Removal of subdeltoid calcareous deposits, open
CPT4 code
Name of the Procedure:
Removal of subdeltoid calcareous deposits, open
Common names: Open removal of shoulder calcium deposits, Open subdeltoid calcific deposit excision
Medical term: Open Subdeltoid Calcific Tendinitis Surgery
Summary
In this procedure, calcium deposits in the subdeltoid area of the shoulder are surgically removed through an open incision. This is typically done when conservative treatments have failed to relieve pain and improve shoulder function.
Purpose
This surgery addresses calcific tendinitis or bursitis in the shoulder, particularly when calcium deposits cause significant pain or restrict movement. The goal is to alleviate symptoms and restore normal shoulder function.
Indications
- Persistent shoulder pain unresponsive to non-surgical treatments (e.g., physical therapy, medications)
- Reduced range of motion in the shoulder
- Presence of calcium deposits confirmed by imaging (e.g., X-ray, ultrasound)
- Recurrent episodes of shoulder inflammation or bursitis
Preparation
- Fasting: Patients are typically instructed to fast for about 8 hours prior to surgery.
- Medication adjustments: Avoid certain medications (e.g., blood thinners) as directed by your healthcare provider.
- Preoperative evaluations: Diagnostic imaging (X-ray, MRI) to locate calcium deposits accurately, and routine blood tests.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: A small incision is made over the shoulder near the subdeltoid region.
- Exposure: The muscles and tissues are carefully moved aside to expose the calcium deposits.
- Removal: The surgeon removes the calcium deposits using specialized instruments.
- Inspection: The surgeon checks the area to ensure all deposits are removed and assesses for any damage to surrounding tissues.
- Closure: The incision is closed with sutures and the area is bandaged.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
The surgery is usually performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologist
Risks and Complications
- Common risks: Infection, bleeding, swelling, pain at the incision site.
- Rare risks: Nerve damage, blood clots, persistent pain, incomplete removal of deposits, shoulder stiffness.
- Complication management includes antibiotics for infection, pain medications, and physical therapy for mobility issues.
Benefits
- Relief from shoulder pain
- Improved range of motion and shoulder function
- Reduction in inflammation and recurrent symptoms
- Benefits typically start to be realized within a few weeks post-surgery.
Recovery
- Post-procedure care: Keep the surgical site clean and dry; follow instructions for wound care.
- Pain management: Prescribed pain medication, ice packs.
- Restrictions: Avoid heavy lifting and shoulder movements for several weeks.
- Recovery time: Full recovery can take several weeks to a few months; physical therapy is often recommended.
- Follow-up: Regular appointments to monitor healing and progress.
Alternatives
- Non-surgical treatments: Physical therapy, corticosteroid injections, shockwave therapy.
- Arthroscopic removal of calcium deposits.
- Pros and cons: Non-surgical options may be less invasive with shorter recovery times but might not be effective for severe cases. Arthroscopic surgery is less invasive but may not be suitable for large or complex deposits.
Patient Experience
- During the procedure: The patient will be under general anesthesia and will not feel any pain or be aware of the surgery.
- After the procedure: Expect some pain and swelling at the surgical site; pain is usually managed with medications.
- Initial discomfort gradually decreases; physical therapy helps regain shoulder strength and mobility.
- Patient comfort: Pain management strategies include medications, ice applications, and gentle exercises.