Clinical and radiographic results of locking plate with medial support screw in Proximal Humerus fracture - the more, the better?

BACKGROUND: The calcar of the proximal humerus is a fundamental structure for medial humeral column support. This study aimed to assess the outcome of osteosynthesis across cases of unstable proximal humerus fractures (PHFs) with medial calcar comminution, following treatment with a PHILOS locking plate and medial support screw (MSS). METHODS: Between January 2010 and December 2018, we retrospectively analyzed the outcomes of 121 cases of osteosynthesis for PHFs with medial column disruption. For the medial support, at least one oblique screw was inserted within 5 mm of the subchondral bone in the inferomedial quadrant of the humeral head. All patients were categorized into two groups: 26 patients in the single MSS group, and 95 in the multiple MSS group. Follow-up after at least an year involved clinical and radiographic outcome evaluations, and correspondingly measuring the Constant-Murley score, University of California, Los Angeles (UCLA) shoulder scale, pain visual analogue scale (VAS), major complications, neck-shaft angle (NSA), humeral head height (HHH), and the eventual time to bone union. Risk factors for the major complications were assessed by multivariate logistic regression analyses. RESULTS: The cohort's mean age was 64.4 ± 15.4 years, and the mean follow-up duration was 19.5 ± 7.6 months. At the final follow-up, between the single MSS and multiple MSS groups, no significant differences in the Constant-Murley score (p = 0.367), UCLA score (p = 0.558), VAS (p = 0.571), time to bone union (p = 0.621), NSA loss (p = 0.424), and HHH loss (p = 0.364) were observed. The incidence of complications (p = 0.446) based on the number of MSS were not significantly different. The initial insufficient reduction after surgery (of NSA < 125°) was found to be a significant risk factor for post-surgical complications. CONCLUSIONS: To treat unstable PHFs, the use of at least one MSS along with a locking plate system is sufficient to achieve satisfactory outcomes. Successful operative treatment using a locking plate for PHF treatment is inherent in anatomical fracture reduction, coupled with medial column support.

Does the coronoid fracture in terrible triad injury always need to be fixed?

BACKGROUND: The ideal treatment of terrble triad injuries and whether fixation of coronoid process fractures is needed or not are still debated. Therefore, we aimed to investigate if terrible triad injuries necessitate coronoid fracture fixation and evaluate if non-fixation treatments have similar efficacies and outcomes as fixation-treatments in cases of terrible triad injuries. METHODS: From August 2011 to July 2020, 23 patients with acute terrible triad injuries without involvement of the anteromedial facet of the coronoid process were included to evaluate the postoperative clinical and radiological outcomes (minimum follow-up of 20 months). According to the preoperative height loss evaluation of the coronoid process and an intraoperative elbow stability test, seven patients underwent coronoid fracture fixation, and the other eight patients were treated conservatively. The elbow range of motion (ROM), Mayo Elbow Performance Score (MEPS), and modified Broberg-Morrey score were evaluated at the last follow-up. In addition, plain radiographs were reviewed to evaluate joint congruency, fracture union, heterotopic ossification, and the development of arthritic changes. RESULTS: At the last follow-up, the mean arcs of flexion-extension and supination-pronation values were 118.2° and 146.8° in the fixation group and 122.5° and 151.3° in the non-fixation group, respectively. The mean MEPSs were 96.4 in the fixation group (excellent, nine cases; good, tow cases) and 96.7 in the non-fixation group (excellent, ten cases; good, two cases). The mean modified Broberg-Morrey scores were 94.0 in the fixation group (excellent, sevev cases; good, four cases) and 94.0 in the non-fixation group (excellent, ten cases; good, tow cases). No statistically significant differences in clinical scores and ROM were identified between the two groups. However, the non-fixation group showed a significantly lower height loss of the coronoid process than the fixation group (36.3% versus 54.5%). CONCLUSIONS: There were no significant differences in clinical outcomes between the fixation and non-fixation groups in terrible triad injuries.

Novel Use of a Fibular Strut Allograft with Fibular Head in an Elderly Patient with Proximal Humeral Fracture and Severe Metaphyseal Comminution: An Alternative to Shoulder Arthroplasty.

