29807 Arthroscopy, shoulder, surgical; repair of SLAP lesion

Name of the Procedure:

Arthroscopy, shoulder, surgical; repair of SLAP lesion

• Common Names: SLAP Repair, Shoulder Arthroscopy for SLAP Tear

Summary

Arthroscopy for the repair of a SLAP lesion is a minimally invasive surgical procedure that uses a tiny camera (arthroscope) and specialized instruments to repair a tear in the labrum of the shoulder joint. SLAP stands for "Superior Labrum Anterior and Posterior," referring to the top part of the labrum that is injured.

Purpose

This procedure addresses a SLAP tear, which is a specific kind of shoulder injury where the top (superior) part of the labrum is torn. The goal is to reattach the torn labrum to the bone, relieve pain, and restore normal shoulder function.

Indications

This procedure is indicated for patients experiencing:

• Persistent shoulder pain, particularly during overhead activities.
• Shoulder instability or weakness.
• A sensation of popping, clicking, or catching in the shoulder.
• A confirmed SLAP tear through imaging studies (like MRIs).

Preparation

• Patients may be advised to fast for 8-12 hours before the procedure.
• Medications like blood thinners might need to be adjusted under doctor’s guidance.
• Pre-surgical assessments may include imaging tests (MRI/CT scans) and a physical examination.

Procedure Description

1. Anesthesia: General anesthesia or regional block is administered.
2. Incisions: Small incisions (portals) are made around the shoulder.
3. Insertion of Arthroscope: An arthroscope is inserted through one of the incisions, providing visualization of the shoulder joint on a screen.
4. Repair Tools: Specialized surgical instruments are inserted through other incisions.
5. Repair Process: The torn labrum is cleaned, and small anchors with sutures are used to reattach the labrum to the bone.
6. Closure: Incisions are closed with sutures or steri-strips and covered with a sterile bandage.

Duration

The procedure typically takes about 1-2 hours, depending on the complexity of the tear.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic Surgeon
• Surgical Nurse
• Anesthesiologist
• Surgical Technologist

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Stiffness in the shoulder joint
• Recurrence of the tear
• Complications related to anesthesia

Benefits

• Reduction or elimination of pain.
• Improved shoulder stability and function.
• Ability to return to normal activities or sports. Most patients can expect noticeable improvements in shoulder strength and reduced pain within a few months post-surgery.

Recovery

• Immediate Post-Procedure: The shoulder will be in a sling.
• Pain Management: Pain medications will be prescribed.
• Physical Therapy: Begins a few days to weeks after surgery.
• Follow-Up: Regular appointments to monitor healing.
• Restrictions: Avoid using the arm for heavy lifting or overhead activities for several weeks. Complete recovery may take 4-6 months.

Alternatives

• Non-surgical options like physical therapy, anti-inflammatory medications, and corticosteroid injections.
• Pros: Less invasive, no surgical risks.
• Cons: May not fully alleviate symptoms or repair the labrum.

Patient Experience

• During Procedure: No sensation due to anesthesia.
• Post-Procedure: Soreness and pain managed with medications.
• First Few Days: Sling use, mild discomfort, and limited mobility.
• Long-Term: Gradual improvement with physical therapy, eventual resumption of normal activities.