Name of the Procedure:

Arthrotomy, glenohumeral joint (Shoulder Joint Arthrotomy)

Summary

Arthrotomy of the glenohumeral joint, commonly known as a shoulder joint arthrotomy, is a surgical procedure to open the shoulder joint for exploration. This process may involve drainage of fluid, removal of foreign bodies, or repair of damaged tissues to relieve pain and improve function.

Purpose

This procedure addresses issues such as joint infections, persistent swelling, unexplained joint pain, or the presence of foreign objects within the joint. The main goals are to diagnose joint issues accurately, alleviate pain, restore normal joint function, and prevent further complications.

Indications

• Persistent shoulder pain and swelling unresponsive to conservative treatment
• Suspected infection within the shoulder joint
• Presence of foreign bodies, such as splinters or debris, within the joint
• Unexplained loss of shoulder function
• Conditions confirmed by imaging that need direct visualization or intervention

Preparation

• Patients may need to fast for at least 8 hours before the procedure.
• Certain medications, particularly blood thinners, may need to be paused as advised by the doctor.
• Preoperative imaging tests, like X-rays, MRI, or CT scans, are conducted to plan the surgery accurately.
• Blood tests and physical examinations to ensure fitness for surgery.

Procedure Description

1. The patient is usually given general anesthesia to remain unconscious and pain-free during the surgery.
2. An antiseptic solution is applied to the shoulder area to minimize infection risk.
3. A surgical incision is made over the shoulder joint.
4. The surgeon carefully opens the joint capsule to explore the interior.
5. Drainage of any accumulated fluid or pus is performed if necessary.
6. Any foreign bodies are located and carefully removed.
7. Damaged or diseased tissue may be debrided (cleaned) or repaired.
8. The joint capsule and skin are sutured closed.
9. A sterile dressing is applied to the incision site.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

Arthrotomy of the glenohumeral joint is usually performed in a hospital's operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Scrub technician

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Prolonged pain or stiffness
• Scarring
• Anesthesia-related complications
• Blood clots

Benefits

• Relief from persistent shoulder pain
• Improved shoulder function and range of motion
• Resolution of infections or other conditions within the joint
• Removal of foreign irritants from the shoulder joint

Recovery

• Pain management with prescribed medications.
• Keeping the incision site clean and dry.
• Wearing a sling or supportive device to immobilize the shoulder initially.
• Physical therapy may be recommended to regain strength and mobility.
• Follow-up appointments to monitor healing and address any concerns.
• Recovery timeline varies but generally ranges from several weeks to a few months, depending on the extent of the surgery and individual patient factors.

Alternatives

• Conservative treatment with medications and physical therapy
• Arthroscopy, a less invasive procedure, to address certain joint problems
• Joint aspiration for fluid drainage without open surgery
• Each alternative comes with its pros and cons, such as less invasiveness versus potentially incomplete resolution of issues.

Patient Experience

During the procedure, the patient will be asleep and feel no pain due to general anesthesia. Post-surgery, some discomfort, swelling, and limited mobility are expected. Pain is managed with medications, and gradual improvement in symptoms is anticipated. Physical therapy aids in restoring function, though adherence to recovery guidelines is crucial for optimal outcomes.