Treatment of a comminuted proximal humerus fracture (PHF) in elderly patients with severe osteoporosis is challenging, often leading to arthroplasty (such as hemiarthroplasty or reverse shoulder arthroplasty) as the treatment of choice. However, arthroplasty does not always guarantee favorable outcomes. In contrast, the use of intramedullary fibular strut allografts provides additional reduction stability during locking plate fixation; however, to our knowledge, there is limited literature on the use of fibular strut allografts, including the fibular head. Here we aim to report the advantages of using a fibular strut containing the fibular head in severe osteoporotic PHFs. We present the case of an 88-year-old female patient with severe osteoporosis diagnosed with a left PHF accompanied by severe metaphyseal comminution following a fall from a chair. Rather than shoulder arthroplasty, we performed osteosynthesis using a fibular strut allograft containing the fibular head. At the one-year follow-up after surgery, we observed excellent bony union and a favorable functional outcome without major complications, such as reduction loss. The novel use of a fibular strut allograft containing the fibular head could be promising for PHFs with severe metaphyseal comminution, potentially avoiding the need for arthroplasty.

Can convertible metal-backed glenoid components replace cemented polyethylene glenoid components in anatomical total shoulder arthroplasty?

BACKGROUND: Anatomical total shoulder arthroplasty (aTSA) has been used to manage degenerative diseases such as primary osteoarthritis. An increase in the use of this procedure has led to several developments in humeral and glenoid components to improve patient outcomes. This study aimed to compare clinical and radiological outcomes of the newly-introduced convertible metal-backed glenoid components with cemented polyethylene glenoid components in aTSA, and to determine whether the new component would be comparable to a conventional one for reducing the burden of future revision or conversion surgeries. METHODS: Medical records of fifty patients who underwent aTSA with at least two years of follow-up were retrospectively reviewed. Eighteen patients received convertible metal-backed glenoid components with vitamin E1-coated liner (MB group), while thirty-two patients received conventional cemented polyethylene glenoid components (PE group). Pre- and postoperative clinical and radiological outcomes (acromion-greater tuberosity angle [AGA] and humeral lateral offset [LO]) at final follow-up were assessed. Radiolucent lines (RLLs) and loosening around the humeral and glenoid components were also evaluated. RESULTS: Clinical outcomes improved after surgery in both groups (all p < 0.001). The arc of rotation measured by AGA improved postoperatively in both groups (all p < 0.001), and AGA and LO were not different according to the type of glenoid components (all p > 0.05). Overall complication rates including RLLs of PE and MB groups were 43.8% (14/32) and 16.7% (3/18), respectively (p = 0.031). Although the PE group had more RLLs than did the MB group (p < 0.05), related symptoms and/or glenoid implant loosening were not observed in both groups. Subscapularis failure occurred in two patients in the PE group and in one in the MB group. CONCLUSION: The convertible metal-backed glenoid implant with vitamin E1-coated liner may be a good alternative for considering the potential for an easier conversion to reverse total shoulder arthroplasty.

Scheduling Framework for Accelerating Multiple Detection-Free Object Trackers.

In detection-free tracking, after users freely designate the location of the object to be tracked in the first frame of the video sequence, the location of the object is continuously found in the following video frame sequence. Recently, technologies using a Siamese network and transformer based on DNN modules have been evaluated as very excellent in terms of tracking accuracy. The high computational complexity due to the usage of the DNN module is not a preferred feature in terms of execution speed, and when tracking two or more objects, a bottleneck effect occurs in the DNN accelerator such as the GPU, which inevitably results in a larger delay. To address this problem, we propose a tracker scheduling framework. First, the computation structures of representative trackers are analyzed, and the scheduling unit suitable for the execution characteristics of each tracker is derived. Based on this analysis, the decomposed workloads of trackers are multi-threaded under the control of the scheduling framework. CPU-side multi-threading leads the GPU to a work-conserving state while enabling parallel processing as much as possible even within a single GPU depending on the resource availability of the internal hardware. The proposed framework is a general-purpose system-level software solution that can be applied not only to GPUs but also to other hardware accelerators. As a result of confirmation through various experiments, when tracking two objects, the execution speed was improved by up to 55% while maintaining almost the same accuracy as the existing method.

