Shoulder Arthroscopy

Position

• Beach chair position 60° with the patient positioned laterally to allow access to shoulder
• Prep & drape arm free

Landmarks

• Spine of scapula
• Acromion
• Coracoid process
• Soft spot
  • 2cm inferior & 1 cm medial to posterolateral tip of acromion

Incision

• Posterior
  • Stab incision in soft spot
  • Plane
    • Teres minor
      • Axillary nerve
    • Infraspinatus
      • Suprascapular nerve
• Anterior
  • Plane
    • Pectoralis major
      • Medial & lateral pectoral nerves
    • Deltoid
      • Axillary nerve

Posterior Portal

• Palpate coracoid process
• Insert the trochar & arthroscopic sheath aiming towards coracoid process

Anterior Portal

• Identify rotator interval between
  • Supraspinatus
  • Subscapularis
• Insert long hypodermic needle into interval & incise the skin & capsule under direct vision

Structures

• Biceps tendon
• Supraspinatus
• Inferior recess
• Posterior recess
• Humeral head
• glenoid

Dangers

• Posteriorly
  • Axillary nerve
  • Suprascapular nerve
• Anteriorly
  • Musculocutaneous nerve

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.