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Patient Positioning for Shoulder Arthroscopy: Beach Chair vs. Lateral Decubitus

Introduction

In shoulder arthroscopy, the surgeon must carefully consider the advantages and disadvantages of the two most prominent patient positions: the beach chair position and the lateral decubitus position.

Beach Chair Position

The beach chair position is a reliable, safe, and effective position for nearly all types of shoulder arthroscopic procedures. It offers an intuitive anatomic view with the advantage of shoulder maneuverability.

Lateral Decubitus Position

The lateral decubitus position is frequently used for arthroscopic rotator cuff repairs and for procedures in which the patient position may need to be changed intraoperatively. It provides improved access to the posterior aspect of the shoulder joint but may also increase the risk of nerve damage.

Clinical Implications

Clinical trials have examined the incidence of hypotension in both the beach chair and lateral decubitus positions, with varying results. Strategies for the management of hypotension in these positions continue to be investigated.

Conclusion

The choice between the beach chair and lateral decubitus positions in shoulder arthroscopy depends on the specific procedure being performed and the individual patient's anatomy. Understanding the advantages and disadvantages of each position allows the surgeon to make an informed decision that optimizes patient outcomes.