Name of the Procedure:

Arthrotomy of the Acromioclavicular and Sternoclavicular Joint

Summary

An arthrotomy of the acromioclavicular (AC) and/or sternoclavicular (SC) joint is a surgical procedure that involves making an incision into these joints to explore, drain, or remove foreign bodies. This helps to diagnose and treat conditions affecting these joints.

Purpose

The goal of this procedure is to address problems within the AC or SC joints, such as infection, arthritis, or the presence of foreign bodies. It aims to alleviate pain, restore function, and prevent further joint damage.

Indications

• Persistent joint pain unresponsive to conservative treatments
• Swelling, redness, or signs of infection within the joint
• Suspected foreign body within the joint
• Mechanical symptoms such as locking or catching of the joint

Preparation

• Patients may need to fast for a specific period before the surgery.
• Medication adjustments, such as blood thinners, may be necessary under medical guidance.
• Preoperative imaging studies such as X-rays or MRIs are often required for surgical planning.

Procedure Description

1. The patient is administered anesthesia; this could be local, regional, or general anesthesia based on the specific case.
2. An incision is made over the targeted joint.
3. The joint capsule is carefully exposed and opened.
4. The surgeon will explore the joint, drain any accumulated fluid or pus, and remove any foreign bodies.
5. Repairs may be made to the joint structures if necessary.
6. The incision is then closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes between 45 minutes to 1.5 hours, depending on the complexity.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technologist

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Adverse reactions to anesthesia
• Joint stiffness or instability
• Scarring

Benefits

• Relief from pain
• Improved joint function
• Removal of infectious material or foreign bodies
• Prevention of further joint damage
• Typically noticeable improvements soon after the recovery period

Recovery

• Post-procedure care includes keeping the incision clean and dry.
• Pain management with medications as prescribed.
• Physical therapy might be recommended to restore joint mobility and strength.
• Most patients can resume normal activities within a few weeks, though heavy lifting and vigorous activities should be avoided until cleared by the doctor.
• Follow-up appointments are crucial for monitoring healing and joint function.

Alternatives

• Non-surgical treatments such as anti-inflammatory medications, joint injections, and physical therapy
• Arthroscopy, a minimally invasive procedure, may be an option for certain conditions
• Each alternative has its own pros and cons, and the choice depends on the patient's specific condition and response to initial treatments.

Patient Experience

During the procedure, patients under general anesthesia will be asleep and feel nothing. Those under local or regional anesthesia may be awake but should not feel pain due to numbing. Postoperatively, mild to moderate pain can be expected, which is managed with pain-relief measures. Bruising and swelling at the incision site are normal and should subside over time.