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Shoulder - Anatomy and Arthroscopy PowerPoint Presentation

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Description : Check out this medical presentation on Orthopaedics, which is titled "Shoulder - Anatomy and Arthroscopy", to know about the Anatomy and Arthroscopy of the Shoulder.

Tags : Orthopaedics, Shoulder, Anatomy, Arthroscopy

Published on : Aug 18, 2021 | Views : 2570 | Downloads : 12

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Shoulder Anatomy and Arthroscopy Mohsen Mardani-Kivi M.D. GUMS
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Shoulder Anatomy
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Greatest ROM No inherent bony stability Relies on soft tissues for stability Many injuries involve the soft tissues (rotator cuff, labrum) Little glenoid bone stock Shoulder Anatomy
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Shoulder Anatomy
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Rotator Cuff- dynamic stabilizer passive muscle tension ligament tightening compression of articular surface GHL- static stabilizer Shoulder Anatomy
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Ligaments SGLH MGHL IGHL PIGHL CAL CHL
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Rotator Cuff
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Rotator Cuff
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Subacromial Bursa
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MRI for shoulder Axial plane Bankart Lesion, BT Sagittal oblique plane Coronal oblique plane Rotator cuff, SLAP
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Shoulder MRI Coronal Oblique View
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Shoulder MRI, Sagital Oblique View
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Rotator cuff tear
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Muscles comprising rotator cuff Supraspinatus Infraspinatus Teres Minor Subscapularis
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Cause: the rotator cuff can be torn from a single traumatic injury. A cuff tear may also happen at the same time as another injury to shoulder,such as a fracture or dislocation. Most tears, however, are the result of overuse of these muscles and tendons over a period of years. People who are especially at risk for overuse are those who engage in repetitive overhead motions. These include participants in sports such as baseball, tennis, weight lifting, and rowing.
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…. injury to 1 or more of the 4 muscles in the shoulder. Rotator cuff tears are most common in people who are over the age of 40. Younger people tend to have rotator cuff tears following acute trauma or repetitive overhead work or sports activity. Rotator cuff tear may often happen as a result of wear and tear.
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Symptoms: Pain on the lateral aspect of the shoulder Often worse at night When lifting the arm may radiate to deltoid insertion Weakness, instability, tenderness (There may be increase in the pain and weakness experienced when elevating or rotating the arm) Atrophy or thinning of the muscles about the shoulder
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How is it diagnosed? Diagnosis of a rotator cuff tear is based on the symptoms and physical examination. X-rays, and imaging studies, such as MRI or ultrasound, are also helpful. An MRI can sometimes tell how large the tear is, as well as its location within the tendon itself or where the tendon attaches to bone. Shoulder pain is variable and does not always correspond to the size of the tear.
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A complete tear of the supraspinatus resulting in a shift upwards of the head of the humerus
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Glenohumeral Joint Anterior Instability
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Glenohumeral Joint Anterior Instability Mechanism/Etiology Hill-Sachs Lesion Bankart Lesion
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Glenohumeral Joint Anterior Instability Mechanism/Etiology Hill-Sachs Lesion Bankart Lesion
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Bankart Lesion Traumatic avulsion of anterior/inferior labrum Cadaver studies have shown that 4 o’clock region is weakest part of labrum
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SLAP Lesions Superior Labrum Anterior to Posterior Tear Labral Fraying (21%) Labral Avulsion (55%) Bucket Handle Tear (9%) Bucket Handle Tear into Biceps Tendon (10%)
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SLAP Lesion: Type I
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SLAP Lesion: Type II
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SLAP Lesion Variants: Type II
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SLAP Lesion: Type III
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SLAP Lesion: Type IV
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“Complex” SLAP Lesions V. Type II + Bankart VI. Type II + Unstable radial or flap tears Type II + Extension into MGHL
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Sub-acromial Bursitis
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Impingement Syndrome
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Patient Position Beach chair (the most common) Lateral
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Patient Position
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Patient Position
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Basic Instrument Arthroscope 30° and 70° scopes Arthroscope sheath with matching sharp and blunt trochars Punches, Graspers, Seizers, Probes Suture passers, Knot pusher
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Instrumentation #11 scalpel blade Skin marking pencil 18 g. needle 20 cc syringe (if insufflating) 76 mm plastic cannula with a rubber dam Motorized shaver with soft tissue and bone shaving blades Suction punch Suture punch
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Anchor Sutures Metal Anchor Suture 5, 6.5 Bio Anchor Suture 5, 6.5 Knotless Anchor Suture; push lock
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Arthroscopic Portals
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Arthroscopic Portals
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Arthoscopic surgery for shoulder surgery 1- Arthroscopic Bankart repair (one row repair) 2-Casiope Repair (double Bankart row repair) 3-All arthroscopic Latarjet procedure 4- Capsular shift 5-Rotator interval closure Repair of HAGEL lesion Repair of SLAP lesion
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Arthroscopic Rotaor cuff Surgery Arthroscopic Subacromion decompression Arthroscopic Acropmioplasty rotator cuff repair -one row -double row Arthoscopic surgery for shoulder surgery
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Actual DOUBLE ROW Technique
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Arthroscopic Tendon Transfer Latissmos dorsi transfer for rotator cuff deficiency, irreparable tears Arthroscopic priscapular bursectomy
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AC Joint Arthroscopic Surgery Arthroscopic AC arthroplasty Arthroscopic AC instability reconstruction
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