Arthroscopy and Endoscopy of the Shoulder: Principle and Practice

Foreword
Preface
Acknowledgement
Contents
Part I: Basic Knowledge
	1: Arthroscopic Anatomy of Shoulder
		1.1	 Introduction
		1.2	 Patient Positioning and Common Portals
		1.3	 Arthroscopic Anatomy of Shoulder
			1.3.1	 Glenohumeral Joint
				1.3.1.1	 Glenoid Surface and Labrum
				1.3.1.2	 Humeral Head and Long Head of the Biceps Tendon
				1.3.1.3	 Rotator Cuff and Rotator Interval
				1.3.1.4	 Subcoracoid Space
				1.3.1.5	 Capsule and Glenohumeral Ligaments
			1.3.2	 Subacromial Space
				1.3.2.1	 Acromion
				1.3.2.2	 Rotator Cuff and Subcoracoid Space
				1.3.2.3	 Acromioclavicular Joint
				1.3.2.4	 Humeral Footprint of the Rotator Cuff
		References
	2: Role of Radiological Investigations in Diagnosis of Shoulder Disorders and Surgical Planning of Arthroscopic and Endoscopic Shoulder Surgery
		2.1	 Brief Overview of Imaging Modalities
			2.1.1	 Radiography
			2.1.2	 Magnetic Resonance Imaging (MRI) and Magnetic Resonance Arthrography (MRA)
			2.1.3	 Computed Tomography (CT) and CT Arthography (CTA)
			2.1.4	 Ultrasound
		2.2	 Glenohumeral Pathologies
			2.2.1	 Glenohumeral Instability
			2.2.2	 Superior Glenoid Labral Lesions
		2.3	 Impingement and Injuries of the Rotator Cuff and Biceps Pulley
			2.3.1	 Subacromial Impingement
				2.3.1.1	 Acromial Slope
				2.3.1.2	 Acromial Morphology
				2.3.1.3	 Acromial Lateral Extension
				2.3.1.4	 Acromial Spurs
			2.3.2	 Rotator Cuff Tears and Other Secondary Features of Subacromial Impingement
			2.3.3	 Subcoracoid Impingement
			2.3.4	 Biceps Pulley Lesions
			2.3.5	 Adhesive Capsulitis
		2.4	 Acromioclavicular Joint Pathologies
			2.4.1	 Acromioclavicular Joint Dislocation
			2.4.2	 Acromioclavicular Joint Osteoarthritis (OA)
		2.5	 Summary
		References
	3: Setup, Equipment, and Surgical Instruments of Shoulder Arthroscopy and Endoscopy
		3.1	 Setup
			3.1.1	 Theatre Arrangement
			3.1.2	 Patient Position
				3.1.2.1	 Modified Lateral Decubitus
				3.1.2.2	 Beach Chair
		3.2	 Equipment and Surgical Instruments
			3.2.1	 Arthroscopes
			3.2.2	 Cannulas
			3.2.3	 Fluid Management
			3.2.4	 Hand Instruments
			3.2.5	 Power Instruments
		3.3	 Summary
		References
	4: Complications of Arthroscopic Shoulder Surgery
		4.1	 Introduction
		4.2	 Preoperative Complications
		4.3	 Intraoperative Complications
		4.4	 Postoperative Complications
		4.5	 Summary
		References
Part II: Treatment of Glenohumeral Problems: Shoulder Instability
	5: Arthroscopic Management of Acute Traumatic Shoulder Instability: Arthroscopic Fixation Techniques of Bony Bankart (Bigliani Type I or II)
		5.1	 Introduction
			5.1.1	 Acute and Chronic Bony Bankart Lesions
			5.1.2	 Classification of Bony Bankart Lesion
		5.2	 Surgical Treatment of Bony Bankart Lesion
			5.2.1	 Arthroscopic Fixation Techniques for Bony Bankart Lesion (Bigliani Type I or II)
				5.2.1.1	 Single Row Fixation
				5.2.1.2	 Double Row Fixation
				5.2.1.3	 Cannulated Screws Fixation
		5.3	 Our Preferred Double Row Fixation Techniques
			5.3.1	 Preoperative Radiological Evaluation
			5.3.2	 Anesthesia and Positioning
			5.3.3	 Arthroscopic Portals
				5.3.3.1	 Key Point Double Row Technique
				5.3.3.2	 Double Pulley Double Row Technique
			5.3.4	 Rehabilitation Protocol
		5.4	 Prognosis and Outcomes
		5.5	 Conclusions
		References
	6: Management of Anterior Shoulder Instability with Minimum Glenoid Bone Loss: Arthroscopic Bankart Repair with Modified Capsular Shift
		6.1	 Introduction
		6.2	 Indications
		6.3	 Contraindications
		6.4	 Author Preferred Technique
			6.4.1	 Preoperative Planning
			6.4.2	 Patient Positioning
			6.4.3	 Portal Design
			6.4.4	 Step-by-Step Description of the Technique
			6.4.5	 Complications and Management
			6.4.6	 Postoperative Care
			6.4.7	 Outcomes
		6.5	 Summary
		References
	7: Management of Bony Bankart Lesions/Glenoid Bone Loss: Arthroscopic Latarjet Procedure
		7.1	 Introduction
		7.2	 Indications
		7.3	 Contraindications
		7.4	 Related Anatomy
		7.5	 Surgical Technique
			7.5.1	 Patient Positioning
			7.5.2	 Portals
			7.5.3	 Procedures
				7.5.3.1	 Step One: Joint Evaluation and Exposure
				7.5.3.2	 Step Two: Coracoid Preparation
				7.5.3.3	 Step Three: Coracoid Drilling and Osteotomy
				7.5.3.4	 Step Four: Subscapularis Split
