23335 Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)

Name of the Procedure:

Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (e.g., total shoulder)

Summary

In this procedure, doctors remove a shoulder prosthesis, often used in total shoulder replacements. Along with the prosthesis removal, they may also clean out any unhealthy tissue (debridement) and remove inflamed joint lining (synovectomy) if needed.

Purpose

The primary goal is to address issues related to a failed or problematic shoulder prosthesis, which can include infection, wear and tear, or mechanical failure. The procedure aims to alleviate pain, improve shoulder function, and prevent further complications.

Indications

• Chronic shoulder pain not relieved by other treatments
• Persistent shoulder infection
• Loosening or mechanical failure of the shoulder prosthesis
• Significant wear of the prosthetic components
• Chronic inflammation and swelling in the shoulder joint

Preparation

• Fasting for a specified period before surgery
• Stopping certain medications, as directed by your doctor
• Blood tests and imaging studies to assess shoulder condition
• Pre-operative clearance from a primary care physician or specialist

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made over the shoulder to access the joint.
3. The shoulder prosthesis is carefully removed.
4. Debridement is performed to clean out any unhealthy tissue.
5. Synovectomy is done if there's inflamed lining in the joint.
6. The area is thoroughly cleaned and checked for any remaining debris.
7. The surgical site is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes 2-3 hours, depending on the complexity.

Setting

The procedure is usually performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Nerve or blood vessel damage
• Shoulder stiffness or instability
• Need for additional surgeries

Benefits

The primary benefit is the relief of pain and improved shoulder function. Patients can expect an improvement in quality of life and a reduction in symptoms shortly after recovery.

Recovery

• Hospital stay for 1-3 days post-surgery
• Pain medications and antibiotics as prescribed
• Physical therapy to restore motion and strength
• Recovery period ranges from several weeks to a few months
• Follow-up appointments with the surgeon to monitor healing

Alternatives

• Medication and physical therapy
• Revisions or partial replacements of the prosthetic components
• Non-surgical management like injections

Patient Experience

Patients may experience pain and swelling after the procedure, managed with pain medication and ice packs. Gradual improvement in shoulder movement will be achieved through physical therapy and following the surgeon's post-operative care plan.