Duke Orthopaedics
presents
Wheeless' Textbook of Orthopaedics

Arthroscopy of the Shoulder Joint

- See: shoulder joint menu and arthroscopic RCT repair

- Fluid Management:
- Positioning:
      - beach chair position is comfortable for both the patient and the surgeon and allows the option of converting to
               an open procedure (if necessary);
      - patients need to be seated with the torso raised to 70 deg with a foled sheet placed on the medial border of
               affected scapula (to maximize posterior exposure)
      - complications: hypoglossal nerve injury;
      - references:
              - Measurements of brachial plexus strain in arthroscopy of the shoulder.  
              - Hypoglossal nerve palsy after arthroscopy of the shoulder and open operation with the patient in the beach-chair position. A case report. 
              - Avoiding catastrophic complications of stroke and death related to shoulder surgery in the sitting position.
              - Pathomechanisms and Complications Related to Patient Positioning and Anesthesia During Shoulder Arthroscopy
              - A cardiovascular collapse occurred in beach chair position for shoulder arthroscopy under general anesthesia -A case report.


 
- Portal Placement:
      - posterior portal   
      - anterior portal   
      - lateral portal   
    





- references:
      - Glenohumeral arthroscopy portals established using an outside-in technique: neurovascular anatomy at risk.
      - The low anterior five-o'clock portal during arthroscopic shoulder surgery performed in the beach-chair position
      - Anatomic Risks of Shoulder Arthroscopy Portals: Anatomic Cadaveric Study of 12 Portals.


- Arthroscopic Techniques: 
    - arthroscopic acromioplasty
    - arthroscopic glenohumeral reconstruction 
    - slap lesions 
    - rotator cuff tears:  - management of massive rotator cuff tears 



   “Put Your ‘Extended’ Finger on the Bleeder”: The Use of Direct Pressure From the Shaver Blade to Achieve Hemostasis



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, June 28, 2016 6:45 am

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