- See:
Arthroscopic Acromioplasty
- Lateral portal:
- used for visualization of, or for insertion of instruments into, subacromial space, (usually for
arthroscopic acromioplasty or for
calcific tendinitis); calcific tendinitis);
- the key to lateral portal placement is that it must allow triangulation over the entire undersurface
of the anterior acromion;
- if the portal is placed too posteriorly in a large muscular patient, it will be difficult for
instruments to "turn the corner" inorder to reach the anterior acromion;
- place it laterally, in line with the mid-clavicle, and 2-3 cm lateral to its lateral edge;
- alternatively insert it at a point that bisects the lateral acromion into anterior and
posterior halves;
- when passing instruments thru the lateral portal into the subacromial space, it is often helpful to
direct the instruments directly medial before triangulating toward the AC joint;
- it is also helpful to apply distraction to the arm, inorder to avoid rotator cuff injury;
-
hazards:
- care should be taken, during placement of this portal, to avoid injury to axillary
nerve, which enters deep surface of deltoid approx 5 cm lateral to the acromion;
- it must be noted that smaller branches of the
axillary nerve may
enter
deltoid as close as one centimeter lateral to acromion;
Arthroscopy of the shoulder: technique and normal anatomy.
JR Andrews et al.
Am J. Sports Med. Vol 12: p 1-7, 1984.
