nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2023-12-2-282-290nmp-1618Research ArticleПРЕДВАРИТЕЛЬНОЕ СООБЩЕНИЕPRELIMINARY REPORTОпыт эндоскопического транскапсулярного невролиза подмышечного нерваExperience of Endoscopic Transcapsular Axillary Nerve Decompressionhttps://orcid.org/0000-0002-2542-8308БелякЕ. А.BelyakE. A.

Беляк Евгений Александрович - кандидат медицинских наук, врач травматолог-ортопед, отделение травматологии и ортопедии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ»; доцент кафедры травматологии и ортопедии Медицинского института ФГАОУ ВО РУДН.

115516, Москва, ул. Бакинская, д. 26; 117198, Москва, ул. Миклухо-Маклая, д. 6

Evgeny A. Belyak - Candidate of Medical Sciences, Traumatologist-Orthopedist, Department of Traumatology and Orthopedics, V.M. Buyanov Moscow City Clinical Hospital; Associate Professor, Department of Traumatology and Orthopedics, Medical Institute, Peoples’ Friendship University of Russia.

26 Bakinskaya Str., 115516, Moscow; 6 Miklukho-Maklaya Str., 117198, Moscow

belyakevgen@mail.ruhttps://orcid.org/0000-0001-8472-4249АсратянС. А.AsratyanS. A.

Асратян Саркис Альбертович - кандидат медицинских наук, врач нейрохирург, заместитель главного врача по хирургии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ».

115516, Москва, ул. Бакинская, д. 26

Sarkis A. Asratyan - Candidate of Medical Sciences, Neurosurgeon, Deputy Chief Physician for Surgery, V.M. Buyanov Moscow City Clinical Hospital.

26 Bakinskaya Str., 115516, Moscow

dr.sako@mail.ruhttps://orcid.org/0000-0001-6346-824XЛазкоМ. Ф.LazkoM. F.

Лазко Максим Фёдорович - врач травматолог-ортопед, отделение травматологии и ортопедии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ»; ассистент кафедры Медицинского института ФГАОУ ВО РУДН.

115516, Москва, ул. Бакинская, д. 26; 117198, Москва, ул. Миклухо-Маклая, д. 6

Maxim F. Lazko - Traumatologist-Orthopedist, Department of Traumatology and Orthopedics, V.M. Buyanov Moscow City Clinical Hospital; Assistant, Medical Institute, Peoples’ Friendship University of Russia.

26 Bakinskaya Str., 115516, Moscow; 6 Miklukho-Maklaya Str., 117198, Moscow

maxim_lazko@mail.ruhttps://orcid.org/0000-0001-5292-7930ЛазкоФ. Л.LazkoF. L.

Лазко Фёдор Леонидович - доктор медицинских наук, врач травматолог-ортопед, отделение травматологии и ортопедии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ»; профессор кафедры травматологии и ортопедии Медицинского института ФГАОУ ВО РУДН.

115516, Москва, ул. Бакинская, д. 26; 117198, Москва, ул. Миклухо-Маклая, д. 6

Fedor L. Lazko - Doctor of Medical Sciences, Traumatologist-Orthopedist, Department of Traumatology and Orthopedics, V.M. Buyanov Moscow City Clinical Hospital; Professor, Department of Traumatology and Orthopedics, Medical Institute, Peoples’ Friendship University of Russia.

26 Bakinskaya Str., 115516, Moscow; 6 Miklukho-Maklaya Str., 117198, Moscow

fedor_lazko@mail.ruhttps://orcid.org/0000-0003-3915-7796ПасхинД. Л.PaskhinD. L.

Пасхин Дмитрий Львович - врач нейрохирург, отделение нейрохирургии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ».

115516, Москва, ул. Бакинская, д. 26

Dmitry L. Paskhin - Neurosurgeon, Department of Neurosurgery, V.M. Buyanov Moscow City Clinical Hospital.

26 Bakinskaya Str., 115516, Moscow

yas-moe@mail.ruhttps://orcid.org/0000-0003-3092-9753ПризовА. П.PrizovA. P.

Призов Алексей Петрович - кандидат медицинских наук, врач травматолог-ортопед, отделение травматологии и ортопедии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ»; доцент кафедры травматологии и ортопедии Медицинского института ФГАОУ ВО РУДН.

