Anterior portal selection for shoulder arthroscopy.

Area of Science:

• Orthopedic Surgery
• Arthroscopy Techniques
• Surgical Anatomy

Background:

• The posterior portal is standard for shoulder arthroscopy, but accessory portal placement lacks clear guidelines.
• Thick shoulder musculature and nearby neurovascular structures pose risks during instrument insertion.
• Safer, reproducible accessory portal selection is needed to minimize surgical complications.

Purpose of the Study:

• To establish anatomical guidelines for safe accessory anterior portal placement in shoulder arthroscopy.
• To identify a reliable intraarticular landmark for accessory portal insertion.
• To reduce the risk of iatrogenic injury to neurovascular structures during the procedure.

Main Methods:

• Anatomical dissections were performed on 20 cadaver shoulders.
• The
• intraarticular triangle
• (humeral head, glenoid rim, biceps tendon) was used as a landmark.
• Clinical validation involved 30 shoulder arthroscopies using the identified landmark.

Main Results:

• The intraarticular triangle proved to be an excellent landmark for accessory anterior portal placement.
• Cadaver dissections showed minimal risk to adjacent neurovascular structures when using this portal.
• Clinical cases confirmed the safety and utility of this anterior portal location.

Conclusions:

• The intraarticular triangle provides a safe and reproducible landmark for accessory anterior portals in shoulder arthroscopy.
• This technique can help minimize the risk of neurovascular injury during shoulder arthroscopic procedures.
• Adherence to proper precautions is essential for optimal outcomes when using this portal placement strategy.