Differential Expression of NME4 in Trophoblast Stem-Like Cells and Peripheral Blood Mononuclear Cells of Normal Pregnancy and Preeclampsia.

BACKGROUND: Preeclampsia (PE) is known to arise from insufficient trophoblast invasion as uterine spiral arteries lack remodeling. A significant reduction in placental perfusion induces an ischemic placental microenvironment due to reduced oxygen delivery to the placenta and fetus, leading to oxidative stress. Mitochondria are involved in the regulation of cellular metabolism and the production of reactive oxygen species (ROS). NME/NM23 nuceloside diphosphate kinase 4 (NME4) gene is known to have the ability to supply nucleotide triphosphate and deoxynucleotide triphosphate for replication and transcription of mitochondria. Our study aimed to investigate changes in NME4 expression in PE using trophoblast stem-like cells (TSLCs) from induced pluripotent stem cells (iPSCs) as a model of early pregnancy and peripheral blood mononuclear cells (PBMNCs) as a model of late preterm pregnancy. METHODS: Transcriptome analysis using TSLCs was performed to identify the candidate gene associated with the possible pathophysiology of PE. Then, the expression of NME4 associated with mitochondrial function, p53 associated with cell death, and thioredoxin (TRX) linked to ROS were investigated through qRT-PCR, western blotting and deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP) nick end labelling (TUNEL) assay. RESULTS: In patients with PE, NME4 was significantly downregulated in TSLCs but upregulated in PBMNCs. p53 was shown to be upregulated in TSLCs and PBMNCs of PE. In addition, western blot analysis confirmed that TRX expression had the tendency to increase in TSLCs of PE. Similarly, TUNEL analysis confirmed that the dead cells were higher in PE than in normal pregnancy. CONCLUSION: Our study showed that the expression of the NME4 differed between models of early and late preterm pregnancy of PE, and suggests that this expression pattern may be a potential biomarker for early diagnosis of PE.

Socio-economic and psychosocial determinants of violent discipline among parents in Asia Pacific countries during COVID-19: Focus on disadvantaged populations.

BACKGROUND: Mobility restrictions and economic downfall as a result of the COVID-19 pandemic may increase the risk of child maltreatment, including increased risk for violent discipline use by parents. OBJECTIVE: We examined the socio-economic and psychosocial determinants of violent discipline among parents against children in Asia Pacific countries. PARTICIPANTS & SETTINGS: This secondary data analysis included 7765 parents with children 6-18 years old in eight Asia Pacific countries. METHODS: 24 potential determinants were identified, including household demographic factors, parents' psychosocial status, and livelihood changes. The dependent variable was parental use of violent discipline (physical, severe physical, psycho-social aggression, and any violent discipline). Univariate and multivariable logistic regression analysis was conducted. RESULTS: A total of 41 % of households reported violent discipline. Parental demographic characteristics that were positively related to use of violent discipline were living in rural areas, not being a household head, female sex, age younger than 35 years, and large family size. Poor parental mental health status, loss of job or reduced income due to COVID-19, lack of food at household level, parent engagement in petty trade, and owning a business also predicted violent discipline. Mandatory curfew and receiving pandemic-related education materials were also positive predictors. CONCLUSION: Some socio-demographic factors, economic hardship due to COVID-19, and poor mental health status of parents are associated with the use of violent discipline against children in the Asia Pacific region. These results highlight several potential target areas for child protection interventions by governmental and non-profit organizations, including economic, social, and mental health interventions.

Tissue-engineered tendon nano-constructs for repair of chronic rotator cuff tears in large animal models.