				7.5.3.5	 Step Five: Graft Transfer and Fixation
		7.6	 Rehabilitation Protocol
		7.7	 Complications
			7.7.1	 Graft Bone Resorption/Osteolysis
			7.7.2	 Bone Block Nonunion
			7.7.3	 Graft Fracture
			7.7.4	 Neurological Complications
			7.7.5	 Osteoarthritis
			7.7.6	 Infection
		7.8	 Prognosis and Outcomes
			7.8.1	 Instability Recurrence
			7.8.2	 Return to Sports
		7.9	 Surgical Variations
			7.9.1	 Graft Fixation
			7.9.2	 Coracoid Position
		7.10	 Conclusions
		References
	8: Management of Bony Bankart Lesion/Glenoid Bone Loss: Arthroscopic J-Bone Grafting Technique
		8.1	 Introduction
		8.2	 Authors Preferred Technique
			8.2.1	 Preoperative Preparation
			8.2.2	 Patient Positioning
			8.2.3	 Graft Harvesting and Preparation
			8.2.4	 Arthroscopic Surgery Technique
			8.2.5	 Complications and Management
			8.2.6	 Postoperative Care
		8.3	 Outcomes
		References
	9: Management of Bony Bankart Lesions/Glenoid Bone Loss: Arthroscopic Bone Grafting Combined with Arthroscopic Subscapularis Augmentation
		9.1	 Introduction
		9.2	 Indications
		9.3	 Contraindications
		9.4	 Author Preferred Technique
			9.4.1	 Preoperative Planning
			9.4.2	 Patient Positioning
			9.4.3	 Portals
			9.4.4	 Step-by-Step Description of the Technique to Address the GBL
				9.4.4.1	 Graft Preparation
				9.4.4.2	 ASA: Maiotti Technique
			9.4.5	 Postoperative Care
			9.4.6	 Complications and Management
		9.5	 Summary
		9.6	 Limitations
		9.7	 Conclusion
		References
	10: Management of Bony Bankart Lesions/Glenoid Bone Loss: Arthroscopic Distal Clavicle Osteochondral Autograft Transfer
		10.1	 Introduction
		10.2	 Indications
		10.3	 Contraindications
		10.4	 Author Preferred Technique
			10.4.1	 Preoperative Planning
			10.4.2	 Patient Positioning
			10.4.3	 Portal Design
			10.4.4	 Step-by-Step Description of the Technique
			10.4.5	 Complications and Management
			10.4.6	 Postoperative Care
			10.4.7	 Outcome
		10.5	 Summary
		References
	11: Arthroscopic Revision for Failed Latarjet Procedure
		11.1	 Introduction
		11.2	 Indications
		11.3	 Contraindication
		11.4	 Author preferred Technique
			11.4.1	 Preoperative Planning
			11.4.2	 Patient Positioning
			11.4.3	 Portal Design
			11.4.4	 Step-by-Step Description of the Technique
				11.4.4.1	 Evaluation and Debridement
				11.4.4.2	 Graft Preparation
				11.4.4.3	 Graft Insertion
				11.4.4.4	 Bankart Repair
			11.4.5	 Complications and Management
			11.4.6	 Postoperative Protocol
			11.4.7	 Outcomes
		11.5	 Summary
		References
	12: Arthroscopic Management of Hill-Sachs Lesion: Remplissage Procedure
		12.1	 Introduction
		12.2	 Indications
		12.3	 Contraindications
		12.4	 Author Preferred Technique
			12.4.1	 Preoperative Planning
			12.4.2	 Patient Positioning
			12.4.3	 Portal Design
			12.4.4	 Step-by-Step Description of the Technique
				12.4.4.1	 Thorough Evaluation
				12.4.4.2	 Hill-Sachs Lesion Preparation
				12.4.4.3	 Cannula Preparation
				12.4.4.4	 Anchors Placement
				12.4.4.5	 Standard Bankart Repair
				12.4.4.6	 Remplissage Tying
			12.4.5	 Postoperative Care
		12.5	 Summary
		References
	13: Arthroscopic Management of HAGL (Humeral Avulsion of Glenohumeral Ligament) and Reverse HAGL Lesions
		13.1	 Introduction
		13.2	 Indications
		13.3	 Contraindications
		13.4	 Author’s Preferred Techniques
			13.4.1	 Pre-operative Planning
			13.4.2	 Patient Positioning
			13.4.3	 Portals
			13.4.4	 Step-by-Step Description of the Techniques
				13.4.4.1	 Anterior HAGL
				13.4.4.2	 Reverse HAGL
				13.4.4.3	 Low Inferior HAGL
				13.4.4.4	 Combined HAGL and Bankart
			13.4.5	 Complications
			13.4.6	 Post-operative Care
		13.5	 Summary
		References
	14: Arthroscopic Trillat Procedure
		14.1	 Introduction
		14.2	 Indications
		14.3	 Contraindications
		14.4	 Author’s Preferred Technique
			14.4.1	 Pre-operative Planning
			14.4.2	 Patient Positioning
			14.4.3	 Portal Design
			14.4.4	 Step-by-Step Description of the Technique
				14.4.4.1	 Step 1: Diagnostic Arthroscopy and Rotator Interval Debridement
				14.4.4.2	 Step 2: Coracoid Process Preparation and Osteotomy
				14.4.4.3	 Step 3: Preparation of the Transfer
				14.4.4.4	 Step 4: Coracoid Transfer
				14.4.4.5	 Step 5: Capsulolabral Plasty
			14.4.5	 Complications and Management
