Jae-Sung Yoo

Correlation of clinical symptoms and function with fatty degeneration of infraspinatus in rotator cuff tear

AbstractPurpose The aim of this study was to analyse the correlation of clinical symptoms and function with the fatty degeneration of the infraspinatus in rotator cuff tears.Methods A total of 152 patients who had rotator cuff tears was enroled retrospectively. The infraspinatus muscle was divided into two compartments according to the bundle of fibres, and the patients were divided into four groups that reflected fatty degeneration. The muscle strength of the shoulder and clinical symptoms was investigated.ResultsThe severity of the rotator cuff tear and retraction increased with fatty degeneration of both the superior and inferior parts in the infraspinatus muscles. Because of the increasing fatty degeneration of the superior part of the infraspinatus, the shoulder strength index (SSI) of abduction had poor results. Additionally, as the fatty degeneration of the inferior part of the infraspinatus increased, the SSI of abduction and external rotation had worse results.ConclusionsFatty degeneration of the superior part of the infraspinatus has no correlation with the power of external rotation but has a negative correlation with the power of abduction. Moreover, fatty degeneration of the inferior part of the infraspinatus has a negative correlation with both the power of abduction and external rotation.Level of evidenceRetrospective study, Level IV.

Usefulness of Contralateral Indirect Decompression through Minimally Invasive Unilateral Transforaminal Lumbar Interbody Fusion.

Study Design Retrospective study. Purpose This study aims to investigate the clinical and radiological results of contralateral indirect decompression through minimally invasive unilateral transforaminal lumbar interbody fusion (MI-TLIF). Overview of Literature Several studies have proposed that blood loss and operation time could be reduced through a unilateral approach, although many surgeons have forecast that satisfactory foraminal decompression is difficult to achieve through a unilateral approach. Methods The study included 30 subjects who had undergone single-level MI-TLIF. Visual analogue scale (VAS) and Oswestry disability index (ODI) were analyzed for clinical assessment. Disc height, segmental lordosis, and lumbar lordosis angle were examined for radiological assessment. The degree of contralateral indirect decompression was evaluated through a comparative analysis, with a magnetic resonance imaging (MRI) performed preoperatively and at one year postoperatively. Results Intraoperative blood loss volume was 308.75 mL in the unilateral approach group (UAP), and 575.00 mL in the bilateral approach group (BAP), showing a statistically significant difference. Operation time was 139.50 minutes in the UAP group, and 189.00 minutes in the BAP group, exhibiting a statistically significant difference (p<0.05). On the other hand, no significant difference was found in VAS, ODI, disc height, lordosis angles and the degree of nerve decompression in the vertebral foramen, using MRI, between the two groups (p>0.05). Conclusions Satisfactory results were acquired with MI-TLIF conducted through the unilateral approach of contralateral indirect decompression, in alignment with the bilateral approach. Therefore, contralateral indirect decompression is thought to be a useful procedure in reducing the operation time and volume of blood loss.

Deformity Correction by Femoral Supracondylar Dome Osteotomy with Retrograde Intramedullary Nailing in Varus Deformity of the Distal Femur after Pathologic Fracture of Giant Cell Tumor

Angular deformities of the distal femur occur in congenital diseases or due to acquired causes, such as malunion after a fracture of the distal femur. Angular deformities of the lower extremities affect the mechanical axis, causing changes in the weight pressure on the articular surface. As a result, angular deformities quicken the progression of osteoarthritis. Therefore, correction of deformities should be performed to prevent the progression of osteoarthritis. Distal femoral osteotomy is one of the methods to correct angular deformities in unicompartmental osteoarthritis. However, femoral supracondylar dome osteotomy with retrograde intramedullary nailing in the distal femur with a varus deformity has been rarely reported. Herein, we describe a technique for femoral supracondylar dome osteotomy with retrograde intramedullary nailing in a varus deformity after a pathologic fracture of giant cell tumor in the distal femur with a review of the relevant literature.

Baker's Cyst Filled with Hematoma at the Lower Calf.

Bakers cyst is a distension of the gastrocnemius-semimembranosus bursa of the knee, which communicates with the posterior portion of the joint capsule. Bakers cyst is commonly located in the inferomedial or superficial layers of the knee joint and rarely extends laterally or proximally. Complications of Bakers cysts are dissection, rupture, pseudothrombophlebitis, leg ischemia, nerve entrapment, and compartment syndrome. However, hematomas in the Bakers cyst have not been reported in Korea. We report a rare case of hematoma in the Bakers cyst with subfascial extension into the calf. The hematoma was demonstrated by magnetic resonance imaging and removed by mass excision.