Chronic rotator cuff tears (RCTs) are one of the most common injuries of shoulder pain. Despite the recent advances in surgical techniques and improved clinical outcomes of arthroscopically repaired rotator cuffs (RCs), complete functional recovery-without retear-of the RC tendon through tendon-to-bone interface (TBI) regeneration remains a key clinical goal to be achieved. Inspired by the highly organized nanostructured extracellular matrix in RC tendon tissue, we propose herein a tissue-engineered tendon nano-construct (TNC) for RC tendon regeneration. When compared with two currently used strategies (i.e., transosseous sutures and stem cell injections), our nano-construct facilitated more significant healing of all parts of the TBI (i.e., tendon, fibrocartilages, and bone) in both rabbit and pig RCT models owing to its enhancements in cell proliferation and differentiation, protein expression, and growth factor secretion. Overall, our findings demonstrate the high potential of this transplantable tendon nano-construct for clinical repair of chronic RCTs.

Time-Constrained Adversarial Defense in IoT Edge Devices through Kernel Tensor Decomposition and Multi-DNN Scheduling.

The development of deep learning technology has resulted in great contributions in many artificial intelligence services, but adversarial attack techniques on deep learning models are also becoming more diverse and sophisticated. IoT edge devices take cloud-independent on-device DNN (deep neural network) processing technology to exhibit a fast response time. However, if the computational complexity of the denoizer for adversarial noises is high, or if a single embedded GPU is shared by multiple DNN models, adversarial defense at the on-device level is bound to represent a long latency. To solve this problem, eDenoizer is proposed in this paper. First, it applies Tucker decomposition to reduce the computational amount required for convolutional kernel tensors in the denoizer. Second, eDenoizer effectively orchestrates both the denoizer and the model defended by the denoizer simultaneously. In addition, the priority of the CPU side can be projected onto the GPU which is completely priority-agnostic, so that the delay can be minimized when the denoizer and the defense target model are assigned a high priority. As a result of confirming through extensive experiments, the reduction of classification accuracy was very marginal, up to 1.78%, and the inference speed accompanied by adversarial defense was improved up to 51.72%.

Quantification method to objectively evaluate the fibrous structural status of tendons based on polarization-sensitive OCT.

Histological analysis is widely used to evaluate injured tendons; however, it has the limitation of being semi-quantitative. Hence, we developed a quantification method to objectively evaluate the fibrous structure of tendons, exhibiting the optical property of birefringence, using polarization-sensitive optical coherence tomography (PS-OCT). We used a partial-rupture rat model in which the middle 0.75 cm of the Achilles tendon was cut with a blade. Rats were sacrificed at 2, 4 or 6 weeks after the injury, and PS-OCT and histological analyzes were performed. The PS-OCT phase retardation images and score well represented the structural changes of the injured tendon according to the wound healing state. Therefore, the proposed novel quantification method using PS-OCT can be used to evaluate the fibrous structural status of tendons.

Neuropsychological Profile of College Students Who Engage in Binge Drinking.

This study investigated the neuropsychological profile of college students who engage in binge drinking (BD) using comprehensive neuropsychological tests evaluating verbal/non-verbal memory, executive functions, and attention. Groups were determined based on scores on the Korean version of the Alcohol Use Disorder Identification Test (AUDIT-K) and Alcohol Use Questionnaire (AUQ). There were 79 and 81 participants in the BD and non-BD groups, respectively. We administered the Korean version of the California Verbal Learning Test (K-CVLT) and Rey-Osterrieth Complex Figure Test (RCFT) to evaluate verbal and non-verbal memory, respectively, and measured executive functions using the Wisconsin Card Sorting Test (WCST), Trail-Making Test, Controlled Oral Word Association Test and Stroop Color-Word Test. We administered the d2 test to evaluate attention. Neuropsychological performance was analyzed by multivariate analysis of variance. The BD group showed significantly poorer performance in the long-term free recall condition of the K-CVLT and delayed recall condition of the RCFT and completed significantly fewer categories on the WCST than the non-BD group. In addition, there were significant negative associations among the AUDIT-K total score, AUQ binge score, and long-term free recall score of the K-CVLT. There were significant negative associations between the total AUDIT-K score and delayed recall RCFT score, and between the total AUDIT-K total score and numbers of completed categories on the WCST. These results indicate that college students who participate in BD have difficulties with verbal/non-verbal memory and executive functions, and further suggest that excessive alcohol use could have detrimental effects on the hippocampal-prefrontal circuit even with a relatively short period of alcohol use.

