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Abstract
Arthroscopy is without doubt the most comprehensive procedure for shoulder lesions,
providing even better inspection of the interior of the joint than conventional open
procedures. In 174 diagnostic arthroscopies, it proved more reliable than the computed
tomography scan, ultrasound, or arthrography. The results of ultrasonography proved
disappointing despite the enthusiastic reports on this technique, probably due to
imperfections of equipment and lack of expertise rather than any inherent defect in
the method. Arthrography seems to have a high incidence of false results. Though an
invasive method requiring anesthesia, arthroscopy offers many diagnostic advantages
such as an assessment of the role of the long biceps tendon and glenohumeral ligaments
in recurrent or ordinary dislocation and the recognition of rotator cuff lesions not
detectable at arthrography. It is also possible to assess the nature of shoulder instability
and so to plan the appropriate operative procedure. A major advantage of arthroscopy
is the possibility of carrying out treatment in the same session, though many of the
suggested procedures are very demanding in terms of technical skill and time; the
complication rate is often excessive. It is therefore best to restrict operative arthroscopy
to simpler procedures such as irrigation in joint infections, the trimming of infolded
flaps of labrum or stubs of biceps tendon, and the removal of loose bodies, where
results are excellent. Arthroscopic repair of the rotator cuff or stapling of the
labrum are more questionable regarding successes, complications, and recurrence. The
equipment for arthroscopic operations needs improvement. Perhaps the major advantage
of arthroscopic diagnosis is that it directs open procedures to the essential, thus
minimizing operative trauma.
Keywords
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References
- The shoulder joint: an arthroscopist's perspective of anatomy and pathology.Clin Orthop Rel Res. 1987; 223: 113-125
- Sonography as a new diagnostic procedure for resolving shoulder problems.ROFO. 1986; 145: 288-295
- Complications in arthroscopy: the knee and other joints.Arthroscopy. 1986; 2: 253-258
- Measurement of brachial plexus strain in arthroscopy of the shoulder.Arthroscopy. 1987; 3: 45-52
- The role of the biceps tendon in the impingement syndrome.Orthop Clin North Am. 1987; 18: 383-386
- Diagnostische Arthroskopie des Schultergelenkes.in: Fortschritte in der Arthroskopie. Enke, Stuttgart1978: 31-37
- Involuntary inferior and multidirectional instability of the shoulder: etiology, recognition and treatment.Instr Course Lect. 1985; 34: 232-238
- A prospective comparison study of double contrast computed tomography (CT) arthrography and arthroscopy of the shoulder.J Sports Med. 1988; 16: 13-20
- Computed arthrotomography of the glenohumeral joint to evaluate anterior instability: correlation with arthroscopic findings.Arthroscopy. 1987; 3: 273-276
Lehrberger L, Loffler L, Englehard A. Sonographie and arthroskopie der Schulter-Erganzung oder Konkurrenz? In:Fortschritte in der Arthroskopie Stuttgart: Enke, 198:21–30.
- The clinical relevance of glenoid labrum lesions.Arthroscopy. 1987; 3: 223-230
- Anterior glenoid labrum damage: a painful lesion in swimmers.Am J Sports Med. 1986; 14: 383-387
- Arthroscopy and stability testing of the shoulder joint.Arthroscopy. 1986; 2: 35-40
- Arthroscopy of the shoulder in the management of partial tears of the rotator cuff.Arthroscopy. 1985; 1: 117-122
- Arthroscopic subacromial decompression: analysis of one to three year results.Arthroscopy. 1987; 3: 173-181
- Arthroscopic subscromial decompression. An anatomical study.Am J Sports Med. 1988; 16: 48-50
- Arthroscopic surgery of the shoulder. A general appraisal.J Bone Joint Surg [Br]. 1986; 68: 201-207
- Technik der arthroskopischen Limbusrefixation.in: Fortschritte in der Arthroskopie. Enke, Stuttgart1987: 63-66
- Arthroscopic Bankhart suture repair: technique and early results.Arthroscopy. 1987; 3: 111-122
- CT arthrography of capsular structures of the shoulder.AJR. 1986; 146: 361-367
- Arthroscopy of the shoulder.Orthop Clin North Am. 1987; 18: 361-372
Article info
Footnotes
This article was originally published in German inArthroskopie [Springer-Verlag] 1988;1:162-70. Translated into English by Storz Company, Tuttlingen, Germany. Reproduced with permission.
Identification
Copyright
© 1992 Arthroscopy Association of North America. Published by Elsevier Inc.
