Beach Chair Versus Lateral Decubitus Surgical Positioning for Arthroscopic Shoulder Stabilization Surgery: What Does The Evidence Say?

Abstract

Purpose of review: The purpose of this review is to compare beach chair (BC) and lateral decubitus (LD) positioning for arthroscopic shoulder stabilization, with an emphasis on the technical considerations, visualization and access, position-specific complications, and clinical outcomes.

Recent findings: Recent cohort studies, systematic reviews, and editorials consistently demonstrate that both beach chair (BC) and lateral decubitus (LD) positioning is safe and effective for arthroscopic shoulder stabilization procedures with comparable rates of recurrent instability, revision surgery, return to sports, and patient-reported outcomes. Reported differences between BC and LD positions are more consistently observed in intraoperative mechanics and workflow than in clinical outcomes. Though patient factors are often the most influential with respect to the outcome of surgery, it remains important to understand any available modifiable factors and how they can influence clinical outcomes. Patient position selection for arthroscopic shoulder stabilization procedures should be guided by surgeon experience, operative team familiarity, patient-specific factors, and the technical demands of the instability pattern being addressed. Future prospective and randomized studies are needed to more definitively evaluate whether surgical positioning independently influences outcomes.