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Αρθροσκόπηση Ώμου και άμεση μετεγχειρητική παρακολούθηση

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.

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Αρθροσκόπηση Ώμου και άμεση μετεγχειρητική παρακολούθηση

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  1. Αρθροσκόπηση Ώμουκαι άμεση μετεγχειρητικήπαρακολούθηση Μάνος Αντωνογιαννάκης Διευθυντής Κέντρου Αρθροσκοπικής Χειρουργικής Ώμου ΙΑΣΩ General

  2. 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

  3. History • 1931 First Cadaver Shoulder Arthroscopy Burman • 1974 First Shoulder Arthroscopy in vivo Johnson LL • 1982 First Arthroscopic repair Johnson LL of Shoulder Instability

  4. Diagnostic arthroscopy The way everything began!!

  5. Light General Anesthesia with Laryngeal Mask

  6. Plus Local Anesthesia Scalene Block

  7. Patient Positioning Padding bony prominences Beware of the neck

  8. Room Set up Lateral decubitus allows easy access to the anterior and posterior part of the joint

  9. Keep the operating room cold to avoid fogging butKeep the patient warm

  10. Basic Arthroscopic ToolsHave them all ready from the beginning

  11. Cannulated Tools

  12. Draping

  13. Arm DrapingBe careful with traction

  14. Traction:NOT more than 4 Kgrs

  15. Skin Marking

  16. Before Entering the Scope Saline Backflow Saline in

  17. Making the scope portal

  18. 30º Scope Entrance

  19. 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

  20. Shoulder Arthroscopy the evolution of the technique Diagnostic Tool From tool of the devil the treatment of choice of most shoulder pathologies Final Treatment

  21. 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

  22. Therapeutic Arthroscopy • SLAP lesions • Frozen Shoulder • AC joint • Arthritis • Dislocation • Biceps Pathology

  23. Rotator Cuff Massive Tears

  24. Rotator Cuff Massive Tears

  25. Rotator Cuff Subscapularis Tear

  26. Rotator Cuff Subscapularis Tear

  27. Rotator Cuff Calcifying Tendonitis

  28. Rotator Cuff Calcifying Tendonitis

  29. Frozen Shoulder

  30. AC Joint Distal Clavicle Excision

  31. AC Joint Distal Clavicle Excision

  32. AC Joint • Dislocation

  33. Shoulder Instability

  34. Arthroscopic success rate • Savoie 1997 93% • Burchart, De Bear 2000 96% • J Tauro 2000 93% • Kim 2003 96% • Snyder 2006 93% • Fabbriciani 2004 100%

  35. Thank you

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