Arthroscopy and Endoscopy of the Shoulder: Principle and Practice

Foreword
Preface
Acknowledgement
Contents
Part I: Basic Knowledge
1: Arthroscopic Anatomy of Shoulder
1.1 Introduction
1.2 Patient Positioning and Common Portals
1.3 Arthroscopic Anatomy of Shoulder
1.3.1 Glenohumeral Joint
1.3.1.1 Glenoid Surface and Labrum
1.3.1.2 Humeral Head and Long Head of the Biceps Tendon
1.3.1.3 Rotator Cuff and Rotator Interval
1.3.1.4 Subcoracoid Space
1.3.1.5 Capsule and Glenohumeral Ligaments
1.3.2 Subacromial Space
1.3.2.1 Acromion
1.3.2.2 Rotator Cuff and Subcoracoid Space
1.3.2.3 Acromioclavicular Joint
1.3.2.4 Humeral Footprint of the Rotator Cuff
References
2: Role of Radiological Investigations in Diagnosis of Shoulder Disorders and Surgical Planning of Arthroscopic and Endoscopic Shoulder Surgery
2.1 Brief Overview of Imaging Modalities
2.1.1 Radiography
2.1.2 Magnetic Resonance Imaging (MRI) and Magnetic Resonance Arthrography (MRA)
2.1.3 Computed Tomography (CT) and CT Arthography (CTA)
2.1.4 Ultrasound
2.2 Glenohumeral Pathologies
2.2.1 Glenohumeral Instability
2.2.2 Superior Glenoid Labral Lesions
2.3 Impingement and Injuries of the Rotator Cuff and Biceps Pulley
2.3.1 Subacromial Impingement
2.3.1.1 Acromial Slope
2.3.1.2 Acromial Morphology
2.3.1.3 Acromial Lateral Extension
2.3.1.4 Acromial Spurs
2.3.2 Rotator Cuff Tears and Other Secondary Features of Subacromial Impingement
2.3.3 Subcoracoid Impingement
2.3.4 Biceps Pulley Lesions
2.3.5 Adhesive Capsulitis
2.4 Acromioclavicular Joint Pathologies
2.4.1 Acromioclavicular Joint Dislocation
2.4.2 Acromioclavicular Joint Osteoarthritis (OA)
2.5 Summary
References
3: Setup, Equipment, and Surgical Instruments of Shoulder Arthroscopy and Endoscopy
3.1 Setup
3.1.1 Theatre Arrangement
3.1.2 Patient Position
3.1.2.1 Modified Lateral Decubitus
3.1.2.2 Beach Chair
3.2 Equipment and Surgical Instruments
3.2.1 Arthroscopes
3.2.2 Cannulas
3.2.3 Fluid Management
3.2.4 Hand Instruments
3.2.5 Power Instruments
3.3 Summary
References
4: Complications of Arthroscopic Shoulder Surgery
4.1 Introduction
4.2 Preoperative Complications
4.3 Intraoperative Complications
4.4 Postoperative Complications
4.5 Summary
References
Part II: Treatment of Glenohumeral Problems: Shoulder Instability
5: Arthroscopic Management of Acute Traumatic Shoulder Instability: Arthroscopic Fixation Techniques of Bony Bankart (Bigliani Type I or II)
5.1 Introduction
5.1.1 Acute and Chronic Bony Bankart Lesions
5.1.2 Classification of Bony Bankart Lesion
5.2 Surgical Treatment of Bony Bankart Lesion
5.2.1 Arthroscopic Fixation Techniques for Bony Bankart Lesion (Bigliani Type I or II)
5.2.1.1 Single Row Fixation
5.2.1.2 Double Row Fixation
5.2.1.3 Cannulated Screws Fixation
5.3 Our Preferred Double Row Fixation Techniques
5.3.1 Preoperative Radiological Evaluation
5.3.2 Anesthesia and Positioning
5.3.3 Arthroscopic Portals
5.3.3.1 Key Point Double Row Technique
5.3.3.2 Double Pulley Double Row Technique
5.3.4 Rehabilitation Protocol
5.4 Prognosis and Outcomes
5.5 Conclusions
References
6: Management of Anterior Shoulder Instability with Minimum Glenoid Bone Loss: Arthroscopic Bankart Repair with Modified Capsular Shift
6.1 Introduction
6.2 Indications
6.3 Contraindications
6.4 Author Preferred Technique
6.4.1 Preoperative Planning
6.4.2 Patient Positioning
6.4.3 Portal Design
6.4.4 Step-by-Step Description of the Technique
6.4.5 Complications and Management
6.4.6 Postoperative Care
6.4.7 Outcomes
6.5 Summary
References
7: Management of Bony Bankart Lesions/Glenoid Bone Loss: Arthroscopic Latarjet Procedure
7.1 Introduction
7.2 Indications
7.3 Contraindications
7.4 Related Anatomy
7.5 Surgical Technique
7.5.1 Patient Positioning
7.5.2 Portals
7.5.3 Procedures
7.5.3.1 Step One: Joint Evaluation and Exposure
7.5.3.2 Step Two: Coracoid Preparation
7.5.3.3 Step Three: Coracoid Drilling and Osteotomy
