Diagnostic shoulder arthroscopy

Abstract

Shoulder arthroscopy turned, in the last 20 years, in a fundamental diagnostic and treatment tool. Since the first description of subacromial decompression by Ellman (Arthroscopy 3:173-181, 1987), there has been a constant evolution driven by basic science, biomechanics, and engineering that turned possible that nowadays most of the instability, rotator cuff, and part of the articular degenerative problems of the shoulder girdle are treated using arthroscopy. Arthroscopy should be looked as a tool to deal with certain problems. This means that it should be used in the right indication, with the correct technique and taking into account the “state of the art” for the treatment of the pathology. Behind the technical gesture lies the most important part of arthroscopy. The ability of the surgeon to recognize what is not normal, what is a normal variance, if the structural damage observed is the primary cause of the patient complaints, and finally the decisions of the correct way to deal with the problem, allied with a good technique, are altogether the keys of success. In this chapter, we will explain the technical aspects together with the pathologic and clinical relevant issues.