Shoulder Arthroscopy Presentation v0.4.Pptx

8/9/2019 Shoulder Arthroscopy Presentation v0.4.Pptx

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Arthroscopic Surgery for theShoulder Joint

Team 5

Sam Graham Matthew Ratcliff

Sarah Gadd Andrew Rendall

Sam Wilson Mohammad N.R.Khan



Anatomy of the Shoulder Joint



Anatomy of the Shoulder Joint



Open shoulder surgery

• Repair injuries of shoulder• One or several incisions made

Arthroplasty

• replaces defective joints with implants

• Other techniques can be used to remodel the joint surface

Reverse GeometryTotal Arthroplasty

Hemi Arthroplasty

Types of Shoulder Arthroplasty





Rotator Cuff Repair







Rotator cuff tears

•Previously repaired by open surgery•New techniques being developed withbiological scaffolds

•Cannot address co-existent

glenohumeral pathology

Complications

• No less severe than with open surgery• Revision surgery unsuccessful

• Infection & thromboembolic complications (very rare)



Future Strategies

Improved techniques

•Lower re-tear rates

• Increased number ofsuture anchors

Materials with magnesium

• Biocompatible• Osteoinductive

• Beneficial in titanium implants

• Potential use in Hydroxyapaetite(HA)

Single-row Double-row

FSEM micrographMg-HA

Image adapted from (Zhao et al., 2013)

Images adapted from Arthex.com





Thank you for listening

Are there any questions?



Ghost Slides





Other structures contributing tostability

● Biceps Brachii

● Glenoid Labrum

● Ligaments



Portals for Rotator Cuff SurgeryPortal Uses

Posterior (P) Primary viewing portal

Instrumental access to the articular surface of the infraspinatus and

periglenoid capsuleAnterior (A) View the articular surface of the infraspinatus and posterior capsule

Instrumental access to the periglenoid capsule, supraspinatus and

infraspinatus tendons

Posterior Subacromial (PSA) View entire subacromial space, acromio-clavicular joint and extra-

articular biceps

Instrumental access to the anterior acromion and posterior bursa

Lateral Subacromial (LSA) View and instrument the subacromial space, acromio-clavicular joint and

extra-articular bicepsPosterolateral Subacromial (PLSA) Primary viewing portal for rotator cuff pathology

Lateral Acromial (LA) Primary instrument access to the greater tuberosity of the joint, where

the drill, tap and anchor insertion takes place



Reasons for Open Surgery

• Glenoid & humeral loosening

• Glenoid wear• Instability

• Infection

• Rotator cuff tears

Indications for Shoulder Arthroplasty• Rotator cuff tear arthroplasty• Avascular necrosis

• Post-traumatic arthritis• Severe proximal humeral fractures

• Osteoarthritis & Rheumtoid arthritis

• Avascular necrosis





Manufacturing and Regulations

•Adhere to national regulators using standards such asConformité Européene and ISO (9000, 17853:2011,14283:2004, 13485:2003)

•Clean Room Environment

•Each component is fabricated using a series of processesdue to the precision required



Platelet-rich plasma (PRP)

Bone grafts to repair bone loss

Images adapted from (Tokish et al., 2014)

Antibiotic bone cements

• Reduce infection

• Infection is a common

complication

Future Strategies

http://panamericannewimage.com/our-services-2/the-platelet-rich-plasma-therapy/prp-2/

Shoulder Arthroscopy Presentation v0.4.Pptx

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