7.5.3.4 Step Four: Subscapularis Split
7.5.3.5 Step Five: Graft Transfer and Fixation
7.6 Rehabilitation Protocol
7.7 Complications
7.7.1 Graft Bone Resorption/Osteolysis
7.7.2 Bone Block Nonunion
7.7.3 Graft Fracture
7.7.4 Neurological Complications
7.7.5 Osteoarthritis
7.7.6 Infection
7.8 Prognosis and Outcomes
7.8.1 Instability Recurrence
7.8.2 Return to Sports
7.9 Surgical Variations
7.9.1 Graft Fixation
7.9.2 Coracoid Position
7.10 Conclusions
References
8: Management of Bony Bankart Lesion/Glenoid Bone Loss: Arthroscopic J-Bone Grafting Technique
8.1 Introduction
8.2 Authors Preferred Technique
8.2.1 Preoperative Preparation
8.2.2 Patient Positioning
8.2.3 Graft Harvesting and Preparation
8.2.4 Arthroscopic Surgery Technique
8.2.5 Complications and Management
8.2.6 Postoperative Care
8.3 Outcomes
References
9: Management of Bony Bankart Lesions/Glenoid Bone Loss: Arthroscopic Bone Grafting Combined with Arthroscopic Subscapularis Augmentation
9.1 Introduction
9.2 Indications
9.3 Contraindications
9.4 Author Preferred Technique
9.4.1 Preoperative Planning
9.4.2 Patient Positioning
9.4.3 Portals
9.4.4 Step-by-Step Description of the Technique to Address the GBL
9.4.4.1 Graft Preparation
9.4.4.2 ASA: Maiotti Technique
9.4.5 Postoperative Care
9.4.6 Complications and Management
9.5 Summary
9.6 Limitations
9.7 Conclusion
References
10: Management of Bony Bankart Lesions/Glenoid Bone Loss: Arthroscopic Distal Clavicle Osteochondral Autograft Transfer
10.1 Introduction
10.2 Indications
10.3 Contraindications
10.4 Author Preferred Technique
10.4.1 Preoperative Planning
10.4.2 Patient Positioning
10.4.3 Portal Design
10.4.4 Step-by-Step Description of the Technique
10.4.5 Complications and Management
10.4.6 Postoperative Care
10.4.7 Outcome
10.5 Summary
References
11: Arthroscopic Revision for Failed Latarjet Procedure
11.1 Introduction
11.2 Indications
11.3 Contraindication
11.4 Author preferred Technique
11.4.1 Preoperative Planning
11.4.2 Patient Positioning
11.4.3 Portal Design
11.4.4 Step-by-Step Description of the Technique
11.4.4.1 Evaluation and Debridement
11.4.4.2 Graft Preparation
11.4.4.3 Graft Insertion
11.4.4.4 Bankart Repair
11.4.5 Complications and Management
11.4.6 Postoperative Protocol
11.4.7 Outcomes
11.5 Summary
References
12: Arthroscopic Management of Hill-Sachs Lesion: Remplissage Procedure
12.1 Introduction
12.2 Indications
12.3 Contraindications
12.4 Author Preferred Technique
12.4.1 Preoperative Planning
12.4.2 Patient Positioning
12.4.3 Portal Design
12.4.4 Step-by-Step Description of the Technique
12.4.4.1 Thorough Evaluation
12.4.4.2 Hill-Sachs Lesion Preparation
12.4.4.3 Cannula Preparation
12.4.4.4 Anchors Placement
12.4.4.5 Standard Bankart Repair
12.4.4.6 Remplissage Tying
12.4.5 Postoperative Care
12.5 Summary
References
13: Arthroscopic Management of HAGL (Humeral Avulsion of Glenohumeral Ligament) and Reverse HAGL Lesions
13.1 Introduction
13.2 Indications
13.3 Contraindications
13.4 Author’s Preferred Techniques
13.4.1 Pre-operative Planning
13.4.2 Patient Positioning
13.4.3 Portals
13.4.4 Step-by-Step Description of the Techniques
13.4.4.1 Anterior HAGL
13.4.4.2 Reverse HAGL
13.4.4.3 Low Inferior HAGL
13.4.4.4 Combined HAGL and Bankart
13.4.5 Complications
13.4.6 Post-operative Care
13.5 Summary
References
14: Arthroscopic Trillat Procedure
14.1 Introduction
14.2 Indications
14.3 Contraindications
14.4 Author’s Preferred Technique
14.4.1 Pre-operative Planning
14.4.2 Patient Positioning
14.4.3 Portal Design
14.4.4 Step-by-Step Description of the Technique
14.4.4.1 Step 1: Diagnostic Arthroscopy and Rotator Interval Debridement
14.4.4.2 Step 2: Coracoid Process Preparation and Osteotomy
14.4.4.3 Step 3: Preparation of the Transfer
14.4.4.4 Step 4: Coracoid Transfer
14.4.4.5 Step 5: Capsulolabral Plasty
14.4.5 Complications and Management
