The accessory posterior portal for shoulder arthroscopy: Description of technique and cadaveric study

As the indications for shoulder arthroscopy continue to expand, so too does the need for complete access to the glenohumeral joint. Specific regions o f the joint, including the axillary recess, are often times difficult to ac cess using traditionally described posterior and anterior portals. In this article, we describe a technique for the placement of an accessory posterio r portal into the inferior hemisphere of the glenohumeral joint, effectivel y in the 8 o'clock or 4 o'clock position. To demonstrate the safety and eff ectiveness of this portal, 6 cadaveric specimens were dissected after the p lacement of a standard and accessory posterior portal. The proximity of the posterior portals to the axillary and suprascapular nerves was analyzed. M easurements were made in simulated beach-chair and lateral decubitus positi ons. The authors show that the accessory posterior portal is safe to use an d may prove useful to the surgeon who wishes to gain access to the inferior recesses of the glenohumeral joint.