1. Αρθροσκόπηση Ώμου και άμεση μετεγχειρητική παρακολούθηση 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 but Keep the patient warm

10. Basic Arthroscopic Tools Have them all ready from the beginning

11. Cannulated Tools

12. Draping

13. Arm Draping Be 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 Final Treatment From tool of the devil the treatment of choice of most shoulder pathologies

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