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Diagnostic Shoulder Arthroscopy

Patrick Vavken, MD
Smith & Nephew
Diagnostic Shoulder Arthroscopy in Beach Chair Position

Landmarks

  • Draw out bony landmarks – acromion, coracoid, soft spot
  • Use thumbnail to delineate Anterolateral and Posterolateral acromion

Posterior Portal

  • 2 cm inferior and slightly medial to acromial angle in the “Soft spot” between infraspinatus and teres minor
  • Aiming toward coracoid, pierce skin with an 18 guage needle
  • Insufflate joint with 50 cc of saline/epi solution
  • Make an incision with #11 blade
  • Place a blunt trocar through through capsule
  • Attach inflow to arthroscopic cannula, suction as well

Diagnostic Arthroscopy (Beach Chair Position)

Examine:
  1. Glenoid, Biceps, Humeral Head, Subscapularis, and Rotator Interval
  2. Visualize Rotator Cuff, check Bare Area, Labrum, and Humeral Avulsion Glenohumeral Ligament (HAGL)
  3. Create instrument portal through Rotator Interval
  4. Test Biceps Tendon
  5. Enter Subacromial Space

CA Ligament Release

  • While in the subacromial space, release the Coraco-acromial (CA) Ligament off the bone with a radiofrequency ablator

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