Amine Plasma-Polymerization of 3D Polycaprolactone/ß-Tricalcium Phosphate Scaffold to Improving Osteogenic Differentiation In Vitro.

This study aims to investigate the surface characterization and pre-osteoblast biological behaviors on the three-dimensional (3D) poly(ε-caprolactone)/ß-tricalcium phosphate (ß-TCP) scaffold modified by amine plasma-polymerization. The 3D PCL scaffolds were fabricated using fused deposition modeling (FDM) 3D printing. To improve the pre-osteoblast bioactivity, the 3D PCL scaffold was modified by adding ß-TCP nanoparticles, and then scaffold surfaces were modified by amine plasma-polymerization using monomer allylamine (AA) and 1,2-diaminocyclohexane (DACH). After the plasma-polymerization of PCL/ß-TCP, surface characterizations such as contact angle, AFM, XRD, and FTIR were evaluated. In addition, mechanical strength was measured by UTM. The pre-osteoblast bioactivities were evaluated by focal adhesion and cell proliferation. Osteogenic differentiation was investigated by ALP activity, Alizarin red staining, and Western blot. Plasma-polymerization induced the increase in hydrophilicity of the surface of the 3D PCL/ß-TCP scaffold due to the deposition of amine polymeric thin film on the scaffold surface. Focal adhesion and proliferation of pre-osteoblast improved, and osteogenic differentiation was increased. These results indicated that 3D PCL/ß-TCP scaffolds treated with DACH plasma-polymerization showed the highest bioactivity compared to the other samples. We suggest that 3D PCL/ß-TCP scaffolds treated with DACH and AA plasma-polymerization can be used as a promising candidate for osteoblast differentiation of pre-osteoblast.

Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: a retrospective cohort study.

BACKGROUND: Surgical fixation using hook plates is widely used in the treatment of acromioclavicular (AC) joint dislocations. The purpose of this study was to evaluate the incidence and shape of subacromial erosions after removal of the hook plate in type 5 AC joint dislocations. Further, we evaluated the effect of the shape of the subacromial erosion on the rotator cuff. METHODS: We retrospectively reviewed 30 patients who underwent hook plate fixation for type 5 AC joint dislocations at our hospital between December 2010 and December 2018. Patients with a follow-up of at least 1 year were included. Clinical outcomes were assessed using the final follow-up Constant-Murley, Korean Shoulder, and visual analog scores. To ensure that the appropriate reduction was well maintained, the coracoclavicular distances of the injured and contralateral sides were evaluated at the last follow-up. Computed tomography was performed to investigate the presence and shape of the subacromial erosion after hook plate removal at 4 months after surgery. Ultrasonography was performed to investigate the presence of rotator cuff lesions at the last follow-up. Clinical and radiological outcomes were compared between groups divided according to the presence and types of subacromial erosions. RESULTS: Subacromial erosion was observed in 60% of patients (18/30): 13, 2, and 3 simple groove, cave, and marginal protrusion types, respectively. Four patients showed reduction loss at the final follow-up. There were no significant differences in clinical and radiological outcomes between the groups with and without subacromial erosion. Moreover, there were no significant differences between groups according to the types of subacromial erosion. There were no rotator cuff lesions, such as partial tears, in the injured shoulders. CONCLUSIONS: Hook plate fixation may induce subacromial erosions. However, the subacromial erosions caused by the hook plate did not affect the clinical outcomes of type 5 AC joint dislocations. Moreover, regardless of its shape, the subacromial erosion did not affect the clinical outcomes nor cause rotator cuff lesions after plate removal.

Combined radial wedge and shortening osteotomy versus scaphocapitate arthrodesis in advanced Kienböck's disease.

