Optimizing Visualization in Shoulder Arthroscopy: An Evidence-Based Guide.

J Am Acad Orthop Surg · Nov 15 2024 · Review

Hoffman RA, Green A, Paxton ES

From the Division of Shoulder and Elbow Surgery, Warren Alpert Medical School of Brown University, Providence, RI

Shoulder & Elbow Sports Medicine

SUMMARY — THE REDUCTIONThis evidence-based review examines techniques—positioning, débridement, radiofrequency ablation, epinephrine, tranexamic acid, and hypotensive anesthesia—for improving visualization during shoulder arthroscopy.
Abstract, as published

Advances in arthroscopy have contributed toward improved understanding and management of diverse pathological conditions in the shoulder. As a result, arthroscopy is often preferred by both patients and surgeons. However, surgery can be complicated by limited visualization. Techniques to improve visualization include patient and portal positioning, mechanical débridement, radiofrequency ablation, epinephrine added to irrigation fluid, tranexamic acid administration, and controlled hypotensive anesthesia. Despite published literature on each, a thorough understanding of the evidence supporting these techniques and adjuvants is essential to interpret the clinical utility of each.

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