1. Endoscopic Removal of a Scapular Osteophyte Using Scapulothoracic Arthroscopy 
Christian Lycke, M.D., Jan-Dirk Theopold, M.D., Bastian Marquass, M.D., Nikolaus von Dercks, M.D., Pierre Hepp, M.D. 
Arthroscopy Techniques 
Volume 5, Issue 1, Pages e109-e112 (February 2016)
DOI: /j.eats
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
The patient is positioned prone in the chicken-wing position; that is, the shoulder is in retroversion and maximum internal rotation and adduction, and the hand is behind the back to enlarge the subscapular space. (A) The bony landmarks and entrance points of the working portal (plus sign) and camera portal have been identified and marked with a pen. The arthroscope has been introduced through the camera portal in the lower angle of the scapula, approximately 3 cm medial to the scapular border, just below the level of the scapular spine. The asterisk indicates the needle. (B) A needle marks the position of the osseous pathology.
Arthroscopy Techniques 2016 5, e109-e112DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
(A) After fluid pressure (50 mm Hg) is introduced into the scapulothoracic space through the arthroscope, debridement with an electrothermal vapor system (plus sign) is performed to optimize the overview through the working portal. (B) The previously positioned needle indicates the correct position of the scapular pathology from the intra-articular side (asterisk).
Arthroscopy Techniques 2016 5, e109-e112DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
(A) Complete debridement is performed using an electrothermal vapor system (plus sign). The subscapular bony pathology can be completely identified (asterisk). (B) The electrothermal vapor system has been replaced by an acromionizer (pound sign). The asterisk indicates the subscapular bony pathology. (C) The osseous spine can be removed through the working portal until a smooth surface is achieved at the scapulothoracic articulation.
Arthroscopy Techniques 2016 5, e109-e112DOI: ( /j.eats )
Copyright © 2016 Arthroscopy Association of North America Terms and Conditions