14.4.6 Post-operative Care
14.4.7 Outcome
14.5 Summary
References
15: Arthroscopic Management of Posterior Shoulder Instability
15.1 Introduction
15.2 Indications
15.3 Contraindications
15.4 Author’s Preferred Technique
15.5 Rehabilitation
15.6 Complications and Management
15.7 Outcomes
15.8 Summary
References
16: Arthroscopic Management of Multidirectional Shoulder Instability
16.1 Introduction
16.2 Indications
16.3 Contraindications
16.4 Author’s Preferred Technique
16.4.1 Pre-operative Planning
16.4.2 Patient Positioning
16.4.3 Portal Design
16.4.4 Step-by-Step Description of the Technique
16.4.5 Complications
16.4.6 Post-operative Care
16.4.7 Outcome
16.5 Summary
References
Part III: Treatment of Glenohumeral Problems: Rotator Cuff Pathologies and Impingement Syndromes
17: Subacromial Impingement
17.1 Introduction
17.2 Classification
17.3 Anatomy/Pathoanatomy
17.4 Biomechanics
17.5 History and Physical Examination
17.6 Investigation
17.7 Treatment
17.8 Postoperative Rehabilitation
17.9 Complications
17.10 Outcome
17.11 Summary
References
18: Arthroscopic Repair of Anterosuperior Rotator Cuff Tears
18.1 What Are the Anterosuperior Rotator Cuff Tear and Its Pathoanatomy
18.2 Clinical Evaluation
18.2.1 Symptoms
18.3 Physical Examination
18.4 Radiographic Evaluation
18.5 Treatment
18.6 The Arthroscopic Repair of Anterosuperior Rotator Cuff Tears
References
19: Arthroscopic Repair of Posterosuperior Rotator Cuff Tears
19.1 Introduction
19.2 Indications
19.3 Contraindications
19.4 Author’s Preferred Technique: Linked Double Row-Suture Bridge Technique (LDR-SB)
19.4.1 Pre-operative Planning
19.4.2 Patient Positioning
19.4.3 Portal Design
19.4.4 Step-by-Step Description of the Technique: Linked Double Row-Suture Bridge Repair (LDR-SB)
19.4.5 Complications
19.4.6 Post-operative Care
19.4.7 Outcome
19.5 Conclusion
References
20: Subcoracoid Impingement and Endoscopic Coracoplasty
20.1 Introduction
20.2 Pathogenesis and Mechanism of Subcoracoid Impingement
20.3 Clinical Presentation and Physical Examination
20.4 Imaging Evaluation
20.5 Diagnosis
20.6 Treatment
20.6.1 Conservative Treatment
20.6.2 Surgical Treatment
20.6.2.1 Anesthesia
20.6.2.2 Patient Positioning
20.6.2.3 Portals
20.6.3 Operation Steps
20.6.3.1 Routine Examination
20.6.3.2 Identify the Coracoid
20.6.3.3 Coracoplasty
20.6.3.4 Postoperative Treatment
20.7 Conclusion
References
21: Arthroscopic Repair of Subscapularis Tendon Tear
21.1 Introduction
21.2 Arthroscopic SSC Repair
21.3 Patient Positioning
21.4 Portal Placement
21.5 Visualization and Working Space in the Coracoid Space
21.6 Identification and Mobilization of the SSC Tendon
21.7 Preparation of the Tendon Lateral Edge and Footprint on Lesser Tuberosity
21.8 Anchor Placement, Suture Passage, and Tendon Fixation
21.9 Rehabilitation
21.10 Complications
21.11 Outcomes
21.12 Summary
References
22: Arthroscopic Management of Massive Rotator Cuff Tear
22.1 Introduction
22.2 Indications
22.3 Contraindications
22.4 Author’s Preferred Technique
22.4.1 Pre-operative Planning
22.4.2 Patient Positioning
22.4.3 Portal Design
22.4.4 Step-by-Step Description of the Technique
22.4.5 Complications and Management
22.4.6 Post-operative Care
22.4.7 Outcome
22.5 Summary
References
23: Arthroscopic Subacromial Spacer Implantation
23.1 Introduction
23.2 Indications
23.3 Contra-Indications
23.4 Author Preferred Technique
23.4.1 Pre-operative Planning
23.4.2 Patient Positioning
23.4.3 Portal Design
23.4.4 Step-by-Step Description of the Technique
23.4.5 Complications and Management
23.4.6 Post-operative Care
23.4.7 Outcome
23.5 Summary
References
24: Arthroscopic Management of Irreparable Massive Rotator Cuff Tears: Biceps Patch Technique
24.1 Introduction
24.2 Indications
24.3 Contraindications
24.4 Biceps Patch Technique
24.4.1 Pre-operative Planning
24.4.2 Patient Positioning
24.4.3 Portal Design
