Criteria for assessing the effectiveness of arthroscopic access in the treatment of traumatic anterior instability of the shoulder joint

Abstract

For an objective evaluation of the effectiveness of surgical ap­proach, topographic anatomical criteria are known, which include: the axis of the operating performance, wound depth, angle of surgical performance and operating performance axis tilt, access zone. With the use of technology in arthroscopic treatment of anterior instability of the shoulder joint it was nec­essary to adapt the proposed concepts in open surgery. Objec­tive:to evaluate the performance criteria of arthroscopic ac­cess to treatment of traumatic anterior instability of the shoul­der joint. Methods: We applied Sozon-Yaroshevich method and criteria for evaluating the effectiveness of surgical approach adapted for endoscopy. Results: The authors have changed some concepts that are used for evaluation of the wound in the ab­dominal endoscopic surgery. In particular, the angle of the op­erating performance, the apex of which is the point of setting the endoscopic port and rays — the direction of the instrument determines the possibility of moving the wound instruments and achieve extreme points of accessibility zones. Important for ar­throscopic surgery is the concept of range of motion of the in­strument (extreme possible its position within the port), the ef­fective angle of operational steps (between the extreme positions of the tool by which the execution of the necessary manipula­tions) area accessibility (areas of the bottom of the wound, which can be opened for inspection and manipulation). The concept: an optimal angle of attack, formed a line slope edge instruments and glenoid border when convenient to carry out manipulations to prepare input channel and anchor in articular edge of the blade; the effective accessibility zone (bottom area of the wound where the manipulations performed without restrictions). This scheme calculation of surgical approach. Conclusions: Ar­throscopic method of operation has certain performance stan­dards. Clinical features of pathology determine the different ap­proaches to treatment and improving arthroscopic technique.