			14.4.6	 Post-operative Care
			14.4.7	 Outcome
		14.5	 Summary
		References
	15: Arthroscopic Management of Posterior Shoulder Instability
		15.1	 Introduction
		15.2	 Indications
		15.3	 Contraindications
		15.4	 Author’s Preferred Technique
		15.5	 Rehabilitation
		15.6	 Complications and Management
		15.7	 Outcomes
		15.8	 Summary
		References
	16: Arthroscopic Management of Multidirectional Shoulder Instability
		16.1	 Introduction
		16.2	 Indications
		16.3	 Contraindications
		16.4	 Author’s Preferred Technique
			16.4.1	 Pre-operative Planning
			16.4.2	 Patient Positioning
			16.4.3	 Portal Design
			16.4.4	 Step-by-Step Description of the Technique
			16.4.5	 Complications
			16.4.6	 Post-operative Care
			16.4.7	 Outcome
		16.5	 Summary
		References
Part III: Treatment of Glenohumeral Problems: Rotator Cuff Pathologies and Impingement Syndromes
	17: Subacromial Impingement
		17.1	 Introduction
		17.2	 Classification
		17.3	 Anatomy/Pathoanatomy
		17.4	 Biomechanics
		17.5	 History and Physical Examination
		17.6	 Investigation
		17.7	 Treatment
		17.8	 Postoperative Rehabilitation
		17.9	 Complications
		17.10	 Outcome
		17.11	 Summary
		References
	18: Arthroscopic Repair of Anterosuperior Rotator Cuff Tears
		18.1	 What Are the Anterosuperior Rotator Cuff Tear and Its Pathoanatomy
		18.2	 Clinical Evaluation
			18.2.1	 Symptoms
		18.3	 Physical Examination
		18.4	 Radiographic Evaluation
		18.5	 Treatment
		18.6	 The Arthroscopic Repair of Anterosuperior Rotator Cuff Tears
		References
	19: Arthroscopic Repair of Posterosuperior Rotator Cuff Tears
		19.1	 Introduction
		19.2	 Indications
		19.3	 Contraindications
		19.4	 Author’s Preferred Technique: Linked Double Row-Suture Bridge Technique (LDR-SB)
			19.4.1	 Pre-operative Planning
			19.4.2	 Patient Positioning
			19.4.3	 Portal Design
			19.4.4	 Step-by-Step Description of the Technique: Linked Double Row-Suture Bridge Repair (LDR-SB)
			19.4.5	 Complications
			19.4.6	 Post-operative Care
			19.4.7	 Outcome
		19.5	 Conclusion
		References
	20: Subcoracoid Impingement and Endoscopic Coracoplasty
		20.1	 Introduction
		20.2	 Pathogenesis and Mechanism of Subcoracoid Impingement
		20.3	 Clinical Presentation and Physical Examination
		20.4	 Imaging Evaluation
		20.5	 Diagnosis
		20.6	 Treatment
			20.6.1	 Conservative Treatment
			20.6.2	 Surgical Treatment
				20.6.2.1	 Anesthesia
				20.6.2.2	 Patient Positioning
				20.6.2.3	 Portals
			20.6.3	 Operation Steps
				20.6.3.1	 Routine Examination
				20.6.3.2	 Identify the Coracoid
				20.6.3.3	 Coracoplasty
				20.6.3.4	 Postoperative Treatment
		20.7	 Conclusion
		References
	21: Arthroscopic Repair of Subscapularis Tendon Tear
		21.1	 Introduction
		21.2	 Arthroscopic SSC Repair
		21.3	 Patient Positioning
		21.4	 Portal Placement
		21.5	 Visualization and Working Space in the Coracoid Space
		21.6	 Identification and Mobilization of the SSC Tendon
		21.7	 Preparation of the Tendon Lateral Edge and Footprint on Lesser Tuberosity
		21.8	 Anchor Placement, Suture Passage, and Tendon Fixation
		21.9	 Rehabilitation
		21.10	 Complications
		21.11	 Outcomes
		21.12	 Summary
		References
	22: Arthroscopic Management of Massive Rotator Cuff Tear
		22.1	 Introduction
		22.2	 Indications
		22.3	 Contraindications
		22.4	 Author’s Preferred Technique
			22.4.1	 Pre-operative Planning
			22.4.2	 Patient Positioning
			22.4.3	 Portal Design
			22.4.4	 Step-by-Step Description of the Technique
			22.4.5	 Complications and Management
			22.4.6	 Post-operative Care
			22.4.7	 Outcome
		22.5	 Summary
		References
	23: Arthroscopic Subacromial Spacer Implantation
		23.1	 Introduction
		23.2	 Indications
		23.3	 Contra-Indications
		23.4	 Author Preferred Technique
			23.4.1	 Pre-operative Planning
			23.4.2	 Patient Positioning
			23.4.3	 Portal Design
			23.4.4	 Step-by-Step Description of the Technique
			23.4.5	 Complications and Management
			23.4.6	 Post-operative Care
			23.4.7	 Outcome
		23.5	 Summary
		References
	24: Arthroscopic Management of Irreparable Massive Rotator Cuff Tears: Biceps Patch Technique
		24.1	 Introduction
		24.2	 Indications
		24.3	 Contraindications
		24.4	 Biceps Patch Technique
			24.4.1	 Pre-operative Planning
			24.4.2	 Patient Positioning
			24.4.3	 Portal Design
