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Paralabral Cyst Decompression: Set-up and Technique

Paralabral Cyst Decompression: Set-up and Technique. Brian R. Wolf, MD, MS Univ. of Iowa Sports Medicine ACESS 2008. Paralabral cysts. spinoglenoid. Anterior. Paralabral cysts. Inferior . Posterior . Beach chair set up . Low central rotator interval portal

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Paralabral Cyst Decompression: Set-up and Technique

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  1. Paralabral Cyst Decompression: Set-up and Technique Brian R. Wolf, MD, MS Univ. of Iowa Sports Medicine ACESS 2008

  2. Paralabral cysts spinoglenoid Anterior

  3. Paralabral cysts Inferior Posterior

  4. Beach chair set up • Low central rotator interval portal • High lateral rotator interval portal • Standard posterior • Lateralized for posterior tear Ant-inf Posterior Ant-lat

  5. Cyst decompression • Sub-labral through tear • Tissue liberator • Rasp, shaver • Synovial-capsule debridement if cyst visible • Stable shoulders only

  6. Anterior

  7. Spinoglenoid

  8. High lateral RI portal / debridement

  9. Decompression

  10. Superior / Posterior Repair & Plication

  11. Schroder, et al JBJS ’08 N=42 Repair only 37/42 cyst gone by MRI post op at ave 15 mos Youm et al, Arthroscopy ’06 8/10 resolve w/ repair only MRI post op 10/10 did well Literature Review

  12. Piatt et al JSES ’02 Non op-n=19 53% satisfied Aspiration only-n=11 64% satisfied Repair only-n=6 67% satisfied Repair and decompress N=27 (scope or open) 97% satisfied Westerheide et al, Artrh ’06 Sscap n. palsy, weakness, and cyst N=14 Decompression and repair 100% had improvement of strength 100% satisfied Literature Review

  13. Literature review • Abboud et al CORR ’06 • N=18 • 9 decompression only • 9 decompress and repair • No differences found

  14. Thank you

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