Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Oct 11;7(2):46-55.
doi: 10.1055/s-0039-1697606. eCollection 2019 Jun.

Patient Positioning in Shoulder Arthroscopy: Which is Best?

Jorge Rojas  1 , Filippo Familiari  2 , Alexander Bitzer  1 , Uma Srikumaran  1 , Rocco Papalia  3 , Edward G McFarland  1
Affiliations
Review

Patient Positioning in Shoulder Arthroscopy: Which is Best?

Jorge Rojas et al. Joints. .

Abstract

When performing diagnostic and surgical arthroscopic procedures on the shoulder, the importance of patient positioning cannot be understated. The optimum patient positioning for shoulder arthroscopy should enhance intraoperative joint visualization and surgical accessibility while minimizing potential perioperative risk to the patient. Most shoulder arthroscopy procedures can be reliably performed with the patient either in the lateral decubitus (LD) or beach chair (BC) position. Although patient positioning for shoulder arthroscopy has been subject of controversy, there is no conclusive evidence to suggest superiority of one position versus another. Each position offers advantages and disadvantages and surgeon's experience and training are pivotal on selecting one position versus another. Regardless of the position, a proper positioning of the patient should provide adequate access to the joint while minimizing complications. The purpose of this review is to summarize setup and technical aspects, the advantages and disadvantages, and the possible complications of the LD and BC positions in shoulder arthroscopy.

Keywords: arthroscopy; beach chair; complications; lateral decubitus; neuropraxia; positioning; shoulder; stroke.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Patient prepared and draped for shoulder arthroscopy in the lateral decubitus position.
Fig. 2
Fig. 2
Modified lateral position places shoulder joint in a horizontal plane (Reproduced with permission from Gross and Fitzgibbons 10 ).
Fig. 3
Fig. 3
Arm-positioner devices (e.g., Spider Limb Positioner, Smith and Nephew, Andover, Massachusetts, United States) may be either used for the lateral decubitus or beach chair position.
Fig. 4
Fig. 4
Patient in the beach chair position in a less upright position (30 degree).
See this image and copyright information in PMC

References

    1. Li X, Eichinger J K, Hartshorn T, Zhou H, Matzkin E G, Warner J P. A comparison of the lateral decubitus and beach-chair positions for shoulder surgery: advantages and complications. J Am Acad Orthop Surg. 2015;23(01):18–28. - PubMed
    1. Association of Surgical Technologists.Guidelines for Surgical PositioningAvailable at:http://www.ast.org. Accessed September 1, 2019
    1. Peruto C M, Ciccotti M G, Cohen S B. Shoulder arthroscopy positioning: lateral decubitus versus beach chair. Arthroscopy. 2009;25(08):891–896. - PubMed
    1. Rains D D, Rooke G A, Wahl C J. Pathomechanisms and complications related to patient positioning and anesthesia during shoulder arthroscopy. Arthroscopy. 2011;27(04):532–541. - PubMed
    1. Hamamoto J T, Frank R M, Higgins J D, Provencher M T, Romeo A A, Verma N N. Shoulder arthroscopy in the lateral decubitus position. Arthrosc Tech. 2017;6(04):e1169–e1175. - PMC - PubMed