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Αρθροσκόπηση Ώμου
και άμεση μετεγχειρητική
παρακολούθηση
Μάνος Αντωνογιαννάκης
Διευθυντής Κέντρου Αρθροσκοπικής
Χειρουργικής Ώμου
ΙΑΣΩ General
The Shoulder
 Greatest Range of Motion in the Body
 Motion in all 3 planes of movement
 Prone to injuries
 8-20% of all sports injuries
History
• 1931 First Cadaver Shoulder Arthroscopy Burman
• 1974 First Shoulder Arthroscopy in vivo Johnson LL
• 1982 First Arthroscopic repair Johnson LL
of Shoulder Instability
Diagnostic arthroscopy
The way everything began!!
Light General Anesthesia
with Laryngeal Mask
Plus Local Anesthesia
Scalene Block
Patient Positioning
Padding bony prominences
Beware of the neck
Room Set up
Lateral decubitus allows easy access to the
anterior and posterior part of the joint
Keep the operating room cold
to avoid fogging
but
Keep the
patient warm
Basic Arthroscopic Tools
Have them all ready from the beginning
Cannulated Tools
Draping
Arm Draping
Be careful with traction
Traction:
NOT more than 4 Kgrs
Skin Marking
Before Entering the Scope
Saline Backflow
Saline in
Making the scope portal
30º Scope Entrance
Diagnostic Arthroscopy
• Distinguish Normal Anatomy
• Anatomic Variants
• Variation of GHLs
• Sublaral Hole
• Cord-like middle GHL
• Buford Complex
• Rotator Crescent Sign (cuff “ridge”)
• SLAP lesions
• Bursal side RC tears
• Internal Impingement
Shoulder Arthroscopy
the evolution of the technique
Diagnostic
Tool
Final
Treatment
From tool of the devil the treatment of choice of most shoulder
pathologies
Therapeutic Arthroscopy
• Rotator Cuff disease
• Tears (Full, Partial, Intratendonious)
• Calcifying Tendonitis
• Instability
• Anterior, Posterior, Multidirectional
• Bony Bankart lesions
• Glenoid defects
• HAGL and reverse HAGL lesions
Therapeutic Arthroscopy
• SLAP lesions
• Frozen Shoulder
• AC joint
• Arthritis
• Dislocation
• Biceps Pathology
Rotator Cuff
Massive Tears
Rotator Cuff
Massive Tears
Rotator Cuff
Subscapularis Tear
Rotator Cuff
Subscapularis
Tear
Rotator Cuff
Calcifying Tendonitis
Rotator Cuff
Calcifying Tendonitis
Frozen Shoulder
AC Joint
Distal Clavicle Excision
AC Joint
Distal Clavicle Excision
AC Joint
• Dislocation
Shoulder Instability
Arthroscopic success rate
• Savoie 1997 93%
• Burchart, De Bear 2000 96%
• J Tauro 2000 93%
• Kim 2003 96%
• Snyder 2006 93%
• Fabbriciani 2004 100%
Thank you

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