			24.4.4	 Step-by-Step Description of the Technique
			24.4.5	 Complications and Management
			24.4.6	 Post-operative Care
			24.4.7	 Outcome
		24.5	 Summary
		References
	25: Superior Capsular Reconstruction
		25.1	 Introduction
		25.2	 Indications
		25.3	 Contraindications
			25.3.1	 Osteoarthritis of the Joint
		25.4	 Authors Preferred Technique
			25.4.1	 Pre-operative Planning
			25.4.2	 Patient Positioning
			25.4.3	 Portal Design
			25.4.4	 Step-by-Step Description of the Technique
		25.5	 Complications and Management
		25.6	 Post-operative Care
		25.7	 Outcome
		25.8	 Summary
		References
	26: Arthroscopic Latissimus Dorsi Transfer for Massive Irreparable Rotator Cuff Tears
		26.1	 Introduction
		26.2	 Indications
		26.3	 Contraindications
		26.4	 Author Preferred Technique
			26.4.1	 Pre-operative Planning
			26.4.2	 Patient Positioning
			26.4.3	 Portal Design
			26.4.4	 Step-by-Step Description of the Technique
			26.4.5	 Complications and Their Management
			26.4.6	 Post-operative Care
			26.4.7	 Outcome
		26.5	 Summary
		References
	27: Arthroscopic-Assisted Transfer of the Lower Trapezius Tendon for Irreparable Massive Posterosuperior Rotator Cuff Tears
		27.1	 Introduction
		27.2	 Indications
		27.3	 Contraindications
		27.4	 Authors Preferred Technique
			27.4.1	 Pre-operative Planning
			27.4.2	 Patient Positioning
			27.4.3	 Portal Design
			27.4.4	 Step-by-Step Description of the Technique
				27.4.4.1	 Soft Tissue Releases and Great Tuberosity Preparation
				27.4.4.2	 Lower Trapezius Tendon Harvest
				27.4.4.3	 Achilles Tendon-Bone Allograft Preparation
				27.4.4.4	 Arthroscopic Insertion of the Achilles Tendon-Bone Allograft into the Humerus
				27.4.4.5	 Graft Attachment to the Lower Trapezius and Tensioning
			27.4.5	 Complications and Management
			27.4.6	 Post-operative Care
		27.5	 Summary
		References
	28: Arthroscopic Latissimus Dorsi Transfer for Irreparable Tear of the Subscapularis
		28.1	 Introduction
		28.2	 Surgical Technique
			28.2.1	 Open Technique
			28.2.2	 Arthroscopy-Assisted Technique
				28.2.2.1	 Harvest of the LDT Phase
				28.2.2.2	 Arthroscopic Phase
			28.2.3	 Fixation Methods
				28.2.3.1	 Open Surgery Fixation
					Tunnels [12]
				28.2.3.2	 Arthroscopy-Assisted Fixation
					Anchors [10, 13]
					Interferential Screw [13, 14]
					Endobutton [10]
		28.3	 Clinical Outcomes
		28.4	 Rehabilitation
		28.5	 Conclusion
		References
	29: Arthroscopic Treatment of Calcific Tendinitis of the Rotator Cuff
		29.1	 Introduction
		29.2	 Indications
		29.3	 Contraindications
		29.4	 Author’s Preferred Technique
			29.4.1	 Pre-operative Planning
			29.4.2	 Patient and Medical Team Positioning
			29.4.3	 Portal Design
			29.4.4	 Step-by-Step Description of the Technique
			29.4.5	 Complications and Management
			29.4.6	 Post-operative Care
			29.4.7	 Outcome
		29.5	 Summary
		References
	30: Arthroscopic Treatment of Calcific Tendonitis of the Shoulder
		30.1	 Introduction
		30.2	 Indications
		30.3	 Contraindications
		30.4	 Author Preferred Technique
			30.4.1	 Pre-operative Planning
				30.4.1.1	 Radiographic Assessment
				30.4.1.2	 Required Instruments
			30.4.2	 Patient Positioning
			30.4.3	 Portal Design
			30.4.4	 Step-by-Step Description of the Technique
				30.4.4.1	 Subacromial Space
				30.4.4.2	 Localization
				30.4.4.3	 Release and Remove
				30.4.4.4	 Irrigation
				30.4.4.5	 Rotator Cuff Repair
				30.4.4.6	 Subacromial Decompression
			30.4.5	 Complications
			30.4.6	 Post-operative Care
				30.4.6.1	 Curetted Without Suture Anchor Repair
				30.4.6.2	 Large Full-Thickness Defect Repaired with Suture Anchor
		30.5	 Summary
		References
Part IV: Treatment of Glenohumeral Problems: Pathologies of the Glenoid Labrum and Long Head of Biceps Tendon
	31: Arthroscopic Management of SLAP Lesion
		31.1	 Introduction
		31.2	 Classifications
		31.3	 Mechanism of Injury
		31.4	 Clinical Presentation and Physical Examination
			31.4.1	 Active-Compression Test
			31.4.2	 Compression Rotation Test
			31.4.3	 Resisted-Supination External-Rotation Test
			31.4.4	 Clunk Test
		31.5	 Diagnostic Imaging
		31.6	 Treatment
			31.6.1	 Conservative Management
			31.6.2	 Surgical Treatment
		31.7	 Conclusion
		References
	32: Tenoscopy of the Long Head of Biceps Tendon
		32.1	 Introduction
