Diagnostic Shoulder Arthroscopy

Patient positioning:

Lateral or Beach chair – often surgeon’s preference. Each have their own advantages and disadvantages.

Portals:

Posterior – 2cm medial and 2 cm inferior to the posterior lateral corner of the acromion.

Lateral – 5cm (3 finger breadths) distal to acromion and 1 cm anterior to midline

Anterior – in/out technique using switching stick
out/in technique using needle to localise site and direction

Instruments:

4mm 30 degrees scope with camera and light source
Arthroscopy stack
Arthroscopic pump
Arthroscopic instrumentation
Arthroscopy: long head of biceps is a good marker for orientation

GH Joint -
1) subscapularis
2) anterior capsule / glenohumeral ligaments
3) LHB and biceps groove
4) biceps groove
5) posterior labrum
6) glenoid
7) humeral head
8) inferior recess
9) rotator cuff
10) anterior labrum

Bursoscopy -
11) acromion
12) CA ligament
13) AC joint
14) bursal surface of rotator cuff