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 % Burchart, De Bear % J Tauro % Kim % Snyder % Fabbriciani %

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