Name:
Arthroscopic Management of Distal Clavicle Arthritis + Acromioplasty
Description:
Arthroscopic Management of Distal Clavicle Arthritis + Acromioplasty
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/5371df31-affd-4cad-92f8-c8e01800a07d/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H06M16S
Embed URL:
https://stream.cadmore.media/player/5371df31-affd-4cad-92f8-c8e01800a07d
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/5371df31-affd-4cad-92f8-c8e01800a07d/ARTHROSCOPIC MANAGEMENT OF DISTAL CLAVICLE ARTHRITIS ACROMI.mp4?sv=2019-02-02&sr=c&sig=u0Yj8HVwJ14m71zXDYbDKNywgwnFWOwzXL%2FJZZhuVQQ%3D&st=2024-11-21T17%3A14%3A44Z&se=2024-11-21T19%3A19%3A44Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
Hello, my friends, this is me, Dr. Sergio Rowinski, from ShoulderPlanet, here, from São Paulo, Brazil. In today's video, I'm presenting to you the arthroscopic management in order to do, not only an acromioplasty, but a very well done distal clavicle resection, which is, basically, the Mumford surgery, or the arthroscopic Mumford procedure.
In this video, I'm giving you tips, to look to the AC joint, not only from the lateral portal, but also from the posterior portal, and also from the anterior portal, in order to have different ways of doing a nice distal clavicle resection. So before seeing the video, don't forget to subscribe, anytime you subscribe uou help me too much in the development of this channel, and I hope you'll like the video.
So this is a 45-year-old woman who had a very intense AC degenerative disease in her right shoulder. She tried conservative treatment for about one year, but with absolutely no result. This is her MRI. The AP with a lot of edema in the AC joint. Now we are seeing the sagital image of her MRI, this is the T2 Fat-sat image, where we can see that she also had a type III acromion, and the tendon was really looking good, in spite of all the inflammatory process in the AC joint.
Now we are seeing the axillary image in her MRI, this is a T2 image, too, where we can see that there is some cysts, there are some cysts in the posterior part of the distal clavicle. This is her arthroscopy, the articular video, the biceps was really looking good, and there was some, some fraying in the tendon, but the tendon was really looking good in the articular side,
and now we are seeing the insertion of the postero-superior cuff, and the tendon was really looking good. We would just have to perform a very soft debridement of the articular tendon, as we are doing now, and, after that, we entered in the subacromial space. No we are seeing her subacromial space, lot of bursal tissue, and after the removal of all the bursal tissue, we started to cut the coracoacromial ligament.
Now we're starting to cut the coracoacromial ligament through the lateral portal, first with electrocautery, now with a scissor, and, at this moment, there were some bleeding. This is a very common feature in this part of the surgery. We stopped the bleeding with the electrocautery and finished cutting the ligament with the electrocautery. After that, we switched the portals,
Now we are watching through the lateral portal, We can see a type III acromion, it was looking like in the MRI, and we are performing, through the posterior portal, a standard and formal acromioplasty, and the acromion, now, is becoming very flat, as it should be. And now we are seeing almost the final image of the acromioplasty, and is the final aspect of the acromion after the acromioplasty was performed.
So, for the next step, was to look in the tendon, now we are looking in the bursal side of the tendon, and the tendon was really looking very nice, so we would have nothing to do but the MUMFORD itself. So now we are starting the MUMFORD, I always start the Mumford procedure watching through the lateral portal and, through the anterior portal, I'm starting to cut the distal clavicle, and now I'm creating a new portal and putting a Kirschner wire,
an this Kirschner wire, passing through the AC joint, is going to guide me to put a camera, first through the posterior part of the AC joint. So now we are entering in the posterior part of the AC joint. I'm seeing the clavicle on the left, the acromion on the right. Taking some parts of the capsule with the basket. And I think that this is an important part of the surgery because there is always some remaining bone in the upper part of the distal clavicle.
Now we are taking of the distal clavicle, the antero-superior part of the distal clavicle, with the burr, and, after that part is done, I always like to switch the portals again, now I'm taking the camera of the posterior part of the distal, of the AC joint, and entering in the anterior part of the AC joint through the anterior portal. Now I'm seeing the acromion on the left, the clavicle on the right.
And there is still, as we can see, some bone in the postero superior part of the gland, and it really should be removed, in order to create a very safe interval, and this is what is the MUMFORD surgery is about. And now the surgery is almost finished. I'm taking the rest of the acromion, and this is the final, the final aspect, the anterior view, right shoulder.
We are seeing the subacromial space, very nice, and now we are seeing the final aspect of the AC joint resection. We have a very safe interval that we created in the end of the surgery. So I hope you have liked the video, showing you a lot of tips and tricks, in order to do a very nice distal clavicle resection, arthroscopicaly. And if you have any doubt, please don't hesitate in writing.
I would be delighted to reply you. And don't forget again to subscribe. Until the next video, and never forget Never stop flying. See you, folks. Bye bye.
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