24.4.4 Step-by-Step Description of the Technique
24.4.5 Complications and Management
24.4.6 Post-operative Care
24.4.7 Outcome
24.5 Summary
References
25: Superior Capsular Reconstruction
25.1 Introduction
25.2 Indications
25.3 Contraindications
25.3.1 Osteoarthritis of the Joint
25.4 Authors Preferred Technique
25.4.1 Pre-operative Planning
25.4.2 Patient Positioning
25.4.3 Portal Design
25.4.4 Step-by-Step Description of the Technique
25.5 Complications and Management
25.6 Post-operative Care
25.7 Outcome
25.8 Summary
References
26: Arthroscopic Latissimus Dorsi Transfer for Massive Irreparable Rotator Cuff Tears
26.1 Introduction
26.2 Indications
26.3 Contraindications
26.4 Author Preferred Technique
26.4.1 Pre-operative Planning
26.4.2 Patient Positioning
26.4.3 Portal Design
26.4.4 Step-by-Step Description of the Technique
26.4.5 Complications and Their Management
26.4.6 Post-operative Care
26.4.7 Outcome
26.5 Summary
References
27: Arthroscopic-Assisted Transfer of the Lower Trapezius Tendon for Irreparable Massive Posterosuperior Rotator Cuff Tears
27.1 Introduction
27.2 Indications
27.3 Contraindications
27.4 Authors Preferred Technique
27.4.1 Pre-operative Planning
27.4.2 Patient Positioning
27.4.3 Portal Design
27.4.4 Step-by-Step Description of the Technique
27.4.4.1 Soft Tissue Releases and Great Tuberosity Preparation
27.4.4.2 Lower Trapezius Tendon Harvest
27.4.4.3 Achilles Tendon-Bone Allograft Preparation
27.4.4.4 Arthroscopic Insertion of the Achilles Tendon-Bone Allograft into the Humerus
27.4.4.5 Graft Attachment to the Lower Trapezius and Tensioning
27.4.5 Complications and Management
27.4.6 Post-operative Care
27.5 Summary
References
28: Arthroscopic Latissimus Dorsi Transfer for Irreparable Tear of the Subscapularis
28.1 Introduction
28.2 Surgical Technique
28.2.1 Open Technique
28.2.2 Arthroscopy-Assisted Technique
28.2.2.1 Harvest of the LDT Phase
28.2.2.2 Arthroscopic Phase
28.2.3 Fixation Methods
28.2.3.1 Open Surgery Fixation
Tunnels [12]
28.2.3.2 Arthroscopy-Assisted Fixation
Anchors [10, 13]
Interferential Screw [13, 14]
Endobutton [10]
28.3 Clinical Outcomes
28.4 Rehabilitation
28.5 Conclusion
References
29: Arthroscopic Treatment of Calcific Tendinitis of the Rotator Cuff
29.1 Introduction
29.2 Indications
29.3 Contraindications
29.4 Author’s Preferred Technique
29.4.1 Pre-operative Planning
29.4.2 Patient and Medical Team Positioning
29.4.3 Portal Design
29.4.4 Step-by-Step Description of the Technique
29.4.5 Complications and Management
29.4.6 Post-operative Care
29.4.7 Outcome
29.5 Summary
References
30: Arthroscopic Treatment of Calcific Tendonitis of the Shoulder
30.1 Introduction
30.2 Indications
30.3 Contraindications
30.4 Author Preferred Technique
30.4.1 Pre-operative Planning
30.4.1.1 Radiographic Assessment
30.4.1.2 Required Instruments
30.4.2 Patient Positioning
30.4.3 Portal Design
30.4.4 Step-by-Step Description of the Technique
30.4.4.1 Subacromial Space
30.4.4.2 Localization
30.4.4.3 Release and Remove
30.4.4.4 Irrigation
30.4.4.5 Rotator Cuff Repair
30.4.4.6 Subacromial Decompression
30.4.5 Complications
30.4.6 Post-operative Care
30.4.6.1 Curetted Without Suture Anchor Repair
30.4.6.2 Large Full-Thickness Defect Repaired with Suture Anchor
30.5 Summary
References
Part IV: Treatment of Glenohumeral Problems: Pathologies of the Glenoid Labrum and Long Head of Biceps Tendon
31: Arthroscopic Management of SLAP Lesion
31.1 Introduction
31.2 Classifications
31.3 Mechanism of Injury
31.4 Clinical Presentation and Physical Examination
31.4.1 Active-Compression Test
31.4.2 Compression Rotation Test
31.4.3 Resisted-Supination External-Rotation Test
31.4.4 Clunk Test
31.5 Diagnostic Imaging
31.6 Treatment
31.6.1 Conservative Management
31.6.2 Surgical Treatment
31.7 Conclusion
References
32: Tenoscopy of the Long Head of Biceps Tendon
32.1 Introduction
32.2 Indications [8]
