23156 Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor of Proximal Humerus with Allograft

Summary

This is a surgical procedure aimed at removing a bone cyst or a benign tumor located in the proximal humerus (the upper part of the arm bone). The removed portion is then replaced with an allograft, which is a piece of donor bone tissue.

Purpose

The procedure addresses non-cancerous bone growths or cysts in the upper arm bone that may cause pain, weaken the bone, or lead to fractures. The goal is to remove the abnormal growth and restore structural integrity to the bone using donor tissue.

Indications

• Persistent pain in the shoulder or upper arm
• Swelling or a noticeable mass in the upper arm
• Risk of bone fracture due to a cyst or tumor
• Diagnostic imaging showing a benign tumor or cyst in the proximal humerus

Preparation

• Fasting for at least 8 hours prior to the procedure
• Discontinuation of certain medications, as advised by the healthcare provider
• Pre-operative imaging tests like X-rays or MRI scans
• Blood tests and possibly a biopsy of the cyst/tumor

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made over the affected area of the proximal humerus.
3. The cyst or benign tumor is carefully excised or scraped out (curettage).
4. The cavity left behind is filled with the allograft bone tissue.
5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours to complete.

Setting

The surgery is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Fracture or weakening of the proximal humerus
• Rejection or non-integration of the allograft
• Pain or stiffness in the shoulder
• Nerve or blood vessel damage

Benefits

• Relief from pain and discomfort
• Reduced risk of fractures
• Restoration of normal bone structure and function
• Improved quality of life and mobility The benefits are often realized shortly after recovery but full integration of the allograft may take several months.

Recovery

• Post-procedure care includes pain management, antibiotics to prevent infection, and regular follow-up visits.
• Initial recovery period is typically 1-2 weeks, with full recovery in about 2-3 months.
• Physical therapy may be required to restore full function and strength.
• Patients should avoid heavy lifting or strenuous activities for several weeks.

Alternatives

• Observation and monitoring if the cyst or tumor is asymptomatic and stable.
• Aspiration or drainage of the cyst followed by injection of bone cement.
• Orthopedic braces to stabilize and protect the bone.
• Each alternative has its pros and cons related to effectiveness, risks, and recovery times.

Patient Experience

• The patient is under general anesthesia, so they will not feel any pain during the procedure.
• Post-operatively, there may be soreness and discomfort at the surgical site, managed with pain medications.
• Physical therapy and gentle exercises will aid in recovery.
• Most patients can return to normal activities within a few weeks to months, depending on individual healing rates.