29819 Arthroscopy, shoulder, surgical; with removal of loose body or foreign body

Name of the Procedure:

Arthroscopy, shoulder, surgical; with removal of loose body or foreign body.
Common name(s): Shoulder Arthroscopy, Arthroscopic Shoulder Surgery

Summary

Arthroscopy of the shoulder is a minimally invasive surgical procedure that allows doctors to visualize, diagnose, and treat problems inside the shoulder joint. During the procedure, loose bodies or foreign objects within the joint are removed using specialized tools.

Purpose

This procedure addresses issues caused by loose bodies (such as bone fragments or cartilage) or foreign objects in the shoulder joint. The goals include alleviating pain, reducing inflammation, and improving shoulder function and range of motion.

Indications

• Persistent shoulder pain that does not respond to conservative treatments.
• Limited range of motion or shoulder locking/catching.
• Previous shoulder injury or surgery leading to loose fragments.
• Detection of loose bodies via imaging studies like X-rays or MRIs.
• Symptoms such as swelling, stiffness, and decreased shoulder function.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Certain medications, especially blood thinners, may need to be adjusted or stopped as advised by the physician.
• Preoperative tests, such as blood work, imaging studies, and a physical examination, may be needed.

Procedure Description

1. The patient is positioned, usually receiving regional or general anesthesia.
2. Small incisions are made around the shoulder joint.
3. An arthroscope (a small camera) is inserted through one incision to visualize the joint.
4. Special surgical instruments are introduced through other small incisions to remove loose bodies or foreign objects.
5. Once the procedure is completed, the small incisions are closed with sutures.

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon specialized in arthroscopic procedures.
• Anesthesiologist or Nurse Anesthetist
• Surgical nurses and possibly physician assistants or surgical technologists.

Risks and Complications

• Infection
• Bleeding or blood clots
• Nerve or vessel injury
• Adverse reactions to anesthesia
• Shoulder stiffness or difficulty in moving the shoulder
• Rarely, the need for additional surgery

Benefits

• Relief from pain and discomfort in the shoulder.
• Improved shoulder mobility and function.
• Minimally invasive with typically shorter recovery time compared to open surgery.
• Typically, a quicker return to daily activities and sports.

Recovery

• Patients may need to use a sling for a few days post-surgery.
• Physical therapy is often recommended to regain strength and range of motion.
• Restrictions on heavy lifting or strenuous activities for several weeks.
• Follow-up appointments to monitor progress and remove stitches if necessary.

Alternatives

• Non-surgical treatments like physical therapy, medications, and steroid injections.
• Open shoulder surgery in more complex cases.
• Pros of alternatives include avoiding surgery; cons include possibly less effective symptom relief and longer recovery.

Patient Experience

• During the procedure: under anesthesia, so no pain will be felt.
• After the procedure: some discomfort, swelling, and bruising managed with prescribed pain medication and ice packs.
• Patients often report initial soreness but typically feel relief from previous symptoms as they heal.