32.3 Contraindications [9]
32.4 Author’s Preferred Technique
32.4.1 Preoperative Planning
32.4.2 Patient and Medical Team Positioning
32.4.3 Portal Design
32.4.4 Step-by-Step Description of the Technique
32.4.5 Complications and Management [7, 9]
32.4.6 Postoperative Care
32.4.7 Outcomes
32.5 Summary
References
33: Arthroscopic Long Head of Biceps Tenodesis
33.1 Introduction
33.2 Indications
33.3 Contraindications
33.4 Author Preferred Technique
33.4.1 Pre-operative Planning
33.4.2 Patient Positioning
33.4.3 Portal Design
33.4.4 Step-by-Step Description of the Technique
33.4.5 Complications
33.4.6 Post-operative Care
33.4.7 Outcome
33.5 Conclusion
References
34: A Technique for Endoscopic-Assisted Subpectoral Biceps Tenodesis
34.1 Introduction
34.2 Indications
34.3 Contraindications
34.4 Author Preferred Technique
34.4.1 Pre-operative Planning
34.4.2 Patient Positioning
34.4.3 Portal Design
34.4.4 Step-by-Step Description of the Technique
34.4.4.1 Stage 1: Glenohumeral Diagnostic Arthroscopy and Tenotomy
34.4.4.2 Stage 2: Extra-articular Retrieval and Preparation of the Long Head of the Bicep Tendon
34.4.4.3 Stage 3: Endoscopic-Assisted Tenodesis of the Long Head of the Bicep Tendon
34.4.5 Complications and Management
34.4.6 Post-operative Care
34.5 Outcomes
34.6 Summary
References
Part V: Treatment of Glenohumeral Problems: Miscellaneous
35: Arthroscopic Coracohumeral Ligament Release: Surgical Management of Frozen Shoulder
35.1 Introduction
35.2 Indications
35.3 Contraindications
35.4 Author’s Preferred Technique
35.4.1 Pre-operative Planning
35.4.2 Patient Positioning
35.4.3 Portal Design
35.4.4 Step-by-Step Description of the Technique
35.4.5 Complications
35.4.6 Post-operative Care
35.4.7 Outcomes
35.5 Summary
References
36: Arthroscopic Circumferential Capsulotomy for Patients with Frozen Shoulder
36.1 Introduction
36.2 Indications
36.3 Contraindications
36.4 Author’s Preferred Technique
36.4.1 Pre-operative Planning
36.4.2 Patient and Medical Team Positioning
36.4.3 Portal Design
36.4.4 Step-by-Step Description of the Technique
36.4.5 Complications
36.4.6 Post-operative Care
36.4.7 Outcome
36.5 Summary
References
37: Arthroscopic Treatment of Glenohumeral Osteoarthritis: The CAM Approach
37.1 Introduction
37.2 Clinical Examination, Imaging, and Staging
37.3 Treatment (Non-operative and Surgical Options)
37.4 Surgical Technique
37.5 Summary
References
38: Arthroscopic Glenohumeral Arthrodesis for Flail Shoulder
38.1 Introduction
38.2 Indications
38.3 Contraindications
38.4 Author’s Preferred Technique
38.4.1 Pre-operative Planning
38.4.2 Patient Positioning
38.4.3 Portal Design
38.4.4 Step-by-Step Description of the Technique
38.4.5 Post-operative Care
38.4.6 Complications and Management
38.4.7 Outcomes
38.5 Summary
References
39: Arthroscopic Management of Shoulder Periarticular Cysts
39.1 Introduction
39.2 Indications
39.3 Contraindications
39.4 Author Preferred Technique
39.4.1 Pre-operative Planning
39.4.2 Patient Positioning
39.4.3 Portal Design
39.4.4 Step-by-Step Description of the Technique
39.4.4.1 Intraarticular Stage: Management of Labral Lesions
39.4.4.2 Subacromial Stage: Spinoglenoid Ganglion Cyst Decompression
39.4.5 Complications
39.4.6 Post-operative Care
39.4.7 Outcome
39.5 Conclusion
References
40: Arthroscopic Management of Synovial Chondromatosis of the Glenohumeral Joint
40.1 Introduction
40.2 Indications
40.3 Contraindications
40.4 Author Preferred Technique
40.4.1 Pre-operative Planning
40.4.2 Patient Positioning
40.4.3 Portal Design
40.4.4 Step-by-Step Description of the Technique
40.4.5 Complications and Management
40.4.6 Post-operative Care
40.4.7 Outcome
40.5 Summary
References
41: Arthroscopic Management of Septic Arthritis of the Glenohumeral Joint
41.1 Introduction
41.2 Indications
41.3 Contraindications
41.4 Author’s Preferred Technique
41.4.1 Preoperative Planning
