= J. Martin Leland, M.D. @DrMartinLeland Orthopaedic Sports - PowerPoint PPT Presentation

The True Arthroscopic Subacromial Decompression: 5 Tips in 5 Minutes = J. Martin Leland, M.D. @DrMartinLeland Orthopaedic Sports Surgeon & Medical Director of Sports Medicine University Hospitals Geauga Medical Center, Cleveland, OH Associate Editor, Arthroscopy Journal Board of Directors, AANA DrMartinLeland

Disclosure J. Martin Leland III, MD The following conflicts exist: Consulting: ConMed 1. Editorial Board: Arthroscopy Journal 2. Board of Directors: AANA 3. Research / Educational support - NONE 4. Royalties and stock options - NONE 5. DrMartinLeland

Tip 1  I ALMOST NEVER do a subacromial decompression as an ISOLATED procedure DrMartinLeland

Subacromial Decompression  1949: Armstrong – compression of RC tendon under acromion  pain / tears  1972: Neer – cuff tears caused by mechanical impingement of acromion  1986: Bigliani – classified acromial morphology DrMartinLeland

Subacromial Decompression The Rise of the Subacromial Decompression!!! DrMartinLeland

Subacromial Decompression  Nirschl: Suspicious of subacromial decompressions – Rotator cuff pathology caused by INTRINSIC factors in the tissue itself – Has shown results of partial rotator cuff debridement WITHOUT subacromial decompression: – 89% good to excellent results at 2-5 years – 81% good to excellent results at 5+ years DrMartinLeland

Subacromial Symptoms?  Young patients – Scapular dyskinesis – Instability (including MDI) – Labral tears  Older patients – Partial rotator cuff tears  don’t overlook superior subscap. tears – Biceps pathology DrMartinLeland

Tip 2: It’s all about Point of View… DrMartinLeland

Partial Acromioplasty 2 options:  1. Scope in the posterior portal, burr in the lateral portal Left Shoulder Acromion Lateral Medial Rotator Cuff DrMartinLeland

Partial Acromioplasty 2 options:  2. *** Cutting Block: scope in the lateral portal, burr in the posterior portal*** Left Shoulder Anterior Posterior Rotator Cuff DrMartinLeland

Subacromial Decompression DrMartinLeland

More Tips (in Video)  Tip 3: Start by “Painting the corners”  Tip 4: Then go “High and tight”  Tip 5: “Cutting Block” ROCKS! DrMartinLeland

VIDEO DrMartinLeland

14 Thank You! & : DrMartinLeland DrMartinLeland