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

j martin leland m d drmartinleland orthopaedic sports
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= 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


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DrMartinLeland

The True Arthroscopic Subacromial Decompression: 5 Tips in 5 Minutes

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  • 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

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DrMartinLeland

Disclosure

  • J. Martin Leland III, MD

The following conflicts exist:

1.

Consulting: ConMed

2.

Editorial Board: Arthroscopy Journal

3.

Board of Directors: AANA

4.

Research / Educational support - NONE

5.

Royalties and stock options - NONE

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DrMartinLeland

Tip 1

 I ALMOST NEVER do a subacromial

decompression as an ISOLATED procedure

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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

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DrMartinLeland

Subacromial Decompression

The Rise of the Subacromial Decompression!!!

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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

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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

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DrMartinLeland

Tip 2: It’s all about Point of View…

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DrMartinLeland

Partial Acromioplasty

2 options:

 1. Scope in the posterior portal, burr in the

lateral portal

Left Shoulder Lateral Medial Acromion Rotator Cuff

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DrMartinLeland

Partial Acromioplasty

2 options:

 2. ***Cutting Block: scope in the lateral

portal, burr in the posterior portal***

Left Shoulder Anterior Posterior Rotator Cuff

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DrMartinLeland

Subacromial Decompression

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DrMartinLeland

More Tips (in Video)

Tip 3: Start by “Painting the corners” Tip 4: Then go “High and tight” Tip 5: “Cutting Block” ROCKS!

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DrMartinLeland

VIDEO

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DrMartinLeland

Thank You!

: DrMartinLeland

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