Name of the Procedure:

Arthrotomy, Glenohumeral Joint, with Joint Exploration, with or without Removal of Loose or Foreign Body

Summary

An arthrotomy of the glenohumeral joint is a surgical procedure that involves making an incision into the shoulder joint to explore it. During the procedure, the surgeon may also remove any loose fragments or foreign bodies if necessary.

Purpose

This procedure addresses conditions such as severe arthritis, unexplained joint pain, joint stiffness, or the presence of loose bodies within the shoulder joint. The goal is to diagnose and treat problems within the joint, relieve pain, improve joint function, and prevent further damage.

Indications

• Severe or persistent shoulder pain not relieved by conservative treatments
• Joint stiffness or decreased range of motion
• Presence of loose or foreign bodies within the joint
• Suspected infections or other pathologies
• Injuries leading to joint instability

Preparation

• The patient may need to fast for a certain period before the procedure.
• Medication adjustments, particularly blood thinners and anti-inflammatory drugs, might be required.
• Pre-operative imaging tests like X-rays or MRIs to assess the joint condition.
• Physical examination and medical history review.

Procedure Description

1. The patient is given anesthesia; either general anesthesia or regional block.
2. The surgeon makes a precise incision over the shoulder joint.
3. The joint capsule is carefully opened to expose the joint.
4. The surgeon explores the joint, removes any loose bodies or foreign material, and addresses any abnormalities found.
5. The joint capsule and incisions are closed using sutures.

Duration

The procedure typically takes about 1-2 hours.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Nerve or blood vessel injury
• Stiffness or loss of motion
• Recurrence of loose bodies
• Adverse reactions to anesthesia

Benefits

• Relief from chronic pain
• Improved range of motion and joint function
• Removal of loose fragments that could cause future issues
• Peace of mind from understanding the joint's condition

Recovery

• Post-operative pain management usually includes medications.
• Instructions will be given for wound care.
• Physical therapy is often recommended to restore movement and strength.
• Recovery time varies, but most patients can expect to return to normal activities within a few weeks to months.
• Follow-up appointments to monitor healing and assess joint function.

Alternatives

• Non-surgical treatments like physical therapy, medications, or corticosteroid injections
• Arthroscopic surgery, which is less invasive
• Joint replacement surgery in cases of severe arthritis

Pros of arthrotomy include a direct view and access to the joint, while cons may include a longer recovery time and higher risk of complications compared to minimally invasive techniques.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Post-procedure, there may be discomfort and swelling; pain management strategies will be advised. Physical therapy and gradual return to normal activities will help in achieving full recovery.