		32.2	 Indications [8]
		32.3	 Contraindications [9]
		32.4	 Author’s Preferred Technique
			32.4.1	 Preoperative Planning
			32.4.2	 Patient and Medical Team Positioning
			32.4.3	 Portal Design
			32.4.4	 Step-by-Step Description of the Technique
			32.4.5	 Complications and Management [7, 9]
			32.4.6	 Postoperative Care
			32.4.7	 Outcomes
		32.5	 Summary
		References
	33: Arthroscopic Long Head of Biceps Tenodesis
		33.1	 Introduction
		33.2	 Indications
		33.3	 Contraindications
		33.4	 Author Preferred Technique
			33.4.1	 Pre-operative Planning
			33.4.2	 Patient Positioning
			33.4.3	 Portal Design
			33.4.4	 Step-by-Step Description of the Technique
			33.4.5	 Complications
			33.4.6	 Post-operative Care
			33.4.7	 Outcome
		33.5	 Conclusion
		References
	34: A Technique for Endoscopic-Assisted Subpectoral Biceps Tenodesis
		34.1	 Introduction
		34.2	 Indications
		34.3	 Contraindications
		34.4	 Author Preferred Technique
			34.4.1	 Pre-operative Planning
			34.4.2	 Patient Positioning
			34.4.3	 Portal Design
			34.4.4	 Step-by-Step Description of the Technique
				34.4.4.1	 Stage 1: Glenohumeral Diagnostic Arthroscopy and Tenotomy
				34.4.4.2	 Stage 2: Extra-articular Retrieval and Preparation of the Long Head of the Bicep Tendon
				34.4.4.3	 Stage 3: Endoscopic-Assisted Tenodesis of the Long Head of the Bicep Tendon
			34.4.5	 Complications and Management
			34.4.6	 Post-operative Care
		34.5	 Outcomes
		34.6	 Summary
		References
Part V: Treatment of Glenohumeral Problems: Miscellaneous
	35: Arthroscopic Coracohumeral Ligament Release: Surgical Management of Frozen Shoulder
		35.1	 Introduction
		35.2	 Indications
		35.3	 Contraindications
		35.4	 Author’s Preferred Technique
			35.4.1	 Pre-operative Planning
			35.4.2	 Patient Positioning
			35.4.3	 Portal Design
			35.4.4	 Step-by-Step Description of the Technique
			35.4.5	 Complications
			35.4.6	 Post-operative Care
			35.4.7	 Outcomes
		35.5	 Summary
		References
	36: Arthroscopic Circumferential Capsulotomy for Patients with Frozen Shoulder
		36.1	 Introduction
		36.2	 Indications
		36.3	 Contraindications
		36.4	 Author’s Preferred Technique
			36.4.1	 Pre-operative Planning
			36.4.2	 Patient and Medical Team Positioning
			36.4.3	 Portal Design
			36.4.4	 Step-by-Step Description of the Technique
			36.4.5	 Complications
			36.4.6	 Post-operative Care
			36.4.7	 Outcome
		36.5	 Summary
		References
	37: Arthroscopic Treatment of Glenohumeral Osteoarthritis: The CAM Approach
		37.1	 Introduction
		37.2	 Clinical Examination, Imaging, and Staging
		37.3	 Treatment (Non-operative and Surgical Options)
		37.4	 Surgical Technique
		37.5	 Summary
		References
	38: Arthroscopic Glenohumeral Arthrodesis for Flail Shoulder
		38.1	 Introduction
		38.2	 Indications
		38.3	 Contraindications
		38.4	 Author’s Preferred Technique
			38.4.1	 Pre-operative Planning
			38.4.2	 Patient Positioning
			38.4.3	 Portal Design
			38.4.4	 Step-by-Step Description of the Technique
			38.4.5	 Post-operative Care
			38.4.6	 Complications and Management
			38.4.7	 Outcomes
		38.5	 Summary
		References
	39: Arthroscopic Management of Shoulder Periarticular Cysts
		39.1	 Introduction
		39.2	 Indications
		39.3	 Contraindications
		39.4	 Author Preferred Technique
			39.4.1	 Pre-operative Planning
			39.4.2	 Patient Positioning
			39.4.3	 Portal Design
			39.4.4	 Step-by-Step Description of the Technique
				39.4.4.1	 Intraarticular Stage: Management of Labral Lesions
				39.4.4.2	 Subacromial Stage: Spinoglenoid Ganglion Cyst Decompression
			39.4.5	 Complications
			39.4.6	 Post-operative Care
			39.4.7	 Outcome
		39.5	 Conclusion
		References
	40: Arthroscopic Management of Synovial Chondromatosis of the Glenohumeral Joint
		40.1	 Introduction
		40.2	 Indications
		40.3	 Contraindications
		40.4	 Author Preferred Technique
			40.4.1	 Pre-operative Planning
			40.4.2	 Patient Positioning
			40.4.3	 Portal Design
			40.4.4	 Step-by-Step Description of the Technique
			40.4.5	 Complications and Management
			40.4.6	 Post-operative Care
			40.4.7	 Outcome
		40.5	 Summary
		References
	41: Arthroscopic Management of Septic Arthritis of the Glenohumeral Joint
		41.1	 Introduction
		41.2	 Indications
		41.3	 Contraindications
		41.4	 Author’s Preferred Technique
