Evaluation of Deltoid Origin Status Following Open and Arthroscopic Repair of Large Rotator Cuff Tears: A Propensity-Matched Case-Control Study

Erica Kholinne,Jae-Man Kwak,Yucheng Sun,Hyojune Kim,Kyoung Hwan Koh,In-Ho Jeon 대한견주관절의학회 2020 대한견주관절의학회지 Vol.23 No.1

Background: The purpose of this study was to evaluate and compare deltoid origin status following large rotator cuff repair carried out using either an open or an arthroscopic method with a propensity score matching technique. Methods: A retrospective review of 112 patients treated for full-thickness, large rotator cuff tear via either a classic open repair (open group) or an arthroscopic repair (arthroscopic group) was conducted. All patients included in the study had undergone postoperative magnetic resonance imaging (MRI) and clinical follow-up for at least 12 and 18 months after surgery, respectively. Propensity score matching was used to select controls matched for age, sex, body mass index, and affected site. There were 56 patients in each group, with a mean age of 63.3 years (range, 50-77 years). The postoperative functional and radiologic outcomes for both groups were compared. Radiologic evaluation for postoperative rotator cuff integrity and deltoid origin status was performed with 3-Tesla MRI. Results: The deltoid origin thickness was significantly greater in the arthroscopic group when measured at the anterior acromion (P=0.006), anterior third (P=0.005), and middle third of the lateral border of the acromion level (P=0.005). The deltoid origin thickness at the posterior third of the lateral acromion was not significantly different between the arthroscopic and open groups. The arthroscopic group had significantly higher intact deltoid integrity with less scarring (P=0.04). There were no full-thickness deltoid tears in either the open or arthroscopic group. Conclusions: Open rotator cuff repair resulted in a thinner deltoid origin, especially from the anterior acromion to the middle third of the lateral border of the acromion, at the 1-year postoperative MRI evaluation. Meticulous reattachment of the deltoid origin is as essential as rotator cuff repair when an open approach is selected.

The Recent Surgical Treatment of Elbow Pain

Erica Kholinne,In-ho Jeon,Jae-Man Kwak Ewha Womans University School of Medicine 2023 EMJ (Ewha medical journal) Vol.46 No.4

The review article explores recent advances in the surgical treatment of elbow pain, a common ailment that can significantly impair daily functioning. With a surge in elbow-related conditions such as tennis elbow, osteoarthritis, and nerve compression disorders, the necessity for surgical approaches has become paramount. This article provides an overview of the cutting-edge procedures now available, including minimally invasive arthroscopic surgery. These modern methods have been shown to significantly reduce recovery times and improve overall patient outcomes. The combination of surgical management and targeted rehabilitation ensures a comprehensive and personalized treatment plan for patients with various elbow pathologies. This article aims to shed light on these recent surgical interventions and their potential for advancing the management of elbow pain, emphasizing the ongoing trend toward precision, efficiency, and patient-centered care.

Primary Linked Total Elbow Arthroplasty for Acute Distal Humerus Fracture Management: A Systematic Review of Clinical Outcome

Erica Kholinne,Lamees Abdullah Altamimi,Aya Aldayel,Razan AlSabti,김효준,박동준,고경환,전인호 대한정형외과학회 2020 Clinics in Orthopedic Surgery Vol.12 No.4

Background: The treatment of distal humerus fractures is often challenging in osteoporotic elderly patients. Total elbow arthroplasty (TEA) is a salvage option for non-reconstructable fractures. The aim of this systematic review was to evaluate the clinical evidence for primary TEA in patients with acute distal humeral fractures. Methods: Literatures were searched through PubMed, Ovid/Medline, Cochrane, Google Scholar, and Embase databases with the keywords, “distal humerus fracture,” “total elbow arthroplasty,” and “outcome” according to the MeSH (Medical Subject Headings) index for English-language studies published from April 2009 to April 2019. We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results: Ten articles with a total of 269 patients were included in the review. The Bryan-Morrey approach was the most common surgical approach (33.7%) with triceps reflecting (42%) for triceps tendon management. The most common implant design used was the Coonrad-Morrey system (83%). The mean postoperative motion arc was 102.3° for flexion-extension and 145.8° for pronation- supination. The average functional outcome score was 89.5 with Mayo Elbow Performance Score (MEPS). An excellent MEPS was found in studies with less than 7 days of average time from injury to surgery. The overall complication rate was 21.5%. Conclusions: The current review showed favorable outcome of primary linked TEA for acute distal humerus fractures. Despite the promising functional outcomes, the complication rate was still considerably high. This systematic review will give surgeons help in explaining to patients regarding the expected outcome after primary TEA for acute distal humerus fractures.

The relationship between age, rotator cuff integrity, and osseous microarchitecture of greater tuberosity: Where should we put anchor?

