1Arthroscopy of the shoulder: Technique and normal anatomy

We present our technique of diagnostic and surgical arthroscopy of the shoulder and describe the normal and normal variational arthroscopic anatomy of the structures within the shoulder joint. To ensure accu-racy, strict attention is given to consistent patient po-sition and technical detail. Posterior and anterior portals are consistently located with the aid of bony anatomic landmarks. Using a large diameter angled arthroscope, structures within the shoulder joint are identified and examined in sequential order. Diagnostic arthroscopy of the shoulder can be systematic and reproducible when the surgeon is knowledgeable of the normal and normal variational anatomy of the shoulder and when attention is given to accurate placement of the arthro-scopic portals and to consistent surgical technique. Over the past 10 years, arthroscopy has become firmly established both as a diagnostic and therapeutic modality, especially regarding the knee joint. Its use in the evaluation of the shoulder joint has been less firmly established, how-ever, although several reports of its use exist.’,’,’, 14-17,28 Because the shoulder joint is a common source of pain, most physicians are familiar with the usual diagnostic modalities of evaluating the shoulder, such as routine radiographs and arthrography. Recent reports of advanced radiologic tech-niques, including arthrotomography, have furthered our knowledge of the shoulder joint. ’ ’~,19, 22 Arthroscopy of the shoulder has increased our knowledge of the anatomy and pathologic processes of this complex joint even further. To be effective, however, arthroscopic examination must be systematic and reproducible. In this report, we present our technique of shoulder arthroscopy and describe the normal arthroscopic anatomy of the shoul-der. * Address correspondence and repnnt requests to James R Andrews, MD