115516, Москва, ул. Бакинская, д. 26; 117198, Москва, ул. Миклухо-Маклая, д. 6

Alexey P. Prizov - Candidate of Medical Sciences, Traumatologist-Orthopedist, Department of Traumatology and Orthopedics, V.M. Buyanov Moscow City Clinical Hospital; Associate Professor, Department of Traumatology and Orthopedics, Medical Institute, Peoples’ Friendship University of Russia.

26 Bakinskaya Str., 115516, Moscow; 6 Miklukho-Maklaya Str., 117198, Moscow

aprizov@yandex.ruhttps://orcid.org/0000-0002-2433-4027СмирновД. С.SmirnovD. S.

Смирнов Даниил Сергеевич - кандидат медицинских наук, врач-нейрохирург, отделение нейрохирургии, ГБУЗ «ГКБ им. В.М. Буянова ДЗМ».

115516, Москва, ул. Бакинская, д. 26

Daniil S. Smirnov - Candidate of Medical Sciences, Neurosurgeon, Department of Neurosurgery, V.M. Buyanov Moscow City Clinical Hospital.

26 Bakinskaya Str., 115516, Moscow

dan.smirnov@mail.ruГБУЗ «Городская клиническая больница им. В.М. Буянова» ДЗМ; ФГАОУ ВО «Российский университет дружбы народов»РоссияV.M. Buyanov Moscow City Clinical Hospital; Peoples’ Friendship University of RussiaRussian FederationГБУЗ «Городская клиническая больница им. В.М. Буянова» ДЗМРоссияV.M. Buyanov Moscow City Clinical HospitalRussian Federation202329072023122282290Copyright © Беляк Е.А., Асратян С.А., Лазко М.Ф., Лазко Ф.Л., Пасхин Д.Л., Призов А.П., Смирнов Д.С., 20232023Беляк Е.А., Асратян С.А., Лазко М.Ф., Лазко Ф.Л., Пасхин Д.Л., Призов А.П., Смирнов Д.С.Belyak E.A., Asratyan S.A., Lazko M.F., Lazko F.L., Paskhin D.L., Prizov A.P., Smirnov D.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/1618

АКТУАЛЬНОСТЬ Посттравматическая нейропатия подмышечного нерва является достаточно распространенной патологией при травмах области плечевого сустава. Стандартным вмешательством в таких случаях является открытый невролиз подмышечного нерва, который в силу анатомического расположения нервного ствола травматичен, сопровождается относительно высокой частотой осложнений, обладает плохим косметическим эффектом. Малоинвазивной альтернативой открытому невролизу является эндоскопическая хирургическая техника.

ЦЕЛЬ Улучшить результаты лечения пациентов с посттравматической нейропатией подмышечного нерва.

МАТЕРИАЛ И МЕТОДЫ За период с 2018 по 2021 год нами были прооперированы 5 пациентов с клинической картиной посттравматической нейропатии подмышечного нерва. Всем больным была выполнена артроскопия плечевого сустава с диагностическим и лечебным компонентами, транскапсулярный эндоскопический невролиз подмышечного нерва по оригинальной методике. Статистическое сравнение параметров проводилось согласно критерию Манна–Уитни.

РЕЗУЛЬТАТЫ Средний возраст пациентов составил 44,4±14,9 года. По шкале ВАШ интенсивность болевого синдрома до операции составила 7±1 балл, через 6 месяцев после операции боль уменьшилась и составила в среднем 1±0,4 балла (p<0,05). По шкале DASH функция плечевого сустава до операции была 77,6±6,9 балла, через 6 месяцев после операции составила 12±5,2 балла (p<0,05). По шкале BMRC (M0–M5) сила дельтовидной мышцы до операции составляла 2±0,4 балла, а после операции увеличилась до 4,6±0,5 балла (p<0,05). Амплитуда движений в плечевом суставе до операции: сгибание 107±45,6°, отведение 102±49°, наружная ротация 22±13,6°, через 6 месяцев после операции возросла до: сгибание 154±25,6°, отведение 156±22,4°, наружная ротация 50±8° (p<0,05). Толщина среднего пучка дельтовидной мышцы, по данным ультразвукового исследования, до операции составила в среднем 7±0,8 мм, через 6 месяцев после операции 10,6±1,1 мм (p<0,05).

ЗАКЛЮЧЕНИЕ Полученные результаты позволяют охарактеризовать методику эндоскопического невролиза как воспроизводимую, малотравматичную и эффективную, которая позволяет уменьшить интенсивность болевого синдрома и способствует раннему восстановлению функции верхней конечности.