			41.4.1	 Preoperative Planning
			41.4.2	 Patient Positioning
			41.4.3	 Portal Design
			41.4.4	 Step-by-Step Description of the Technique
			41.4.5	 Complications and Management
			41.4.6	 Postoperative Care
		41.5	 Summary
		References
	42: Endoscopic Curettage of Bone Cysts of the Proximal Humerus
		42.1	 Introduction
		42.2	 Indications
		42.3	 Contraindications
		42.4	 Author’s Preferred Technique
			42.4.1	 Pre-operative Planning
			42.4.2	 Patient and Medical Team Positioning
			42.4.3	 Portal Design
			42.4.4	 Step-by-Step Description of the Technique
			42.4.5	 Complications and Management
			42.4.6	 Post-operative Care
			42.4.7	 Outcomes
		42.5	 Summary
		References
	43: Arthroscopic-Assisted Management of Avascular Necrosis of the Humeral Head with Core Decompression and Fibular Strut Grafting
		43.1	 Introduction
		43.2	 Indications
		43.3	 Contraindications
		43.4	 Author’s Preferred Technique
			43.4.1	 Preoperative Planning
			43.4.2	 Patient Positioning
			43.4.3	 Portal Design
			43.4.4	 Step-by-Step Description of the Technique
			43.4.5	 Complications and Management
			43.4.6	 Postoperative Care
			43.4.7	 Outcomes
		43.5	 Summary
		References
	44: Shoulder Arthroscopy after Shoulder Arthroplasty
		44.1	 Introduction
		44.2	 Indications
		44.3	 Contraindications
		44.4	 Author’s Preferred Technique
			44.4.1	 Preoperative Planning
			44.4.2	 Patient Positioning
			44.4.3	 Portal Design
			44.4.4	 Step-by-Step Description of the Technique
			44.4.5	 Complications and Management
			44.4.6	 Postoperative Care
		44.5	 Summary
		References
	45: Shoulder Arthroscopy in Arthroplasty
		45.1	 Introduction
		45.2	 Arthroscopy for Diagnosing Periprosthetic Joint Infection
		45.3	 Timing of Intervention and Surgical Technique
			45.3.1	 Diagnostic Arthroscopy
			45.3.2	 Therapeutic Arthroscopy
			45.3.3	 Limitations and Pitfalls
		45.4	 Conclusion
		References
Part VI: Treatment of Acromioclavicular Problems
	46: Endoscopic Treatment of Acute Acromioclavicular Joint Dislocation
		46.1	 Introduction
		46.2	 Pathologic Anatomy
		46.3	 Classification
		46.4	 Timing of Treatment
		46.5	 Endoscopic Treatment of Acute Acromioclavicular Joint Dislocation
		46.6	 Postoperative Rehabilitation
		46.7	 Literature Reviews
		46.8	 Summary
		References
	47: Arthroscopic Acromioclavicular Joint Reconstruction with TightRope and a FiberTape Loop
		47.1	 Introduction
		47.2	 Indications
		47.3	 Contraindications
		47.4	 Author’s Preferred Technique
			47.4.1	 Pre-operative Planning
			47.4.2	 Patient Positioning
			47.4.3	 Portal Design
			47.4.4	 Step-by-Step Description of the Technique
				47.4.4.1	 Reduction and Coracoclavicular Fixation
				47.4.4.2	 AC Fixation
			47.4.5	 Complications and Outcomes
			47.4.6	 Post-operative Care
		47.5	 Summary
		References
	48: Endoscopic Coracoclavicular Ligament Reconstruction Using Allograft
		48.1	 Introduction
		48.2	 Indications
		48.3	 Contraindications
		48.4	 Author’s Preferred Technique
			48.4.1	 Pre-operative Planning
			48.4.2	 Patient Positioning
			48.4.3	 Portal Design
			48.4.4	 Step-by-Step Description of the Technique
			48.4.5	 Complications and Management
			48.4.6	 Post-operative Care
		48.5	 Summary
		References
	49: Arthroscopic Acromioclavicular Joint Resection
		49.1	 Anatomical Consideration
		49.2	 General Consideration
		49.3	 Arthroscopic Acromioclavicular Resection: Technical Points
		49.4	 Postoperative Cares
		49.5	 Results
		49.6	 Conclusion
		References
	50: Arthroscopic Excision of the Symptomatic Meso-acromiale of the Shoulder
		50.1	 Introduction
			50.1.1	 Diagnostic Imaging
			50.1.2	 Nonsurgical Management
			50.1.3	 Surgical Options
				50.1.3.1	 Open Excision
				50.1.3.2	 Open Reduction and Internal Fixation
				50.1.3.3	 Arthroscopic Subacromial Decompression/Acromioplasty
				50.1.3.4	 Arthroscopic Excision
		50.2	 Indications
		50.3	 Contraindications
		50.4	 Author-Preferred Technique for Arthroscopic Excision
			50.4.1	 Pre-operative Planning
			50.4.2	 Patient Positioning
			50.4.3	 Portal Design/Placement
			50.4.4	 Step-by-Step Technique Description
			50.4.5	 Complications and Management
			50.4.6	 Post-operative Care
		50.5	 Summary
		References
Part VII: Treatment of Scapulothoracic Problems
