Avoiding Complications in Shoulder Arthroscopy: Pearls for Lateral Decubitus and Beach Chair Positioning

Abstract

The beach chair and lateral decubitus positions are both reliable methods to accomplish effective arthroscopic shoulder procedures. The majority of arthroscopic shoulder procedures can be performed in either the beach chair or lateral decubitus position; however, surgeon training, joint positioning, and orientation may favor one position over the other. Regardless of the position, it is absolutely paramount that the patient be positioned carefully, with proper padding, head placement, and appropriately balanced suspension forces to minimize the occurrence of potentially devastating positioning complications. This study reviews common complications associated with the beach chair and lateral decubitus positions and ways in which these complications may be avoided.T he beach chair and lateral decubitus positions are reliable methods to accomplish effective arthroscopic shoulder procedures. The complications associated with each method, and helpful pearls, are discussed below.

Outcomes of Arthroscopic Anterior Shoulder Instability in the Beach Chair Versus Lateral Decubitus Position: A Systematic Review and Meta-Regression Analysis

“…29,[104][105][106][107][108][109][110] The LD position requires the use of a commercially available traction apparatus, which is used to put longitudinal and lateral traction on …”

Pulmonary edema lead by circulation overload following shoulder arthroscopy under general anesthesia with nerve block: an observational study

“…The beach-chair position, requiring less irrigation, has many advantages recommanded by large number of studies. 1.More visual eld: the surgeon will be allowed to easily judge the anatomic structures [20]; 2.A wider range of intraoperative shoulder activity: the shoulder joint will be rotated easily for the lack of traction [21]; 3. Less bleeding: it provides a lower blood pressure and a better exposure; 4.…”

Editorial Commentary: Beach Chair Versus Lateral Decubitus for Arthroscopic Posterior Shoulder Stabilization—Here We Go Again

“…Both the BC and LD positions have proven safe and reliable for the majority of arthroscopic shoulder surgeries, and there are a variety of advantages and disadvantages associated with each. [14][15][16][17][18][19][20][21][22] In the BC position, the shoulder is anatomically oriented, making it easier to teach others and easier to convert to an open procedure if needed. In addition, the BC position may be more ergonomic and comfortable for the surgeon and the assistant.…”