INTRODUCTION Posttraumatic axillary nerve neuropathy is a widely spread pathology, more often seen after shoulder joint trauma. It can also occur as a complication after orthopaedic surgeries, for example, after Latarjet procedure for shoulder stabilization. The technique of open axillary nerve decompression is very popular but has a number of disadvantages: large trauma of soft tissue, severe bleeding, high rate of complications, poor cosmetic effect. Endoscopic surgical technique of decompression is an effective, less traumatic alternative to open procedures.

AIM To improve the outcomes of treatment of patients with axillary nerve neuropathy.

MATERIAL AND METHODS We present the outcomes of endoscopic transcapsular axillary nerve decompression in 5 patients with a clinical picture of neuropathic pain syndrome, hypoesthesia in the deltoid area, hypotrophy of the deltoid muscle, who were operated from 2018 to 2021. The mean age of the patients was 44.4±14.9. An original surgical technique of decompression, which included arthroscopy of the shoulder joint with diagnostic and treatment components and transcapsular endoscopic axillary nerve decompression in the beach-chair position, was developed and applied to all the patients. Statistical analysis was performed using the MannWhitney U test.

RESULTS According to VAS-scale, the severity of pain syndrome before the surgery was 6±4.6 points, 6 months after surgery it decreased to 1.4±0.5 points (p<0.05). According to DASH scale, the function of the of shoulder joint before surgery was 77,6±6,9 points, 6 months after surgery it increased to 12±5,2 points (p<0.05). According to BMRC scale (M0–M5), strength of the deltoid muscle before surgery was 2±0,4 points, after surgery it increased to 4,4±0,5 points (p<0.05). Range of motion in the shoulder joint before surgery was as follows: flexion 107±45,6°, extension 102±49°, external rotation 22±13,6°; 6 months after surgery: flexion 154±25,6°, extension 156±22,4°, external rotation 50±8° (p<0,05). The thickness of the middle portion of the deltoid muscle according to ultrasound examination before the surgery was 7.2±1.04 mm, after surgery 11.8±1.44 mm (p<0.05). All the patients (100%) during long follow-up noticed complete relief of pain and regression of neurological symptoms.

CONCLUSION The achieved results allow us to characterize the method of endoscopic transcapsular decompression as a reproducible, minimally invasive and highly effective technique providing pain relief to patients, curing neurological and intraarticular pathology, thus promoting early restoration of the upper limb function in the treated group of patients.

