29827 Arthroscopy, shoulder, surgical; with rotator cuff repair

Name of the Procedure:

Arthroscopy, shoulder, surgical with rotator cuff repair

Summary

Arthroscopy of the shoulder with rotator cuff repair is a minimally invasive surgical procedure. It uses a small camera (arthroscope) to visualize the shoulder joint and specialized instruments to repair torn rotator cuff tendons.

Purpose

This procedure addresses rotator cuff tears, which can cause pain and restrict shoulder movement. The goal is to alleviate pain, restore shoulder function, and improve the range of motion.

Indications

• Persistent shoulder pain not relieved by non-surgical treatments (e.g., physical therapy, medications)
• Loss of shoulder strength or movement
• Acute tears due to injury or chronic degeneration
• Significant impact on daily activities and quality of life

Preparation

• Fasting for at least 6-12 hours before the procedure
• Adjusting or stopping certain medications as directed by the healthcare provider
• Pre-operative imaging tests like MRI or ultrasound to assess the extent of the tear

Procedure Description

1. Administration of anesthesia (general or regional)
2. Small incisions are made around the shoulder
3. The arthroscope is inserted to visualize the joint
4. Repair instruments are introduced through additional small incisions
5. Torn rotator cuff tendons are sutured back to the bone
6. Incisions are closed with sutures or staples and covered with sterile dressings

Duration

Approximately 1-2 hours, depending on the severity of the tear.

Setting

Typically performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon specialized in shoulder procedures
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection at the surgical site
• Bleeding or blood clots
• Nerve damage or shoulder stiffness
• Incomplete healing of the tendons
• Risks related to anesthesia

Benefits

• Relief from shoulder pain
• Improved shoulder strength and flexibility
• Enhanced overall shoulder function
• Potential return to normal activities within a few months

Recovery

• Initial postoperative pain management with medications
• Use of a sling to immobilize the shoulder for a few weeks
• Physical therapy to regain strength and mobility
• Full recovery and return to normal activities usually take 4-6 months
• Follow-up appointments to monitor healing progress

Alternatives

• Non-surgical treatments like physical therapy, corticosteroid injections, and medications
• Open shoulder surgery for more extensive repairs
• Pros and cons depend on the severity of the tear and patient-specific factors. Arthroscopy generally offers a quicker recovery and less postoperative pain compared to open surgery.

Patient Experience

Patients may feel pain and discomfort immediately after the procedure, managed with prescribed pain medications. During recovery, physical therapy is crucial, and pain tends to decrease as healing progresses. Using a sling helps stabilize the shoulder and minimize movement to promote proper healing.