Although various surgical techniques have been reported for the treatment of advanced Kienböck's disease (Lichtman stage IIIB and above), the ap- propriate operative treatment is still being debated. This study compared the clinical and radiological outcomes of combined radial wedge and shortening osteotomy (CRWSO) and scaphocapitate arthrodesis (SCA) in the treatment of advanced Kienböck's disease (above type IIIB) with a minimum of 3 years of follow-up. We analyzed the data from 16 and 13 patients who underwent CRWSO and SCA, respectively. The average follow-up period was 48.6±12.8 months. Clinical outcomes were evaluated using the flexion-extension arc, grip strength, Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), and Visual Analogue Scale (VAS) for pain. The following radiological parameters were measured: ulnar variance (UV), carpal height ratio (CHR), radioscaphoid angle (RSA), and Stahl index (SI). Osteoarthritic changes in the radiocarpal and midcarpal joints were evaluated using computed tomography (CT). Clinically, both groups showed significant improvements in the grip strength, DASH, and VAS at final follow-up. However, regarding the flexion-extension arc, the CRWSO group showed a significant improvement, while the SCA group did not. Radiologically, compared to the preoperative values, the CHR results improved at final follow-up in the CRWSO and SCA groups. There was no statistically significant difference in the degree of CHR correction between the 2 groups. By the final follow-up visit, none of the patients in either group had progressed from Lichtman stage IIIB to stage IV. Considering restoration of wrist joint range of motion, CRWSO may be a good alternative for limited carpal arthrodesis for advanced Kienböck's disease.

Plasma-assisted multiscale topographic scaffolds for soft and hard tissue regeneration.

The design of transplantable scaffolds for tissue regeneration requires gaining precise control of topographical properties. Here, we propose a methodology to fabricate hierarchical multiscale scaffolds with controlled hydrophilic and hydrophobic properties by employing capillary force lithography in combination with plasma modification. Using our method, we fabricated biodegradable biomaterial (i.e., polycaprolactone (PCL))-based nitrogen gas (N-FN) and oxygen gas plasma-assisted flexible multiscale nanotopographic (O-FMN) patches with natural extracellular matrix-like hierarchical structures along with flexible and controlled hydrophilic properties. In response to multiscale nanotopographic and chemically modified surface cues, the proliferation and osteogenic mineralization of cells were significantly promoted. Furthermore, the O-FMN patch enhanced regeneration of the mineralized fibrocartilage tissue of the tendon-bone interface and the calvarial bone tissue in vivo in rat models. Overall, the PCL-based O-FMN patches could accelerate soft- and hard-tissue regeneration. Thus, our proposed methodology was confirmed as an efficient approach for the design and manipulation of scaffolds having a multiscale topography with controlled hydrophilic property.

Long-Lasting Growth Hormone Regulated by the Ubiquitin-Proteasome System.

To increase the half-life of growth hormones, we proposed its long-lasting regulation through the ubiquitin-proteasome system (UPS). We identified lysine residues (K67, K141, and K166) that are involved in the ubiquitination of human growth hormone (hGH) using ubiquitination site prediction programs to validate the ubiquitination sites, and then substituted these lysine residues with arginine residues. We identified the most effective substituent (K141R) to prevent ubiquitination and named it AUT-hGH. hGH was expressed and purified in the form of hGH-His, and ubiquitination was first verified at sites containing K141 in the blood stream. Through the study, we propose that AUT-hGH with an increased half-life could be used as a long-lasting hGH in the blood stream.

A novel technique of pulley creation for additional sagittal band reconstruction.

Because surgical treatment of chronic extensor tendon dislocation with sagittal band injury is complex and often requires donor grafts, we suggest a new technique: pulley creation for additional sagittal band reconstruction. A 76-year-old man diagnosed with chronic extensor tendon dislocation with radial sagittal band injury was treated by resecting the distended portion of the radial sagittal band, followed by plication. Using the remnant tissue obtained after resection, additional sagittal band reconstruction was performed using two mini soft suture anchors in the form of a pulley surrounding the extensor tendon. Three-year outcome was satisfactory. Pulley creation for additional sagittal band reconstruction with direct repair of the radial sagittal band is a new surgical option for chronic extensor tendon dislocation. The technique is quick and easy, with good patient satisfaction and no donor site complications.

Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear.

BACKGROUND: To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear. METHODS: Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. RESULTS: There were 402 female patients (79%) with mean age of 55 years (range, 31-87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0-35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1-10) and 47 (range, 8-95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05). CONCLUSIONS: This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.