	51: Scapulothoracic Endoscopy for Snapping Scapula Syndrome
		51.1	 Introduction
		51.2	 Indications
		51.3	 Contraindications (Relative)
		51.4	 Preferred Technique
			51.4.1	 Pre-operative Planning
			51.4.2	 Patient Positioning
			51.4.3	 Portal Design
			51.4.4	 Step-by-Step Description of the Technique
			51.4.5	 Complications and Management
			51.4.6	 Post-operative Care
			51.4.7	 Outcomes
		51.5	 Summary
		References
	52: Endoscopically Assisted Resection of Scapular Osteochondroma
		52.1	 Background
		52.2	 Anatomy and Physiology
		52.3	 Osteochondroma of Scapula
		52.4	 Surgical Procedure of Endoscopically Assisted Resection
		52.5	 Representative Case [7]
		52.6	 Discussion [7]
		References
	53: Arthroscopic Pectoralis Minor Release
		53.1	 Introduction
		53.2	 Indications
		53.3	 Contraindications
		53.4	 Author Preferred Technique
			53.4.1	 Pre-operative Planning
			53.4.2	 Patient Positioning
			53.4.3	 Portal Design
			53.4.4	 Step-by-Step Description of the Technique
			53.4.5	 Complications
			53.4.6	 Post-operative Care
			53.4.7	 Outcome
		53.5	 Summary
		References
Part VIII: Treatment of Sternoclavicular Problems
	54: Sternoclavicular Arthroscopy
		54.1	 Introduction
		54.2	 Indications
		54.3	 Contra-indications
		54.4	 Author Preferred Technique
			54.4.1	 Pre-operative Planning
			54.4.2	 Patient Positioning
			54.4.3	 Portals
			54.4.4	 Step-by-Step Description of the Technique
			54.4.5	 Complications and Management
			54.4.6	 Post-operative Care
			54.4.7	 Outcome
		54.5	 Summary
		References
	55: Arthroscopic Resection of the Intra-articular Disc of the Sternoclavicular Joint
		55.1	 Introduction
		55.2	 Indications
		55.3	 Contra-indications
		55.4	 Author Preferred Technique
			55.4.1	 Pre-operative Planning
			55.4.2	 Patient Positioning
			55.4.3	 Portal Design
			55.4.4	 Step-by-Step Description of the Technique
			55.4.5	 Complications and Management
			55.4.6	 Post-operative Care
			55.4.7	 Outcome
		55.5	 Summary
		References
	56: Arthroscopic Excision of the Sternoclavicular Joint
		56.1	 Introduction
		56.2	 Indications
		56.3	 Contra-Indications
		56.4	 Author Preferred Technique
			56.4.1	 Pre-Operative Planning
			56.4.2	 Patient Positioning
			56.4.3	 Portals
			56.4.4	 Step-by-Step Description of the Technique
			56.4.5	 Complications and Management
			56.4.6	 Post-Operative Care
			56.4.7	 Outcome
		56.5	 Summary
		References
	57: Stabilization Procedures for Instability of the Sternoclavicular Joint
		57.1	 Introduction
		57.2	 Indications
		57.3	 Contra-Indications
			57.3.1	 Author Preferred Technique
			57.3.2	 Pre-Operative Planning
			57.3.3	 Patient Positioning
			57.3.4	 Skin Incisions
			57.3.5	 Step-by-Step Description of the Technique
			57.3.6	 Complications and Management
			57.3.7	 Post-Operative Care
			57.3.8	 Outcome
		57.4	 Summary
		Further Reading
			Biomechanical Studies
			Techniques with Semitendinosous Graft
			Techniques with Palmaris Longus or Gracilis Graft
			Techniques with Sternocleidomastoideus
			Techniques with Subclavius
Part IX: Treatment of Neurological Problems
	58: Endoscopic Release of the Brachial Plexus for Thoracic Outlet Syndrome
		58.1	 Introduction
		58.2	 Indications
		58.3	 Contra-Indications
		58.4	 Author Preferred Technique
		58.5	 Rehabilitation
		58.6	 Discussion
		References
	59: Endoscopic Suprascapular Nerve Decompression at the Spinoglenoid and Suprascapular Notches
		59.1	 Introduction
		59.2	 Indications
		59.3	 Contraindications
		59.4	 Author Preferred Techniques
			59.4.1	 Preoperative Planning
			59.4.2	 Patient Positioning
			59.4.3	 Portal Design (Suprascapular Notch)
			59.4.4	 Step-by-Step Description of the Techniques (Suprascapular Notch)
			59.4.5	 Portal Design (Spinoglenoid Notch)
			59.4.6	 Step-by-Step Description of the Techniques (Spinoglenoid Notch)
			59.4.7	 Complications and Management
			59.4.8	 Post-Operative Care
			59.4.9	 Outcomes
		59.5	 Summary
		References
	60: Management of Scapular Winging Secondary to Serratus Nerve Palsy: Endoscopic Lysis of the Long Thoracic Nerve
		60.1	 Introduction
		60.2	 Materials and Methods
			60.2.1	 Procedure Technique in Detail
		60.3	 Results
		60.4	 Discussion
		60.5	 Conclusion
		References
Part X: Treatment of Fracture Related Problems
	61: Endoscopic Treatment of Distal Clavicular Fractures
