Feasibility of Shoulder Joint Visualization Using the 0° Arthrex NanoScope: A Cadaveric Study on Twenty Specimens

Feasibility of Shoulder Joint Visualization Using the 0° Arthrex NanoScope: A Cadaveric Study on Twenty Specimens | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Feasibility of Shoulder Joint Visualization Using the 0° Arthrex NanoScope: A Cadaveric Study on Twenty Specimens Jędrzej Lesman, Błażej Wójtowicz, Łukasz Gołek, Michał Szufnara, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8099934/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Purpose Nanoscopic technology is increasingly employed in minimally invasive orthopedic procedures, offering enhanced access to tight compartments with reduced soft-tissue disruption. This study assessed the feasibility of visualizing key anatomical structures of the shoulder joint using a 0° nanoscope in cadaveric specimens. Methods Twenty fresh-frozen human cadaveric shoulders (10 left, 10 right) were examined by two orthopedic surgeons with different experience levels using a 1.9-mm 0° nanoscope. Standard posterior, anterior, and lateral portals were used to assess glenohumeral and subacromial compartments. Predefined landmarks were graded on a 5-point Likert scale. The primary outcome was feasibility of identifying each structure; secondary outcomes included mean visibility scores and inter-observer variability. Results All predefined landmarks were identified in all 20 specimens. The senior surgeon reported an overall mean visibility score of 4.45 (SD ± 0.18), and the resident 4.18 (SD ± 0.21). Highest scores were observed for the long head of the biceps tendon and superior labrum. Lower scores occurred in the subacromial space, particularly in bursal-side rotator cuff assessment, reflecting challenges inherent to the 0° field of view. Inter-observer agreement was good (mean differences ≤ 0.3). Conclusion Nanoscopic visualization of the shoulder using a 0° device is feasible and yields high visibility scores for most landmarks. Surgeon experience may influence interpretation in anatomically complex regions such as the subacromial space. These findings support a potential diagnostic and adjunctive therapeutic role for shoulder nanoscopy. Level of Evidence Descriptive laboratory study—Level VI. nanoscopy needle arthroscopy shoulder subacromial space minimally invasive Full Text Additional Declarations No competing interests reported. Table 1 is available in the Supplementary Files section. Supplementary Files Tabela1kadawery.odt Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 14 Dec, 2025 Reviewers agreed at journal 08 Dec, 2025 Reviewers agreed at journal 07 Dec, 2025 Reviewers agreed at journal 03 Dec, 2025 Reviewers invited by journal 02 Dec, 2025 Editor assigned by journal 20 Nov, 2025 Submission checks completed at journal 17 Nov, 2025 First submitted to journal 16 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8099934","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":554831461,"identity":"66bf36a2-8c5f-408f-80dc-9077b3d9f9ea","order_by":0,"name":"Jędrzej 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Specimens","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-orthopaedic-surgery-and-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"josr","sideBox":"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)","snPcode":"13018","submissionUrl":"https://submission.nature.com/new-submission/13018/3","title":"Journal of Orthopaedic Surgery and Research","twitterHandle":"@MSKmedBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"nanoscopy, needle arthroscopy, shoulder, subacromial space, minimally invasive","lastPublishedDoi":"10.21203/rs.3.rs-8099934/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8099934/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e\u003cp\u003eNanoscopic technology is increasingly employed in minimally invasive orthopedic procedures, offering enhanced access to tight compartments with reduced soft-tissue disruption. This study assessed the feasibility of visualizing key anatomical structures of the shoulder joint using a 0\u0026deg; nanoscope in cadaveric specimens.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eTwenty fresh-frozen human cadaveric shoulders (10 left, 10 right) were examined by two orthopedic surgeons with different experience levels using a 1.9-mm 0\u0026deg; nanoscope. Standard posterior, anterior, and lateral portals were used to assess glenohumeral and subacromial compartments. Predefined landmarks were graded on a 5-point Likert scale. The primary outcome was feasibility of identifying each structure; secondary outcomes included mean visibility scores and inter-observer variability.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eAll predefined landmarks were identified in all 20 specimens. The senior surgeon reported an overall mean visibility score of 4.45 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18), and the resident 4.18 (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.21). Highest scores were observed for the long head of the biceps tendon and superior labrum. Lower scores occurred in the subacromial space, particularly in bursal-side rotator cuff assessment, reflecting challenges inherent to the 0\u0026deg; field of view. Inter-observer agreement was good (mean differences\u0026thinsp;\u0026le;\u0026thinsp;0.3).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eNanoscopic visualization of the shoulder using a 0\u0026deg; device is feasible and yields high visibility scores for most landmarks. Surgeon experience may influence interpretation in anatomically complex regions such as the subacromial space. These findings support a potential diagnostic and adjunctive therapeutic role for shoulder nanoscopy.\u003c/p\u003e\u003ch2\u003eLevel of Evidence\u003c/h2\u003e\u003cp\u003eDescriptive laboratory study\u0026mdash;Level VI.\u003c/p\u003e","manuscriptTitle":"Feasibility of Shoulder Joint Visualization Using the 0° Arthrex NanoScope: A Cadaveric Study on Twenty Specimens","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-04 18:35:42","doi":"10.21203/rs.3.rs-8099934/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-14T23:04:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"263761580751185291849586639717737065215","date":"2025-12-09T01:23:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"260245188119090786577657478366633510507","date":"2025-12-07T18:36:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"266922475807607455828591930503821114739","date":"2025-12-03T17:28:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-02T16:00:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-20T05:55:51+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-18T04:23:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Orthopaedic Surgery and Research","date":"2025-11-16T21:15:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-orthopaedic-surgery-and-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"josr","sideBox":"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)","snPcode":"13018","submissionUrl":"https://submission.nature.com/new-submission/13018/3","title":"Journal of Orthopaedic Surgery and Research","twitterHandle":"@MSKmedBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c2fef020-1384-4f2b-9cf0-bb1e9fad072f","owner":[],"postedDate":"December 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-04T18:35:42+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-04 18:35:42","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8099934","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8099934","identity":"rs-8099934","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}