basic steps to perform diagnostic shoulder arthroscopy and instruments for arthroscopic bankart repair

1. BASIC STEPS FOR ARTHROSCOPIC
EVALUATION OF SOULDER AND
INSTRUMENTS FOR BANKART
REPAIR
DR. D. P. SWAMI
MS ORTHOPAEDICS
DPS "ONLY FOR EDUCATIONAL PURPOSES"

2. POSITION:
Floppy lateral with shoulder in abduction and flexion
DPS "ONLY FOR EDUCATIONAL PURPOSES"

3. Identify and mark bony landmarks
Spine of scapula
acromion
clavicle
DPS "ONLY FOR EDUCATIONAL PURPOSES"

4. PORTALS
• POSTERIOR: entry point is approximately 2 to
3 cm inferior and 1 to 2 cm medial from the
posterolateral acromial angle
NOTE: KEEP SCOPE IN
BETWEEN GLENOID AND
HEAD OF HUMERS
: DIRECT SCOPE IN
DIRECTION OF CORACOID
DPS "ONLY FOR EDUCATIONAL PURPOSES"

5. PORTALS
• Antero-supirior and antero-inferior :
• Two anterior portals are commonly used.
• Anteroinferior portal is typically the working portal and is
placed just proximal to the subscapularis tendon.
• Anterosuperior portal is an accessory portal that may be used
for viewing or shuttling of sutures and is placed directly above
or just anterior to the biceps tendon.
DPS "ONLY FOR EDUCATIONAL PURPOSES"

6. PERFORM DIAGNOSTIC ARTHROSCOPY STEP BY STEP:
FROM POSTERIOR PORTAL
1. Biceps tendon and superior labrum
2. Posterior labrum and posterior capsule recess
3. Inferior axillary recess and inferior capsular insertion to
the humeral head
4. Inferior labrum and glenoid articular surface
5. Supraspinatus tendon of rotator cuff
6. Posterior rotator cuff insertion and bare area of the
humeral head
7. Articular surface of humeral head
8. Anterior-superior labrum, superior and middle glenohumeral
ligaments, and subscapularis tendon
9. Anterior-inferior labrum
10. Anterior-inferior ligament
DPS "ONLY FOR EDUCATIONAL PURPOSES"

7. PERFORM DIAGNOSTIC ARTHROSCOPY STEP BY STEP:
FROM ANTERIOR PORTAL
11. Posterior glenoid labrum and capsule insertion into the
humeral head
12. Posterior rotator cuff including infraspinatus and the
supraspinatus tendons
13. Anterior glenoid labrum and inferior glenohumeral
ligament
attachments to the humeral head
14. Subscapularis tendon and recess and middle glenohumeral
ligament attachment to the labrum
15. Anterior surface of humeral head with subscapularis
attachment and biceps tendon passage through the
rotator
interval
DPS "ONLY FOR EDUCATIONAL PURPOSES"

8. WISSINGER ROD
DPS "ONLY FOR EDUCATIONAL PURPOSES"

9. DILATOR
DPS "ONLY FOR EDUCATIONAL PURPOSES"

10. DILATOR WITH CANNULA MOUNTED
ON IT
DPS "ONLY FOR EDUCATIONAL PURPOSES"

11. HOOK
DPS "ONLY FOR EDUCATIONAL PURPOSES"

12. ELEVATOR AND RASP
DPS "ONLY FOR EDUCATIONAL PURPOSES"

13. SUTURE ANCHOR
DPS "ONLY FOR EDUCATIONAL PURPOSES"

14. SUTURE MANIPULATER
DPS "ONLY FOR EDUCATIONAL PURPOSES"

15. SUTURELASSO
DPS "ONLY FOR EDUCATIONAL PURPOSES"

16. KNOT PUSHER
DPS "ONLY FOR EDUCATIONAL PURPOSES"

17. SUTURE CUTTER
DPS "ONLY FOR EDUCATIONAL PURPOSES"