23462 Capsulorrhaphy, anterior, any type; with coracoid process transfer

Name of the Procedure:

Capsulorrhaphy, anterior, any type; with coracoid process transfer

Summary

Capsulorrhaphy with coracoid process transfer is a shoulder stabilization surgery where the ligaments in the front of the shoulder are tightened. Additionally, a bone graft from the coracoid process is transferred to improve joint stability.

Purpose

This surgery mainly addresses shoulder instability or recurrent shoulder dislocations. The goal is to restore stability to the shoulder joint, reduce pain, and improve function by preventing future dislocations.

Indications

• Recurrent shoulder dislocations
• Chronic shoulder instability
• Failure of conservative treatments like physical therapy
• Congenital or traumatic laxity of the shoulder ligaments

Preparation

• Fasting for at least 8 hours before surgery
• Adjustments or discontinuation of certain medications as per the doctor's advice
• Pre-operative imaging tests like X-ray, MRI, or CT scan
• Comprehensive medical evaluation to assess fitness for surgery

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the front of the shoulder.
3. The shoulder capsule is tightened by suturing it.
4. The coracoid process is identified, detached along with its attached muscles, and transferred to a new position on the front of the shoulder socket.
5. The transferred bone is fixed in place with screws or sutures.
6. The incision is closed and dressed.

Duration

The procedure typically takes about 1.5 to 3 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Nerve or blood vessel damage
• Failure of the bone graft to heal properly
• Persistent shoulder stiffness or pain
• Recurrent instability or dislocation

Benefits

• Improved shoulder stability
• Reduction in pain and discomfort
• Restoration of shoulder function
• Lower risk of future dislocations

Recovery

• Immobilization of the shoulder with a sling for several weeks
• Pain management with prescribed medications
• Gradual physical therapy starting a few weeks after surgery
• Full recovery may take 3 to 6 months, with return to normal activities

Alternatives

• Physical therapy and strengthening exercises
• Non-surgical management with braces or activity modification
• Less invasive arthroscopic procedures
• Pros and cons vary: non-surgical options may be less risky but may not provide the same level of stability.

Patient Experience

• The patient will be under general anesthesia during the procedure and will not feel pain.
• Post-operative discomfort managed with medications.
• Possible swelling and restricted movement initially; mitigated by cold therapy and prescribed exercises.