Beach chair and lateral shoulder arthroscopic anatomy

Introduction This article details the arthroscopic anatomy of the shoulder in the beach-chair and lateral positions, as well as comparisons between the two positioning options and tips for performing shoulder arthroscopy. Objectives The objectives of this article are to (1) review effective surgical positioning for the lateral decubitus and beach chair positioning for shoulder arthroscopy, (2) review the relevant anatomy for houlder arthroscopy and describe difference in access to the intra-articular and peri-articular anatomy of the shoulder based upon patient positioning, (3) discuss the advantages and disadvanatges of both the lateral decubitus and beach chair positions for shoulder arthroscopy, and (4) learn clinical pearls and pitfalls for performing arthroscopic shoulder procedures in the lateral decubitus and beach chair positions. Methods A narrative literature review was performed to evaluate shoulder arthroscopy in both positions. Relevant literature discussing the advantages and disadvantages of each position was reviewed in addition to clinical pearls, technical consideration, and pitfalls. Results The lateral decubitus position involved applying traction the the extremity, which distracts the glenohumeral joint and provides extra working space to address intra-articular pathology. The beach chair position places the patient in an upright, seated position which more closely resembles normal shoulder posture and alignment. While this position may provide a more limited view of the glenohumeral joint, it allows for easier access to the anterior shoulder and provides a more intuitive arthroscopic view of shoulder anatomy. Conclusions Surgeons may elect to perform arthroscopic shoulder procedures in either the beach chair or lateral decubitus position. Positioning preferences may be dictated by patient, surgeons, or pathology-specific factors. Ensuring appropriate surgical surgical positioning is a key component of safe and effective shoulder arthroscopy.