41.4.2 Patient Positioning
41.4.3 Portal Design
41.4.4 Step-by-Step Description of the Technique
41.4.5 Complications and Management
41.4.6 Postoperative Care
41.5 Summary
References
42: Endoscopic Curettage of Bone Cysts of the Proximal Humerus
42.1 Introduction
42.2 Indications
42.3 Contraindications
42.4 Author’s Preferred Technique
42.4.1 Pre-operative Planning
42.4.2 Patient and Medical Team Positioning
42.4.3 Portal Design
42.4.4 Step-by-Step Description of the Technique
42.4.5 Complications and Management
42.4.6 Post-operative Care
42.4.7 Outcomes
42.5 Summary
References
43: Arthroscopic-Assisted Management of Avascular Necrosis of the Humeral Head with Core Decompression and Fibular Strut Grafting
43.1 Introduction
43.2 Indications
43.3 Contraindications
43.4 Author’s Preferred Technique
43.4.1 Preoperative Planning
43.4.2 Patient Positioning
43.4.3 Portal Design
43.4.4 Step-by-Step Description of the Technique
43.4.5 Complications and Management
43.4.6 Postoperative Care
43.4.7 Outcomes
43.5 Summary
References
44: Shoulder Arthroscopy after Shoulder Arthroplasty
44.1 Introduction
44.2 Indications
44.3 Contraindications
44.4 Author’s Preferred Technique
44.4.1 Preoperative Planning
44.4.2 Patient Positioning
44.4.3 Portal Design
44.4.4 Step-by-Step Description of the Technique
44.4.5 Complications and Management
44.4.6 Postoperative Care
44.5 Summary
References
45: Shoulder Arthroscopy in Arthroplasty
45.1 Introduction
45.2 Arthroscopy for Diagnosing Periprosthetic Joint Infection
45.3 Timing of Intervention and Surgical Technique
45.3.1 Diagnostic Arthroscopy
45.3.2 Therapeutic Arthroscopy
45.3.3 Limitations and Pitfalls
45.4 Conclusion
References
Part VI: Treatment of Acromioclavicular Problems
46: Endoscopic Treatment of Acute Acromioclavicular Joint Dislocation
46.1 Introduction
46.2 Pathologic Anatomy
46.3 Classification
46.4 Timing of Treatment
46.5 Endoscopic Treatment of Acute Acromioclavicular Joint Dislocation
46.6 Postoperative Rehabilitation
46.7 Literature Reviews
46.8 Summary
References
47: Arthroscopic Acromioclavicular Joint Reconstruction with TightRope and a FiberTape Loop
47.1 Introduction
47.2 Indications
47.3 Contraindications
47.4 Author’s Preferred Technique
47.4.1 Pre-operative Planning
47.4.2 Patient Positioning
47.4.3 Portal Design
47.4.4 Step-by-Step Description of the Technique
47.4.4.1 Reduction and Coracoclavicular Fixation
47.4.4.2 AC Fixation
47.4.5 Complications and Outcomes
47.4.6 Post-operative Care
47.5 Summary
References
48: Endoscopic Coracoclavicular Ligament Reconstruction Using Allograft
48.1 Introduction
48.2 Indications
48.3 Contraindications
48.4 Author’s Preferred Technique
48.4.1 Pre-operative Planning
48.4.2 Patient Positioning
48.4.3 Portal Design
48.4.4 Step-by-Step Description of the Technique
48.4.5 Complications and Management
48.4.6 Post-operative Care
48.5 Summary
References
49: Arthroscopic Acromioclavicular Joint Resection
49.1 Anatomical Consideration
49.2 General Consideration
49.3 Arthroscopic Acromioclavicular Resection: Technical Points
49.4 Postoperative Cares
49.5 Results
49.6 Conclusion
References
50: Arthroscopic Excision of the Symptomatic Meso-acromiale of the Shoulder
50.1 Introduction
50.1.1 Diagnostic Imaging
50.1.2 Nonsurgical Management
50.1.3 Surgical Options
50.1.3.1 Open Excision
50.1.3.2 Open Reduction and Internal Fixation
50.1.3.3 Arthroscopic Subacromial Decompression/Acromioplasty
50.1.3.4 Arthroscopic Excision
50.2 Indications
50.3 Contraindications
50.4 Author-Preferred Technique for Arthroscopic Excision
50.4.1 Pre-operative Planning
50.4.2 Patient Positioning
50.4.3 Portal Design/Placement
50.4.4 Step-by-Step Technique Description
50.4.5 Complications and Management
50.4.6 Post-operative Care
50.5 Summary
References
Part VII: Treatment of Scapulothoracic Problems