подмышечный нервэндоскопический невролизнейропатиянейропатический болевой синдромартроскопия плечевого суставаaxillary nerveendoscopic decompressionneuropathyneuropathic pain syndromeshoulder arthroscopyReferencesSharp E, Roberts M, Żurada-Zielińska A, Zurada A, Gielecki J, Tubbs RS, Loukas M. The most commonly injured nerves at surgery: A comprehensive review. Clin Anat. 2021;34(2):244–262. PMID: 33090551 https://doi.org/10.1002/ca.23696Sharp E, Roberts M, Żurada-Zielińska A, Zurada A, Gielecki J, Tubbs RS, Loukas M. The most commonly injured nerves at surgery: A comprehensive review. Clin Anat. 2021;34(2):244–262. PMID: 33090551 https://doi.org/10.1002/ca.23696Avis D, Power D. Axillary nerve injury associated with glenohumeral dislocation: A review and algorithm for management. EFORT Open Rev. 2018;3(3):70–77. PMID: 29657847 https://doi.org/10.1302/2058-5241.3.170003Avis D, Power D. Axillary nerve injury associated with glenohumeral dislocation: A review and algorithm for management. EFORT Open Rev. 2018;3(3):70–77. PMID: 29657847 https://doi.org/10.1302/2058-5241.3.170003Griesser MJ, Harris JD, McCoy BW, Hussain WM, Jones MH, Bishop JY, et al. Complications and re-operations after Bristow-Latarjet shoulder stabilization: a systematic review. J Shoulder Elbow Surg. 2013;22(2):286–292. PMID: 23352473 https://doi.org/10.1016/j.jse.2012.09.009Griesser MJ, Harris JD, McCoy BW, Hussain WM, Jones MH, Bishop JY, et al. Complications and re-operations after Bristow-Latarjet shoulder stabilization: a systematic review. J Shoulder Elbow Surg. 2013;22(2):286–292. PMID: 23352473 https://doi.org/10.1016/j.jse.2012.09.009Bohsali KI, Wirth MA, Rockwood CA Jr. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(10):2279–2292. PMID: 17015609 https://doi.org/10.2106/JBJS.F.00125Bohsali KI, Wirth MA, Rockwood CA Jr. Complications of total shoulder arthroplasty. J Bone Joint Surg Am. 2006;88(10):2279–2292. PMID: 17015609 https://doi.org/10.2106/JBJS.F.00125Patel MS, Wilent WB, Gutman MJ, Abboud JA. Incidence of peripheral nerve injury in revision total shoulder arthroplasty: an intraoperative nerve monitoring study. J Shoulder Elbow Surg. 2021;30(7):1603–1612. PMID: 33096272 https://doi.org/10.1016/j.jse.2020.09.024Patel MS, Wilent WB, Gutman MJ, Abboud JA. Incidence of peripheral nerve injury in revision total shoulder arthroplasty: an intraoperative nerve monitoring study. J Shoulder Elbow Surg. 2021;30(7):1603–1612. PMID: 33096272 https://doi.org/10.1016/j.jse.2020.09.024Doi K, Muramatsu K, Hattori Y, Otsuka K, Tan SH, Nanda V, et al. Restoration of prehension with the double free muscle technique following complete avulsion of the brachial plexus. Indications and longterm results. J Bone Joint Surg Am. 2000;82(5):652–666. PMID: 10819276Doi K, Muramatsu K, Hattori Y, Otsuka K, Tan SH, Nanda V, et al. Restoration of prehension with the double free muscle technique following complete avulsion of the brachial plexus. Indications and longterm results. J Bone Joint Surg Am. 2000;82(5):652–666. PMID: 10819276Skedros JG, Henrie TR, Peterson MD. Rotator cuff tear following long-standing axillary neuropathy in a female motocross racer. BMJ Case Rep. 2018;2018:bcr2017223692. PMID: 29909385 https://doi.org/10.1136/bcr-2017-223692Skedros JG, Henrie TR, Peterson MD. Rotator cuff tear following long-standing axillary neuropathy in a female motocross racer. BMJ Case Rep. 2018;2018:bcr2017223692. PMID: 29909385 https://doi.org/10.1136/bcr-2017-223692Кугуракова Г.М., Волкова К.М., Аблизен С.И. Опыт лечения больных нейропатией лицевого нерва в условиях отделения восстановительного лечения. Здравоохранение Чувашии. 2013;(1):61–64.Kugurakova GM, Volkova KM, Ablizen SI. Opyt lecheniya bol’nykh neyropatiey litsevogo nerva v usloviyakh otdeleniya vosstanovitel’nogo lecheniya. Zdravookhranenie Chuvashii. 2013;(1):61–64. (In Russ.)Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009;61(5):623–632. PMID: 19405008 https://doi.org/10.1002/art.24396Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009;61(5):623–632. PMID: 19405008 https://doi.org/10.1002/art.24396Aids to the examination of the peripheral nervous system. 