1. Positioning for Shoulder Arthroscopy
Christopher M. Aland MD
Rothman Institute, Newtown, Pa

2. Disclaimer
• I own stock in Arthrocare and Johnson and
Johnson
• I am on the Membership committee of AANA
• I have no conflicts of interest that affect my
ability to teach this course

3. Oops, I lied
• I am a Membership
committee member
• Mission statement is to
educate
• Best bargain going
• Mumford and Sons
– Below my Feet
• “Keep my eyes to serve
and hands to learn”

4. Introduction
• Positioning is basically
lateral or beach-chair
• Most procedures can be
done easily from either
postion
• Specialized equipment
is required to facilitate
each option

5. Lateral Decubitus Position
• Standard table may be
used
– Beanbag or support
– Axillary roll
– Head positioner
– Orthopaediclist.com

6. Lateral Decubitus
• Supension device
– Suspension, not traction
• Side support
• Neck support

7. Lateral Decubitus

8. Advantages/ Disadvantages
• Can apply traction to • Orientation is difficult
increase working space • Arm holding boom
• Visualization • Rotational issues
• Bubbles • Conversion to open
procedure is harder
• Anesthesia issues
• Nerve injury

9. Beach chair position
• Standard table with
back support
– Mechanical
– Manual
• Leg support
• Head positioner
• Table position

10. Beach chair position
• Standard table with
back support
– Mechanical
– Manual
• Leg support
• Head positioner
• Table position

11. Advantages/ Disadvantages
• Any discussion fails to • Low posterior access
demonstrate clear-cut • Hypotension issues
difference • Risk of air embolism
• Conversion to open
procedure
• Anesthesia issue

12. Discussion
• Good to be familiar with either positions
• Common complications can be avoided with
attention to details
• There is a decreased need for hypotensive
surgery

13. Thank you