Endo-échographie intra articulaire au cours d’arthroscopie d’épaule : étude anatomique de faisabilité

Background The development of an ultrasound probe that can be used through an arthroscopic portal allows direct access to the deep tissues of the shoulder. These structures are sometimes hardly seen with external ultrasound system and also difficult to analyze under arthroscopy. This intraoperative imaging technique can thus make possible the refine of the diagnosis, the surgical procedure and thus to propose a more adequate therapy. The main objective of the study is to evaluate the feasibility to use an endo-ultrasound probe, to realize images during shoulder arthroscopy on anatomical subjects without causing secondary lesions. The secondary objectives are the detection of rotator cuff tears, tendinous calcification, chondropathies, acromioclavicular arthropathy and labrum lesions. Results We were able to realize ultrasound images of 68% of all the structures of interest. A part of the missing acquisitions is due to the old age of the anatomical subjects (average age 90 years) where structures of interest were no longer present. The secondary objective was partially fulfilled with the detection of total tears of the supraspinatus tendon in 3 shoulders. We have also been able to produce partial rupture images of intra-tendon cleavage. Intra-tendinous calcifications were explored in 1 shoulder. Humeral or glenoid chondropathy were present on all the shoulders under study. Finally, we did not notice lesions induced by the ultrasound probe during our handling on all 6 shoulders. The acquisition time of the images with the endo-ultrasound probe was no more than 20 minutes for each of the shoulders, with an average time of 10 min 15s for shoulders with complete tissue state. Conclusion It was easy and safe to manipulate an endo-ultrasound probe and to acquire ultrasound images of the different glenohumeral or subacromial structures during shoulder arthroscopy. This result opens the way for further explorations using endo-ultrasound devices.