4-th edition. London: Elsevier Saunders; 2000.Aids to the examination of the peripheral nervous system. 4-th edition. London: Elsevier Saunders; 2000.Reed MD, Van Nostran W. Assessing pain intensity with the visual analog scale: a plea for uniformity. J Clin Pharmacol. 2014;54(3):241–234. https://doi.org/10.1002/jcph.250 PMID: 24374753Reed MD, Van Nostran W. Assessing pain intensity with the visual analog scale: a plea for uniformity. J Clin Pharmacol. 2014;54(3):241–234. https://doi.org/10.1002/jcph.250 PMID: 24374753Erçakmak B, Günenç Beşer C, Özsoy MH, Demiryürek MD, Bayramoğlu A, Hayran KM. Soft spot: the important zone at the standard posterior portal of shoulder arthroscopy. Turk J Med Sci. 2018;48(1):89–92. PMID: 29479963 https://doi.org/10.3906/sag-1708-54Erçakmak B, Günenç Beşer C, Özsoy MH, Demiryürek MD, Bayramoğlu A, Hayran KM. Soft spot: the important zone at the standard posterior portal of shoulder arthroscopy. Turk J Med Sci. 2018;48(1):89–92. PMID: 29479963 https://doi.org/10.3906/sag-1708-54Лазко М.Ф., Маглаперидзе И.Г., Лазко Ф.Л., Призов А.П., Беляк Е.А. Эффективность применения субакромиального баллона INSPACE в лечении пациентов с большими и массивными повреждениями вращательной манжеты плеча. Медицинские новости Грузии (Georgian Medical News). 2021;315(6):33–39.Lazko MF, Maglaperidze IG, Lazko FL, Prizov AP, Belyak EA. Effektivnost’ primeneniya subakromial’nogo ballona INSPACE v lechenii patsientov s bol’shimi i massivnymi povrezhdeniyami vrashchatel’noy manzhety plecha. Georgian Medical News. 2021;315(6):33–39. (In Russ.)Lee S, Saetia K, Saha S, Kline DG, Kim DH. Axillary nerve injury associated with sports. Neurosurg Focus. 2011;31(5):E10. PMID: 22044099 https://doi.org/10.3171/2011.8.FOCUS11183Lee S, Saetia K, Saha S, Kline DG, Kim DH. Axillary nerve injury associated with sports. Neurosurg Focus. 2011;31(5):E10. PMID: 22044099 https://doi.org/10.3171/2011.8.FOCUS11183Kline DG, Kim DH. Axillary nerve repair in 99 patients with 101 stretch injuries. J Neurosurg. 2003;99(4):630–636. PMID: 14567596 https://doi.org/10.3171/jns.2003.99.4.0630Kline DG, Kim DH. Axillary nerve repair in 99 patients with 101 stretch injuries. J Neurosurg. 2003;99(4):630–636. PMID: 14567596 https://doi.org/10.3171/jns.2003.99.4.0630Gutkowska O, Martynkiewicz J, Mizia S, Bąk M, Gosk J. Results of Operative Treatment of Brachial Plexus Injury Resulting from Shoulder Dislocation: A Study with A Long-Term Follow-Up. World Neurosurg. 2017;105:623–631. PMID: 28624567 https://doi.org/10.1016/j.wneu.2017.06.059Gutkowska O, Martynkiewicz J, Mizia S, Bąk M, Gosk J. Results of Operative Treatment of Brachial Plexus Injury Resulting from Shoulder Dislocation: A Study with A Long-Term Follow-Up. World Neurosurg. 2017;105:623–631. PMID: 28624567 https://doi.org/10.1016/j.wneu.2017.06.059Guerra WK, Baldauf J, Schroeder HW. Long-term results after microsurgical repair of traumatic nerve lesions of the upper extremities. Zentralbl Neurochir. 2007;68(4):195–199. PMID: 17968781 https://doi.org/10.1055/s-2007-985859Guerra WK, Baldauf J, Schroeder HW. Long-term results after microsurgical repair of traumatic nerve lesions of the upper extremities. Zentralbl Neurochir. 2007;68(4):195–199. PMID: 17968781 https://doi.org/10.1055/s-2007-985859Chen WA, Schippert DW, Daws SB, Koman LA, Li Z. Surgical Algorithm and Results of Isolated Traumatic Axillary Nerve Injuries. J Reconstr Microsurg. 2016;32(3):208–14. PMID: 26473794 https://doi.org/10.1055/s-0035-1565250Chen WA, Schippert DW, Daws SB, Koman LA, Li Z. Surgical Algorithm and Results of Isolated Traumatic Axillary Nerve Injuries. J Reconstr Microsurg. 