might be of little practical utility. Further prospective and serial studies should be conducted to develop better shoulder outcome instruments that have significant reliability, responsiveness, validity, and correlation with health-related quality of life. A careful combination of outcome instruments might be necessary to compensate the current evaluation systems.

  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.

  M. C Park , B. J Jun , C. J Park , J. H Oh and T. Q. Lee
  Background

A transtendon interimplant mattress repair along the medial row for partial-thickness rotator cuff repairs has been described with clinical success. However, the biomechanical characteristics for such a repair have not been elucidated.

Hypothesis

A knotless interimplant mattress repair may show improved or equivalent load and strain characteristics, compared with a repair using isolated mattress repairs over each of 2 anchors.

Study Design

Controlled laboratory study.

Methods

Seven matched pairs of human cadaveric shoulders were dissected. Articular-sided tears were created involving 50% of the supraspinatus footprint. In 7 shoulders, repairs were performed with mattress configurations isolated over each of 2 anchor sites (control group). In 7 contralateral shoulders, a knotless interimplant mattress suture configuration was employed creating bridging sutures between implants. For all specimens, a materials-testing machine was used to cyclically load each repair from 10 to 180 N for 30 cycles; each repair was then loaded to failure. A deformation rate of 1 mm per second was employed for all tests. A video-digitizing system was employed to quantitatively measure the gap formation and strain on the footprint area of the repair. For detecting gap formation, 7 matched pairs were necessary for achieving a power of at least 90%.

Results

During cyclic loading, gap formation at the anterior tendon was significantly lower in the control group (P < .05) but did not exceed 0.5 mm. There were no significant differences for linear stiffness, hysteresis, and strain between the 2 constructs. During tensile load-to-failure testing, there were no significant differences at yield load between the control and knotless techniques (293.90 ± 132.72 N and 320.38 ± 237.01 N, respectively; P > .05). There were no differences for stiffness, ultimate load, and energy absorbed to failure between the 2 repairs (P > .05). Gap formation in 3 regions was not significantly different between groups at yield and ultimate loads (P > .05). The anterior regions of the repair were the first to fail in all constructs.

Conclusion

A transtendon interimplant mattress rotator cuff repair for partial articular-sided tendon tears involving 50% of the footprint has biomechanical characteristics similar to those of a repair employing 2 isolated mattress configurations. An interim-plant mattress repair can protect tendon strain; it also exhibits yield loads that exceed those typically experienced in the early postoperative period.

Clinical Relevance

A medial-row interimplant mattress repair configuration that is knotless may facilitate repair without compromising biomechanical characteristics.

  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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