29820 Arthroscopy, shoulder, surgical; synovectomy, partial

Name of the Procedure:

Arthroscopy, shoulder, surgical; synovectomy, partial (Partial Shoulder Synovectomy Arthroscopy)

Summary

A partial shoulder synovectomy arthroscopy is a minimally invasive surgical procedure where a surgeon uses an arthroscope to remove part of the inflamed synovium (joint lining) in the shoulder. This is typically performed using small incisions and specialized tools.

Purpose

This procedure addresses inflammation and pain in the shoulder joint due to conditions like rheumatoid arthritis, synovitis, or other inflammatory joint diseases. The goal is to reduce pain, improve joint function, and prevent further joint damage.

Indications

• Persistent shoulder pain and swelling not relieved by medications or physical therapy.
• Inflammatory joint diseases such as rheumatoid arthritis or synovitis.
• Decreased shoulder mobility affecting daily activities.
• Diagnostic imaging showing inflamed synovium.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Adjustment or cessation of certain medications, as advised by the healthcare provider.
• Preoperative physical examination and blood tests.
• Imaging studies such as X-rays or MRI scans to visualize the joint.

Procedure Description

1. The patient is administered anesthesia, usually general or regional (nerve block).
2. Small incisions are made around the shoulder area.
3. An arthroscope, a small camera, is inserted through one of the incisions to visualize the joint.
4. Specialized surgical instruments are inserted through other incisions to remove the inflamed synovium.
5. The area is thoroughly examined to ensure all targeted tissue has been removed.
6. The incisions are closed with sutures or adhesive strips.

Duration

The procedure typically takes about 1 to 2 hours, depending on the extent of the inflammation and the patient's specific condition.

Setting

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

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a surgical technician

Risks and Complications

• Infection at the incision sites
• Bleeding or hematoma
• Damage to surrounding tissues or structures
• Joint stiffness or continued pain
• Deep vein thrombosis (rare)
• Risks associated with anesthesia

Benefits

• Reduction in shoulder pain and inflammation
• Improved joint function and mobility
• Reduced risk of further joint damage
• Smaller incisions leading to quicker recovery compared to open surgery

Recovery

• Patients typically go home the same day of the surgery.
• Pain management with prescribed medications.
• Use of a shoulder sling for a few days to weeks.
• Instructions for wound care and any physical activity restrictions.
• Physical therapy to restore strength and mobility.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Medication management (e.g., anti-inflammatory drugs, corticosteroids)
• Physical therapy and exercise
• Open surgical synovectomy (more invasive)
• Joint replacement surgery (in severe cases)
• The alternatives depend on the severity of the condition and patient-specific factors.

Patient Experience

• During the procedure, the patient is under anesthesia and should not feel pain.
• Postoperatively, patients might experience discomfort and swelling at the incision sites.
• Pain can be managed with prescribed medications and cold therapy.
• Gradual improvement in shoulder function and pain levels over several weeks.