2016;32(3):208–14. PMID: 26473794 https://doi.org/10.1055/s-0035-1565250Buchanan PJ, Chieng LO, Hubbard ZS, Law TY, Chim H. Endoscopic versus Open in Situ Cubital Tunnel Release: A Systematic Review of the Literature and Meta-Analysis of 655 Patients. Plast Reconstr Surg. 2018;141(3):679–684. PMID: 29481399 https://doi.org/10.1097/PRS.0000000000004112Buchanan PJ, Chieng LO, Hubbard ZS, Law TY, Chim H. Endoscopic versus Open in Situ Cubital Tunnel Release: A Systematic Review of the Literature and Meta-Analysis of 655 Patients. Plast Reconstr Surg. 2018;141(3):679–684. PMID: 29481399 https://doi.org/10.1097/PRS.0000000000004112Vasiliadis HS, Nikolakopoulou A, Shrier I, Lunn MP, Brassington R, Scholten RJ, et al. Endoscopic and Open Release Similarly Safe for the Treatment of Carpal Tunnel Syndrome. A Systematic Review and Meta-Analysis. PLoS One. 2015;10(12):e0143683. PMID: 26674211 https://doi.org/10.1371/journal.pone.0143683Vasiliadis HS, Nikolakopoulou A, Shrier I, Lunn MP, Brassington R, Scholten RJ, et al. Endoscopic and Open Release Similarly Safe for the Treatment of Carpal Tunnel Syndrome. A Systematic Review and Meta-Analysis. PLoS One. 2015;10(12):e0143683. PMID: 26674211 https://doi.org/10.1371/journal.pone.0143683Aldekhayel S, Govshievich A, Lee J, Tahiri Y, Luc M. Endoscopic Versus Open Cubital Tunnel Release: A Systematic Review and Meta-Analysis. Hand (N Y). 2016;11(1):36–44. PMID: 27418887 https://doi.org/10.1177/1558944715616097Aldekhayel S, Govshievich A, Lee J, Tahiri Y, Luc M. Endoscopic Versus Open Cubital Tunnel Release: A Systematic Review and Meta-Analysis. Hand (N Y). 2016;11(1):36-44. PMID: 27418887 https://doi.org/10.1177/1558944715616097Millett PJ, Gaskill TR. Arthroscopic trans-capsular axillary nerve decompression: indication and surgical technique. Arthroscopy. 2011;27(10):1444–1448. PMID: 21831569 https://doi.org/10.1016/j.arthro.2011.05.003Millett PJ, Gaskill TR. Arthroscopic trans-capsular axillary nerve decompression: indication and surgical technique. Arthroscopy. 2011;27(10):1444–1448. PMID: 21831569 https://doi.org/10.1016/j.arthro.2011.05.003Borrel F, Desmoineaux P, Delcourt T, Pujol N. Feasibility of arthroscopic decompression of the axillary nerve in the quadrilateral space: Cadaver study. Orthop Traumatol Surg Res. 2021;107(1):102762. PMID: 33333278 https://doi.org/10.1016/j.otsr.2020.102762Borrel F, Desmoineaux P, Delcourt T, Pujol N. Feasibility of arthroscopic decompression of the axillary nerve in the quadrilateral space: Cadaver study. Orthop Traumatol Surg Res. 2021;107(1):102762. PMID: 33333278 https://doi.org/10.1016/j.otsr.2020.102762Mook WR, Petri M, Greenspoon JA, Millett PJ. The Comprehensive Arthroscopic Management Procedure for Treatment of Glenohumeral Osteoarthritis. Arthrosc Tech. 2015;4(5):e435–441. PMID: 26697301 https://doi.org/10.1016/j.eats.2015.04.003Mook WR, Petri M, Greenspoon JA, Millett PJ. The Comprehensive Arthroscopic Management Procedure for Treatment of Glenohumeral Osteoarthritis. Arthrosc Tech. 2015;4(5):e435–441. PMID: 26697301 https://doi.org/10.1016/j.eats.2015.04.003Millett PJ, Horan MP, Pennock AT, Rios D. Comprehensive Arthroscopic Management (CAM) procedure: clinical results of a joint-preserving arthroscopic treatment for young, active patients with advanced shoulder osteoarthritis. Arthroscopy. 2013;29(3):440–448. PMID: 23544687 https://doi.org/10.1016/j.arthro.2012.10.028Millett PJ, Horan MP, Pennock AT, Rios D. Comprehensive Arthroscopic Management (CAM) procedure: clinical results of a joint-preserving arthroscopic treatment for young, active patients with advanced shoulder osteoarthritis. Arthroscopy. 2013;29(3):440–448. PMID: 23544687 https://doi.org/10.1016/j.arthro.2012.10.028Tao MA, Karas V, Riboh JC, Laver L, Garrigues GE. Management of the Stiff Shoulder with Arthroscopic Circumferential Capsulotomy and Axillary Nerve Release. Arthrosc Tech. 2017;6(2):e319–e324. PMID: 28580248 https://doi.org/10.1016/j.eats.2016.10.005Tao MA, Karas V, Riboh JC, Laver L, Garrigues GE. Management of the Stiff Shoulder with Arthroscopic Circumferential Capsulotomy and Axillary Nerve Release. Arthrosc Tech. 2017;6(2):e319–e324. PMID: 28580248 https://doi.org/10.1016/j.eats.2016.10.005

The authors declare that there are no conflicts of interest present.