Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position

Background: Shoulder arthroscopy can be performed with the patient in the lateral decubitus or beach-chair position, but in both cases, glenohumeral (GH) joint spaces must be increased to improve visualization and allow access of the optical instrument. The aim of this study was to determine the eff...

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Detalhes bibliográficos
Autores: Mário Chaves Corrêa, Érica Antunes Naves, Gilvan Ferreira Vaz, Thalles Abreu Machado, Marco Antônio Percope de Andrade
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2020
País:Brasil
Recursos:Universidade Federal de Minas Gerais (UFMG)
Repositório:Repositório Institucional da UFMG
Idioma:inglês
OAI Identifier:oai:repositorio.ufmg.br:1843/70169
Acesso em linha:http://hdl.handle.net/1843/70169
Access Level:Acceso aberto
Palavra-chave:Artroscopia
Instabilidade Articular
Articulação do Ombro
Posicionamento do Paciente
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spelling Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair positionArtroscopiaInstabilidade ArticularArticulação do OmbroPosicionamento do PacienteBackground: Shoulder arthroscopy can be performed with the patient in the lateral decubitus or beach-chair position, but in both cases, glenohumeral (GH) joint spaces must be increased to improve visualization and allow access of the optical instrument. The aim of this study was to determine the effects of limb setup and longitudinal traction on the opening of the GH space with patients placed in the beach-chair (dorsal decubitus) position. Methods: GH spaces at 3 test points corresponding to the anatomic locations of Bankart lesions were determined indirectly from radiographic images obtained from 67 patients presenting shoulder pathology with an indication for arthroscopic surgery. Measurements were made with the operative limb in neutral rotation and positioned in relation to the coronal plane in adduction, 45° of abduction, or adduction with an axillary spacer, in each case with and without longitudinal traction. Results: GH spaces were optimized at 2 of 3 test points when the operative limb was positioned in adduction or neutral rotation and manual longitudinal traction was applied with or without a polystyrene spacer placed under the axilla, but use of the spacer was essential to maximize the GH space at all 3 locations. In contrast, 45° of abduction proved to be the least appropriate position because it afforded the smallest GH space values with or without traction. Conclusion: Appropriate positioning of the patient on the operating table is a critical aspect of shoulder arthroscopy. Radiographic images revealed that adducted upper-limb traction with the use of an axillary spacer in patients in the beach-chair position generates a significant increase in the GH space in the lower half of the glenoid cavity, thereby facilitating visualization and access of the optical equipment to the GH compartments.Universidade Federal de Minas GeraisBrasilMED - DEPARTAMENTO DE APARELHO LOCOMOTORUFMG2024-07-10T20:25:13Z2024-07-10T20:25:13Z2020info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlepdfapplication/pdf10.1016/j.jses.2019.11.0032666-6383http://hdl.handle.net/1843/70169engJournal of Shoulder and Elbow Surgery Internationalinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGMário Chaves CorrêaÉrica Antunes NavesGilvan Ferreira VazThalles Abreu MachadoMarco Antônio Percope de Andrade2024-07-10T20:25:14Zoai:repositorio.ufmg.br:1843/70169Repositório InstitucionalPUBhttps://repositorio.ufmg.br/oairepositorio@ufmg.bropendoar:2024-07-10T20:25:14Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false
dc.title.none.fl_str_mv Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
title Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
spellingShingle Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
Mário Chaves Corrêa
Artroscopia
Instabilidade Articular
Articulação do Ombro
Posicionamento do Paciente
title_short Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
title_full Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
title_fullStr Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
title_full_unstemmed Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
title_sort Radiographic evaluation of the glenohumeral joint space in patients undergoing arthroscopic shoulder surgery in the beach-chair position
dc.creator.none.fl_str_mv Mário Chaves Corrêa
Érica Antunes Naves
Gilvan Ferreira Vaz
Thalles Abreu Machado
Marco Antônio Percope de Andrade
author Mário Chaves Corrêa
author_facet Mário Chaves Corrêa
Érica Antunes Naves
Gilvan Ferreira Vaz
Thalles Abreu Machado
Marco Antônio Percope de Andrade
author_role author
author2 Érica Antunes Naves
Gilvan Ferreira Vaz
Thalles Abreu Machado
Marco Antônio Percope de Andrade
author2_role author
author
author
author
dc.subject.por.fl_str_mv Artroscopia
Instabilidade Articular
Articulação do Ombro
Posicionamento do Paciente
topic Artroscopia
Instabilidade Articular
Articulação do Ombro
Posicionamento do Paciente
description Background: Shoulder arthroscopy can be performed with the patient in the lateral decubitus or beach-chair position, but in both cases, glenohumeral (GH) joint spaces must be increased to improve visualization and allow access of the optical instrument. The aim of this study was to determine the effects of limb setup and longitudinal traction on the opening of the GH space with patients placed in the beach-chair (dorsal decubitus) position. Methods: GH spaces at 3 test points corresponding to the anatomic locations of Bankart lesions were determined indirectly from radiographic images obtained from 67 patients presenting shoulder pathology with an indication for arthroscopic surgery. Measurements were made with the operative limb in neutral rotation and positioned in relation to the coronal plane in adduction, 45° of abduction, or adduction with an axillary spacer, in each case with and without longitudinal traction. Results: GH spaces were optimized at 2 of 3 test points when the operative limb was positioned in adduction or neutral rotation and manual longitudinal traction was applied with or without a polystyrene spacer placed under the axilla, but use of the spacer was essential to maximize the GH space at all 3 locations. In contrast, 45° of abduction proved to be the least appropriate position because it afforded the smallest GH space values with or without traction. Conclusion: Appropriate positioning of the patient on the operating table is a critical aspect of shoulder arthroscopy. Radiographic images revealed that adducted upper-limb traction with the use of an axillary spacer in patients in the beach-chair position generates a significant increase in the GH space in the lower half of the glenoid cavity, thereby facilitating visualization and access of the optical equipment to the GH compartments.
publishDate 2020
dc.date.none.fl_str_mv 2020
2024-07-10T20:25:13Z
2024-07-10T20:25:13Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv 10.1016/j.jses.2019.11.003
2666-6383
http://hdl.handle.net/1843/70169
identifier_str_mv 10.1016/j.jses.2019.11.003
2666-6383
url http://hdl.handle.net/1843/70169
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Journal of Shoulder and Elbow Surgery International
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de Minas Gerais
Brasil
MED - DEPARTAMENTO DE APARELHO LOCOMOTOR
UFMG
publisher.none.fl_str_mv Universidade Federal de Minas Gerais
Brasil
MED - DEPARTAMENTO DE APARELHO LOCOMOTOR
UFMG
dc.source.none.fl_str_mv reponame:Repositório Institucional da UFMG
instname:Universidade Federal de Minas Gerais (UFMG)
instacron:UFMG
instname_str Universidade Federal de Minas Gerais (UFMG)
instacron_str UFMG
institution UFMG
reponame_str Repositório Institucional da UFMG
collection Repositório Institucional da UFMG
repository.name.fl_str_mv Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)
repository.mail.fl_str_mv repositorio@ufmg.br
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score 15,228081

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