際際滷

際際滷Share a Scribd company logo

Shoulder Arthroscopy positioning and preparation

Download as PPTX, PDF
R
Rishi Doshi

shoulder arthroscopy

1 of 23
Download to read offline
SETUP AND POSITIONING FOR SHOULDER ARTHROSCOPY Dr Rishi Kiran Doshi Consultant Orthopaedic Surgeon Kolhapur Institute Of Orthopaedics and Trauma Knee Arthroscopy Fellow, Sportsmed Clinic Mumbai Shoulder Arthroscopy Fellow, Italy
Today, apart from Shoulder Replacement and major Shoulder Fractures, nearly all Shoulder Pathology can be treated With arthroscopic techniques
Shoulder Arthroscopy the evolution of the technique Diagnostic Tool Final Treatment From tool of the devil , the treatment of choice of most shoulder pathologies
Metal Anchors Absorbable Anchors Peek Anchors Single suture Double sutures
Shoulder Arthroscopy positioning and preparation
Shoulder Arthroscopy positioning and preparation
Shoulder Arthroscopy positioning and preparation
BASIC ARTHROSCOPIC KIT Arthroscope Light source and cable Camera system and monitor with recorder Arthroscopic probe Arthroscopic grasper Arthroscopic scissor Arthroscopy FMS pump Arthroscopy RF Arthroscopic Punches (basket forcepes 2.7 mm upcutting right and left Rotatory ) Motorized shaver
Arthroscopic grasper
Wissinger rod
Arthroscopic trocar /Cannula
Shoulder Arthroscopy may be done in either the Beachchair, or lateral decubitus positions. Recently there have been modifications of both.
Lateral Decubitus Position Standard table Beanbag or support Axillary roll Head positioner Suspension device Limits to traction Limits to Position Side Support
Lateral Decubitus
By tilting the patient 20 to 30 degrees posteriorly, glenoid will be parallel to the floor 1. Less traction: Decrease the risk of neurapraxia of the brachial plexus 2. Accentuation of tears in the glenoid labrum as it pulled away from their beds 3. Improved arthroscopic access to the inferior third of the glenoid labrum and capsule. Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
Vertical and longitudinal traction, with most of the traction applied vertically to distract the glenohumeral joint without subluxing it inferiorly 4 to 6 kgs of traction is applied 30 to 60 degrees of abduction 20 to 30 degrees of forward flexion 23% and 30%: neurapraxia after excessive arm traction. Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
All pressure points Padded with a pillow Acromion, ASIS, Below knee, lateral malleolus and one or more pillows between the knees and ankles. Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
Beach Chair Standard table with back support Head positioner
BEACH CHAIR POSITION The benefits of the beach chair position 1. Interscalene block 2. Faster and easier positioning 3. Reduced risk of neurapraxia 4. Less distortion of intra articular capsular anatomy, 5. Improved mobility of the patients arm 6. Ease in orientation 7. Surgical manipulation in the subacromial space 8. Ease in conversion to an open surgical procedure.
COMPLICATIONS 1. Difficulty in working from posterior portals 2. Stroke 3. Death due to hypotensive episodes Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
Shoulder Arthroscopy positioning and preparation
LATERAL DECUBITUS BEACH CHAIR
Shoulder Arthroscopy positioning and preparation

More Related Content

Shoulder Arthroscopy positioning and preparation

  • 1. SETUP AND POSITIONING FOR SHOULDER ARTHROSCOPY Dr Rishi Kiran Doshi Consultant Orthopaedic Surgeon Kolhapur Institute Of Orthopaedics and Trauma Knee Arthroscopy Fellow, Sportsmed Clinic Mumbai Shoulder Arthroscopy Fellow, Italy
  • 2. Today, apart from Shoulder Replacement and major Shoulder Fractures, nearly all Shoulder Pathology can be treated With arthroscopic techniques
  • 3. Shoulder Arthroscopy the evolution of the technique Diagnostic Tool Final Treatment From tool of the devil , the treatment of choice of most shoulder pathologies
  • 8. BASIC ARTHROSCOPIC KIT Arthroscope Light source and cable Camera system and monitor with recorder Arthroscopic probe Arthroscopic grasper Arthroscopic scissor Arthroscopy FMS pump Arthroscopy RF Arthroscopic Punches (basket forcepes 2.7 mm upcutting right and left Rotatory ) Motorized shaver
  • 12. Shoulder Arthroscopy may be done in either the Beachchair, or lateral decubitus positions. Recently there have been modifications of both.
  • 13. Lateral Decubitus Position Standard table Beanbag or support Axillary roll Head positioner Suspension device Limits to traction Limits to Position Side Support
  • 15. By tilting the patient 20 to 30 degrees posteriorly, glenoid will be parallel to the floor 1. Less traction: Decrease the risk of neurapraxia of the brachial plexus 2. Accentuation of tears in the glenoid labrum as it pulled away from their beds 3. Improved arthroscopic access to the inferior third of the glenoid labrum and capsule. Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
  • 16. Vertical and longitudinal traction, with most of the traction applied vertically to distract the glenohumeral joint without subluxing it inferiorly 4 to 6 kgs of traction is applied 30 to 60 degrees of abduction 20 to 30 degrees of forward flexion 23% and 30%: neurapraxia after excessive arm traction. Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
  • 17. All pressure points Padded with a pillow Acromion, ASIS, Below knee, lateral malleolus and one or more pillows between the knees and ankles. Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013
  • 18. Beach Chair Standard table with back support Head positioner
  • 19. BEACH CHAIR POSITION The benefits of the beach chair position 1. Interscalene block 2. Faster and easier positioning 3. Reduced risk of neurapraxia 4. Less distortion of intra articular capsular anatomy, 5. Improved mobility of the patients arm 6. Ease in orientation 7. Surgical manipulation in the subacromial space 8. Ease in conversion to an open surgical procedure.
  • 20. COMPLICATIONS 1. Difficulty in working from posterior portals 2. Stroke 3. Death due to hypotensive episodes Canale, S T, James H. Beaty, and Willis C. Campbell. Campbell's Operative Orthopaedics. Philadelphia, PA: Elsevier/Mosby, 2013