Kholinne, Erica,Lee, Hyun Joo,Kim, Sung Jung,Park, So Hyun,Jeon, In-Ho Turkish Association of Orthopaedics and Traumatolo 2018 Acta orthopaedica et traumatologica turcica Vol.52 No.1

<P><B>Objective</B></P><P>The aim of this study was to compare the microarchitecture of the greater tuberosity with or without rotator cuff tear and to obtain optimum location for anchor screw insertion for rotator cuff repair.</P><P><B>Methods</B></P><P>Twenty-five humeral heads were harvested from 13 male cadavers of mean age 58.4 years, including 6 humeri with rotator cuff tear and 19 intact humeri. Six regions of interest (proximal, intermediate, and distal zones of the superficial and deep regions) were divided into the anterior (G1), middle (G2), and posterior (G3) areas of the greater tuberosity. Trabecular bone volume and cortical thickness were evaluated.</P><P><B>Results</B></P><P>Total trabecular bone volume was greater in subjects <50 years old than in subjects >50 years old but did not differ significantly in subjects with and without rotator cuff tear. Cortical thickness in both intact and torn rotator cuff groups was significantly greater in the proximal and intermediate zones than in the distal zone. Cortical thickness was related to anatomic location rather than age or cuff tear.</P><P><B>Conclusion</B></P><P>The optimal location for anchor screw insertion during rotator cuff repair is either the proximal or intermediate region of the greater tuberosity. Age has more influence in terms of trabecular bone volume loss than rotator cuff integrity.</P>

The Existence and Distribution of Mechanoreceptors of Elbow’s Medial Collateral Ligament

Kholinne Erica,Lee Hyun-Joo,Jeon In-Ho 대한견주관절의학회 2017 대한견주관절학회 학술대회논문집 Vol.2017 No.3

A Three Dimensional Computed Tomography Modeling for Kinematic Analysis of Double Strands Lateral Ulnar Collateral Ligament Reconstruction

Inho Jeon,Erica Kholinne 대한견주관절의학회 2018 대한견주관절학회 학술대회논문집 Vol.2018 No.3

Arthroscopic Superior Capsular Reconstruction with or without mesh augmentation: A preliminary comparative study

In-Ho Jeon,Erica Kholinne,Jae-Man Kwak,Yucheng Sun 대한견주관절의학회 2019 대한견주관절학회 학술대회논문집 Vol.2019 No.3

Hemiarthroplasty for Distal Humerus Fracture

Jae-Man Kwak,Erica Kholinne,Yucheng Sun,Gwan Bum Lee,Kyoung Hwan Koh,Jae-Myeung Chun,In-Ho Jeon 대한견주관절의학회 2018 대한견주관절의학회지 Vol.21 No.3

Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included ‘distal humerus fracture’ and ‘hemiarthroplasty’. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion (107.6° flexion-extension, 157.5° for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

Arthroscopic Excision of Heterotopic Ossification in the Supraspinatus Muscle

Lamees A. Altamimi,Erica Kholinne,Hyojune Kim,Dongjun Park,In-Ho Jeon 대한견주관절의학회 2020 대한견주관절의학회지 Vol.23 No.1

Heterotopic ossification is formation of bone in atypical extra-skeletal tissues and usually occurs spontaneously or following neurologic injury with unknown cause. We report a 46-year-old female with right shoulder pain and restricted range of motion (ROM) for 3 months without history of trauma. Magnetic resonance imaging (MRI) showed a lesion within the rotator cuff supraglenoid. Excisional biopsy from a previous institution revealed a heterotopic ossificans (HO). Following repeat MRI and bone scan, histopathology from arthroscopic resection confirmed an HO. The patient demonstrated improved pain and ROM at follow-up. Idiopathic HO rarely occurs in the shoulder joint, and resection of HO should be delayed until maturation of the lesion to avoid recurrence. The current case showed that arthroscopic HO resection provides an excellent surgical view to ensure complete lesion removal and minimize soft tissue damage at the supraglenoid area. Furthermore, the minimally invasive procedure of arthroscopy may reduce rehabilitation time and facilitate early return to work.

The Role of Lateral Retinacular Release in Preventing Patellofemoral Malalignment in Double-Bundle Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Ludwig Andre Pontoh,Ismail Hadisoebroto Dilogo,Erica Kholinne,Jessica Fiolin,Toto Suryo Efar 대한정형외과학회 2022 Clinics in Orthopedic Surgery Vol.14 No.3

Background: Loss of internal rotation stability is the major cause of pain after an anterior cruciate ligament reconstruction (ACLR). Many authors described measures to treat this problem to no avail. This is the first study evaluating the role of lateral release with double-bundle ACLR to prevent patellofemoral malalignment after ACLR. Methods: A total of 100 patients were included in this prospective study between January 2018 and December 2019. We compared single-bundle ACLR (group 1, n = 30), double-bundle ACLR (group 2, n = 30), and double-bundle ACLR with lateral release (group 3, n = 40). Clinical outcome was evaluated with the Kujala score while radiological outcome was evaluated using the tibial tubercle-trochlear groove (TTTG) distance in magnetic resonance imaging. The preoperative and postoperative values were compared. Results: At the final follow-up of 6–18 months, group 3 showed the lowest TTTG value (6.7 ± 4.69) compared to group 2 (9.1 ± 4.83) and group 1 (11.74 ± 1.76) (p = 0.03). The Kujala score was significantly improved in all groups: from 68.83 to 89.90 in group 1, from 70.02 to 91.23 in group 2, and from 69.71 to 95.05 in group 3 (p = 0.03). Group 3 showed the most superior improvement in the Kujala score (25.34) compare to group 1 (21.07) and group 3 (21.21) (p = 0.012). Conclusions: Concomitant lateral retinacular release significantly improved the Kujala score. It may serve as a valuable option to overcome patellofemoral pain syndrome in ACLR.