		61.1	 Introduction
		61.2	 Indications
		61.3	 Contraindications
		61.4	 Author’s Preferred Technique
			61.4.1	 Preoperative Planning
			61.4.2	 Patient and Medical Team Positioning
			61.4.3	 Portal Design
			61.4.4	 Step-by-Step Description of the Technique
			61.4.5	 Complications and Management
				61.4.5.1	 Intraoperative Complications
				61.4.5.2	 Postoperative Complications
			61.4.6	 Postoperative Care
			61.4.7	 Outcomes
		61.5	 Summary
		References
	62: Arthroscopic Treatment of Greater Tuberosity Avulsion Fracture
		62.1	 Introduction
		62.2	 Indications
		62.3	 Contra-indications
		62.4	 Author Preferred Technique/Procedures
			62.4.1	 Pre-operative Planning
			62.4.2	 Patient Positioning
			62.4.3	 Portal Design
			62.4.4	 Surgical Technique
			62.4.5	 Complications
			62.4.6	 Technical Tips to Avoid Complications
			62.4.7	 Post-operative Care
			62.4.8	 Outcome
		62.5	 Summary
		References
	63: Arthroscopic Treatment of Lesser Tuberosity Avulsion Fractures
		63.1	 Introduction
		63.2	 Indications
		63.3	 Contra-Indications
		63.4	 Author Preferred Technique
			63.4.1	 Pre-operative Planning
			63.4.2	 Patient Positioning
			63.4.3	 Portal Design
			63.4.4	 Step-by-Step Description of the Technique
			63.4.5	 Post-operative Care
		63.5	 Summary
		References
	64: Arthroscopic Management of Fractures of the Proximal Humerus
		64.1	 Introduction
		64.2	 Indications
		64.3	 Contra-Indications
		64.4	 Author Preferred Technique
			64.4.1	 Pre-operative Planning
			64.4.2	 Patient Positioning
			64.4.3	 Portal Design
			64.4.4	 Step-by-Step Description of the Techniques
				64.4.4.1	 Screw Fixation in Monofragmentary GT Fractures
				64.4.4.2	 Double-Row Anchor Refixation in Multifragmentary GT Fractures
				64.4.4.3	 Double-Row Anchor Refixation in LT Fractures
				64.4.4.4	 Arthroscopic Capsular Release and Implant Removal
				64.4.4.5	 Arthroscopic Intramedullary Nailing
			64.4.5	 Post-operative Care
			64.4.6	 Postoperative Complications and Outcome
		64.5	 Summary
		References
	65: Arthroscopy-Assisted Intra-Medullary Nailing for Treatment of Fractures of the Humeral Shaft
		65.1	 Introduction
		65.2	 Indications
		65.3	 Contraindications
		65.4	 Author’s Preferred Technique
			65.4.1	 Preoperative Planning
			65.4.2	 Patient Positioning
			65.4.3	 Portal Design
			65.4.4	 Step-by-Step Description of the Technique
			65.4.5	 Complications and Management
			65.4.6	 Postoperative Care
		65.5	 Summary
		References
	66: Arthroscopic Management of Glenoid Fractures
		66.1	 Introduction
		66.2	 Indications
		66.3	 Contra-Indications
		66.4	 Surgical Techniques
			66.4.1	 Anterior Glenoid Rim Fractures
			66.4.2	 Transverse Fractures
			66.4.3	 Arthroscopic Techniques
			66.4.4	 Anterior Rim Fractures
			66.4.5	 Transverse Fractures
		66.5	 Author Preferred Technique
			66.5.1	 Surgical Technique
				66.5.1.1	 Postoperative Management
		66.6	 Summary
		References
	67: Arthroscopic Adhesiolysis and Proximal Humeral Plate Removal
		67.1	 Introduction
		67.2	 Indications
		67.3	 Contra-Indications
		67.4	 Author Preferred Technique
			67.4.1	 Pre-Operative Planning
			67.4.2	 Patient Positioning
			67.4.3	 Portal Design
			67.4.4	 Step-by-Step Description of the Technique
			67.4.5	 Complications and Management
			67.4.6	 Post-Operative Care
			67.4.7	 Outcome
		67.5	 Summary
		References
	68: Arthroscopic Management of Malunions and Non-unions of the Greater Tuberosity
		68.1	 Introduction
		68.2	 Indications
		68.3	 Contra-Indications
		68.4	 Pre-Operative Planning
		68.5	 Anesthesia, Positioning and Draping (Fig. 68.3)
		68.6	 Portals (Fig. 68.4)
			68.6.1	 Non-union without Implant
			68.6.2	 Non-union with Screw and Washer
			68.6.3	 Malunion with Impingement
		68.7	 Step-by-Step Description of the Technique
			68.7.1	 Non-union with Screw and Washer
				68.7.1.1	 Step 1: Removal of the Screws
				68.7.1.2	 Step 2: Arthroscopic Fixation of the Greater Tuberosity
			68.7.2	 Malunion with Impingement
			68.7.3	 Post-op Rehabilitation
				68.7.3.1	 Arthroscopic Non-union Fixation
				68.7.3.2	 Arthroscopic Malunion Fixation
				68.7.3.3	 Sample Case of GT Non-union with Implant in Situ
				68.7.3.4	 Sample Case of Malunited GT with Impingement
		68.8	 Summary
		References