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Shoulder Procedures

 


Shoulder Arthroscopy.

Diagnostic Examination: is a key component of all shoulder arthroscopy. The arthroscope gives the surgeon the ability to visually inspect and palpate the intra-articular and subacromial anatomy. The arthroscopic shoulder examination should proceed in a stepwise fashion, and it is important that all structures be evaluated consistently. Diagnostic arthroscopy is a critical and necessary component of any arthroscopy shoulder procedure. An understanding of normal anatomy. 

Shoulder Instability: most patients have had a traumatic anteroinferior shoulder dislocation, without other shoulder pathology or significant laxity. Technique consists: Examination under anesthesia and diagnostic arthroscopy, careful selection of portal positions, adequate preparation of the glenoid neck, appropriate tissue tensioning.

  • Results: reported rates of recurrence range from 0% to 38%.
  • Complications: reactive synovitis can occur, which may require arthroscopy synovectomy. 

Repair of Shoulder Instability: surgical technique includes: shoulder examination under anesthesia, perform arthroscopic reduction if dislocated, create standard arthroscopic portal, place anchor posterior to anterior, between other steps.

  • Results: at 24month’s the patient described earlier had full range of motion compared with his contra lateral shoulder.
  • Complications: are similar to those encountered with any other surgical procedure involving the shoulder, these include infection, neurovascular injury, pain, stiffness and recurrence of instability.

 

Rotator Cuff with Shoulder Arthroscopy: rotator cuff disease has long been recognized as a common cause of shoulder pain in adults. The clinical severity of rotator cuff pathology may be regarded as spectrum of disease from insolated bursitis and impingement to complete, irreparable rotator cuff tears.

  • The primary function of the rotator cuff is to balance the force couples about the glenohumeral joint. Patient with shoulder pain must be careful evaluated for rotator cuff disease and other associated pathologies.
  • Arthroscopic subacromial decompression-acromial platy combined with arthroscopic rotator cuff repair is the gold standard of treatment for repairable rotator cuff tears.
  • If complete repair is not possible, partial rotator cuff repair should be considered.
  • Complication: related to general shoulder arthroscopy (Infection, fluidextravasation, neurovascular injury, and others).