Basics of Shoulder Arthroscopy Part IV: Diagnostic Arthroscopy in the Lateral Decubitus Position

Shoulder arthroscopy is a versatile method for treating a variety of shoulder pathologies in a minimally invasive manner. Typically, it is performed with the patient positioned in a beach-chair or lateral decubitus position with the latter being conventionally preferred for shoulder instability work given the use of traction and creation of a distracted joint. This allows ideal visualization and accessibility of the anterior, inferior, and posterior aspects of the glenoid, labrum, and axillary pouch. Despite the apparent advantages, the lateral decubitus position comes with its own technical challenges. Many of these may stem from surgeon training, experience, and level of familiarity with the positioning and arthroscopic view. This Technical Note demonstrates a reproducible and teachable method for efficient and effective diagnostic shoulder arthroscopy in the lateral decubitus position, along with presenting its associated advantages and disadvantages.