51: Scapulothoracic Endoscopy for Snapping Scapula Syndrome
51.1 Introduction
51.2 Indications
51.3 Contraindications (Relative)
51.4 Preferred Technique
51.4.1 Pre-operative Planning
51.4.2 Patient Positioning
51.4.3 Portal Design
51.4.4 Step-by-Step Description of the Technique
51.4.5 Complications and Management
51.4.6 Post-operative Care
51.4.7 Outcomes
51.5 Summary
References
52: Endoscopically Assisted Resection of Scapular Osteochondroma
52.1 Background
52.2 Anatomy and Physiology
52.3 Osteochondroma of Scapula
52.4 Surgical Procedure of Endoscopically Assisted Resection
52.5 Representative Case [7]
52.6 Discussion [7]
References
53: Arthroscopic Pectoralis Minor Release
53.1 Introduction
53.2 Indications
53.3 Contraindications
53.4 Author Preferred Technique
53.4.1 Pre-operative Planning
53.4.2 Patient Positioning
53.4.3 Portal Design
53.4.4 Step-by-Step Description of the Technique
53.4.5 Complications
53.4.6 Post-operative Care
53.4.7 Outcome
53.5 Summary
References
Part VIII: Treatment of Sternoclavicular Problems
54: Sternoclavicular Arthroscopy
54.1 Introduction
54.2 Indications
54.3 Contra-indications
54.4 Author Preferred Technique
54.4.1 Pre-operative Planning
54.4.2 Patient Positioning
54.4.3 Portals
54.4.4 Step-by-Step Description of the Technique
54.4.5 Complications and Management
54.4.6 Post-operative Care
54.4.7 Outcome
54.5 Summary
References
55: Arthroscopic Resection of the Intra-articular Disc of the Sternoclavicular Joint
55.1 Introduction
55.2 Indications
55.3 Contra-indications
55.4 Author Preferred Technique
55.4.1 Pre-operative Planning
55.4.2 Patient Positioning
55.4.3 Portal Design
55.4.4 Step-by-Step Description of the Technique
55.4.5 Complications and Management
55.4.6 Post-operative Care
55.4.7 Outcome
55.5 Summary
References
56: Arthroscopic Excision of the Sternoclavicular Joint
56.1 Introduction
56.2 Indications
56.3 Contra-Indications
56.4 Author Preferred Technique
56.4.1 Pre-Operative Planning
56.4.2 Patient Positioning
56.4.3 Portals
56.4.4 Step-by-Step Description of the Technique
56.4.5 Complications and Management
56.4.6 Post-Operative Care
56.4.7 Outcome
56.5 Summary
References
57: Stabilization Procedures for Instability of the Sternoclavicular Joint
57.1 Introduction
57.2 Indications
57.3 Contra-Indications
57.3.1 Author Preferred Technique
57.3.2 Pre-Operative Planning
57.3.3 Patient Positioning
57.3.4 Skin Incisions
57.3.5 Step-by-Step Description of the Technique
57.3.6 Complications and Management
57.3.7 Post-Operative Care
57.3.8 Outcome
57.4 Summary
Further Reading
Biomechanical Studies
Techniques with Semitendinosous Graft
Techniques with Palmaris Longus or Gracilis Graft
Techniques with Sternocleidomastoideus
Techniques with Subclavius
Part IX: Treatment of Neurological Problems
58: Endoscopic Release of the Brachial Plexus for Thoracic Outlet Syndrome
58.1 Introduction
58.2 Indications
58.3 Contra-Indications
58.4 Author Preferred Technique
58.5 Rehabilitation
58.6 Discussion
References
59: Endoscopic Suprascapular Nerve Decompression at the Spinoglenoid and Suprascapular Notches
59.1 Introduction
59.2 Indications
59.3 Contraindications
59.4 Author Preferred Techniques
59.4.1 Preoperative Planning
59.4.2 Patient Positioning
59.4.3 Portal Design (Suprascapular Notch)
59.4.4 Step-by-Step Description of the Techniques (Suprascapular Notch)
59.4.5 Portal Design (Spinoglenoid Notch)
59.4.6 Step-by-Step Description of the Techniques (Spinoglenoid Notch)
59.4.7 Complications and Management
59.4.8 Post-Operative Care
59.4.9 Outcomes
59.5 Summary
References
60: Management of Scapular Winging Secondary to Serratus Nerve Palsy: Endoscopic Lysis of the Long Thoracic Nerve
60.1 Introduction
60.2 Materials and Methods
60.2.1 Procedure Technique in Detail
60.3 Results
60.4 Discussion
60.5 Conclusion
References
Part X: Treatment of Fracture Related Problems
