23700 Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)

Name of the Procedure:

Manipulation under anesthesia (MUA), shoulder joint, including application of fixation apparatus (dislocation excluded).

Summary

Manipulation under anesthesia of the shoulder joint involves gently moving the shoulder through its range of motion while the patient is under general anesthesia. This procedure does not address dislocated shoulders but rather aims to improve mobility and reduce stiffness. A fixation apparatus may be applied to stabilize the joint post-manipulation.

Purpose

The procedure aims to treat conditions such as frozen shoulder (adhesive capsulitis) or severe shoulder stiffness that have not responded to other forms of treatment. The goal is to restore mobility and alleviate pain by breaking up the scar tissue around the shoulder joint.

Indications

• Severe shoulder stiffness and pain
• Diagnosed adhesive capsulitis (frozen shoulder)
• Failed conservative treatments such as physical therapy, medications, or injections

Preparation

• The patient may need to fast for at least 6-8 hours before the procedure.
• Adjustments to current medications might be necessary as advised by the doctor.
• Pre-procedure diagnostic tests, such as X-rays or MRIs, may be required to assess the shoulder condition.

Procedure Description

1. The patient is put under general anesthesia to ensure they are unconscious and pain-free.
2. The healthcare provider will use gentle and controlled movements to manipulate the shoulder, moving it through various ranges.
3. Controlled breaks to the adhesions (scar tissue) will be made to improve joint mobility.
4. After manipulation, a fixation apparatus or brace may be applied to stabilize the shoulder and prevent excessive movement.
5. The procedure is closely monitored using imaging technology to ensure effectiveness and safety.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

This procedure is usually performed in a hospital or surgical center equipped with necessary anesthesia and imaging equipment.

Personnel

• Orthopedic surgeon or a specialized healthcare provider
• Anesthesiologist
• Nursing staff assisting with pre and post-procedure care

Risks and Complications

• Bruising and swelling
• Risk of fractures or soft tissue injuries
• Infection
• Adverse reactions to anesthesia
• Recurrence of stiffness or pain

Benefits

• Increased range of motion in the shoulder
• Reduction in pain and discomfort
• Improved functional use of the shoulder for daily activities

Recovery

• Post-procedure: Pain management through prescribed medications.
• Physical therapy will likely be recommended to maintain improvements in mobility.
• The shoulder may be sore for a few weeks.
• Follow-up appointments to monitor progress and adjust treatment if necessary.
• Complete recovery and return to daily activities can take several weeks to a few months.

Alternatives

• Continued physical therapy and home exercise programs
• Corticosteroid injections
• Surgical options, such as arthroscopic capsular release

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain or discomfort. Post-procedure, there may be soreness and mild discomfort, which can be managed with prescribed pain relief and ice. The patient will need to follow specific post-procedure care instructions and engage in physical therapy to ensure optimal recovery.