APEX Foundations in Arthroscopy Basic Lectures-Decompression & AC Joint

Video Transcription

Video Summary

Dr. Mary Mulcahy, a sports medicine surgeon, discusses subacromial arthroscopy with a focus on acromioplasty and distal clavicle excision. She reviews patient positioning (lateral decubitus or beach chair) and key portals for accessing the subacromial space, emphasizing careful portal placement to avoid nerve injury. The subacromial space assessment includes evaluating the bursa, CA ligament, acromion morphology (types 1–3), and rotator cuff. Acromioplasty aims to convert curved or hooked acromions (types 2 or 3) to flat (type 1) to relieve impingement by smoothing the undersurface. Techniques include lateral and posterior approaches using motorized shavers and burrs, with cautions to avoid over-resection and rotator cuff damage. Distal clavicle excision is reserved for symptomatic AC joint arthritis, with attention to preserving ligament integrity. Decisions on decompression and excision are individualized, balancing space improvement and tissue preservation to optimize rotator cuff function and reduce complications.

Asset Caption

Dr. Mary Mulcahey

Keywords

subacromial arthroscopy

acromioplasty

distal clavicle excision

rotator cuff

patient positioning