61: Endoscopic Treatment of Distal Clavicular Fractures
61.1 Introduction
61.2 Indications
61.3 Contraindications
61.4 Author’s Preferred Technique
61.4.1 Preoperative Planning
61.4.2 Patient and Medical Team Positioning
61.4.3 Portal Design
61.4.4 Step-by-Step Description of the Technique
61.4.5 Complications and Management
61.4.5.1 Intraoperative Complications
61.4.5.2 Postoperative Complications
61.4.6 Postoperative Care
61.4.7 Outcomes
61.5 Summary
References
62: Arthroscopic Treatment of Greater Tuberosity Avulsion Fracture
62.1 Introduction
62.2 Indications
62.3 Contra-indications
62.4 Author Preferred Technique/Procedures
62.4.1 Pre-operative Planning
62.4.2 Patient Positioning
62.4.3 Portal Design
62.4.4 Surgical Technique
62.4.5 Complications
62.4.6 Technical Tips to Avoid Complications
62.4.7 Post-operative Care
62.4.8 Outcome
62.5 Summary
References
63: Arthroscopic Treatment of Lesser Tuberosity Avulsion Fractures
63.1 Introduction
63.2 Indications
63.3 Contra-Indications
63.4 Author Preferred Technique
63.4.1 Pre-operative Planning
63.4.2 Patient Positioning
63.4.3 Portal Design
63.4.4 Step-by-Step Description of the Technique
63.4.5 Post-operative Care
63.5 Summary
References
64: Arthroscopic Management of Fractures of the Proximal Humerus
64.1 Introduction
64.2 Indications
64.3 Contra-Indications
64.4 Author Preferred Technique
64.4.1 Pre-operative Planning
64.4.2 Patient Positioning
64.4.3 Portal Design
64.4.4 Step-by-Step Description of the Techniques
64.4.4.1 Screw Fixation in Monofragmentary GT Fractures
64.4.4.2 Double-Row Anchor Refixation in Multifragmentary GT Fractures
64.4.4.3 Double-Row Anchor Refixation in LT Fractures
64.4.4.4 Arthroscopic Capsular Release and Implant Removal
64.4.4.5 Arthroscopic Intramedullary Nailing
64.4.5 Post-operative Care
64.4.6 Postoperative Complications and Outcome
64.5 Summary
References
65: Arthroscopy-Assisted Intra-Medullary Nailing for Treatment of Fractures of the Humeral Shaft
65.1 Introduction
65.2 Indications
65.3 Contraindications
65.4 Author’s Preferred Technique
65.4.1 Preoperative Planning
65.4.2 Patient Positioning
65.4.3 Portal Design
65.4.4 Step-by-Step Description of the Technique
65.4.5 Complications and Management
65.4.6 Postoperative Care
65.5 Summary
References
66: Arthroscopic Management of Glenoid Fractures
66.1 Introduction
66.2 Indications
66.3 Contra-Indications
66.4 Surgical Techniques
66.4.1 Anterior Glenoid Rim Fractures
66.4.2 Transverse Fractures
66.4.3 Arthroscopic Techniques
66.4.4 Anterior Rim Fractures
66.4.5 Transverse Fractures
66.5 Author Preferred Technique
66.5.1 Surgical Technique
66.5.1.1 Postoperative Management
66.6 Summary
References
67: Arthroscopic Adhesiolysis and Proximal Humeral Plate Removal
67.1 Introduction
67.2 Indications
67.3 Contra-Indications
67.4 Author Preferred Technique
67.4.1 Pre-Operative Planning
67.4.2 Patient Positioning
67.4.3 Portal Design
67.4.4 Step-by-Step Description of the Technique
67.4.5 Complications and Management
67.4.6 Post-Operative Care
67.4.7 Outcome
67.5 Summary
References
68: Arthroscopic Management of Malunions and Non-unions of the Greater Tuberosity
68.1 Introduction
68.2 Indications
68.3 Contra-Indications
68.4 Pre-Operative Planning
68.5 Anesthesia, Positioning and Draping (Fig. 68.3)
68.6 Portals (Fig. 68.4)
68.6.1 Non-union without Implant
68.6.2 Non-union with Screw and Washer
68.6.3 Malunion with Impingement
68.7 Step-by-Step Description of the Technique
68.7.1 Non-union with Screw and Washer
68.7.1.1 Step 1: Removal of the Screws
68.7.1.2 Step 2: Arthroscopic Fixation of the Greater Tuberosity
68.7.2 Malunion with Impingement
68.7.3 Post-op Rehabilitation
68.7.3.1 Arthroscopic Non-union Fixation
68.7.3.2 Arthroscopic Malunion Fixation
68.7.3.3 Sample Case of GT Non-union with Implant in Situ
68.7.3.4 Sample Case of Malunited GT with Impingement
68.8 Summary
References