Tenotomy, shoulder area; single tendon
CPT4 code
Name of the Procedure:
Tenotomy, shoulder area; single tendon
Common Names: Tenotomy of the shoulder, Biceps tenotomy, Supraspinatus tenotomy
Technical Terms: Tenotomy
Summary
A tenotomy in the shoulder area is a surgical procedure that involves cutting a tendon to relieve tension and address certain medical conditions affecting the shoulder. This procedure is usually done on one specific tendon, such as the biceps tendon.
Purpose
Medical Conditions Addressed: Chronic shoulder pain, tendon injuries, rotator cuff tears, persistent shoulder inflammation, and tendonitis.
Goals/Expected Outcomes: The primary goal is to alleviate pain, restore mobility, and enhance shoulder function by releasing the tension on the affected tendon.
Indications
Symptoms/Conditions Warranting the Procedure: Persistent shoulder pain, limited range of motion, inflammation unresponsive to conservative treatment, tear or damage to tendon.
Patient Criteria: Patients who have not found relief with physical therapy, medications, or injections; those with significant tendon damage confirmed via imaging.
Preparation
Pre-Procedure Instructions:
- Fasting for at least 8 hours before the procedure.
- Discontinuation of certain medications (e.g., blood thinners) as advised by the doctor.
- Arranging for someone to drive you home post-procedure. Diagnostic Tests/Assessments: MRI or ultrasound imaging to assess the extent of tendon damage, blood tests for general health evaluation.
Procedure Description
Steps Involved:
- Administering local, regional, or general anesthesia.
- Making a small incision in the shoulder area.
- Identifying and isolating the affected tendon.
- Carefully cutting the tendon to relieve tension.
- Closing the incision with sutures or surgical staples.
Tools/Technology Used: Scalpels, surgical scissors, sutures or staples, imaging equipment for guidance.
Anesthesia Details: Local anesthesia (numbs shoulder area), regional anesthesia (nerve block), or general anesthesia (patient is asleep).
Duration
Typically, the procedure takes around 30 minutes to 1 hour.
Setting
Performed in a hospital operating room or an outpatient surgical center.
Personnel
Healthcare team includes the orthopedic surgeon, surgical nurses, anesthesiologist, and possibly a surgical assistant.
Risks and Complications
Common Risks: Infection, bleeding, adverse reaction to anesthesia, temporary shoulder stiffness.
Rare Risks: Nerve damage, failure to alleviate symptoms, chronic shoulder instability.
Complication Management: Use of antibiotics for infections, physical therapy for stiffness, and additional surgical interventions if necessary.
Benefits
Expected benefits include significant pain relief, improved shoulder mobility, and an enhanced quality of life. Benefits are often realized several weeks to months after the procedure, following adequate rest and rehabilitation.
Recovery
Post-Procedure Care: Ice packs to reduce swelling, prescribed medications for pain management, keeping the incision site clean and dry.
Expected Recovery Time: Most patients recover within 6 to 12 weeks but full functionality may take up to 6 months.
Restrictions/Follow-Up: Limited use of the shoulder in initial weeks; follow-up appointments for monitoring healing and potentially physical therapy.
Alternatives
Other Treatment Options: Conservative treatments like physical therapy, corticosteroid injections, medication.
Pros and Cons: Conservative treatments are non-invasive but may not be effective for severe cases. Surgery offers a more permanent solution but carries greater risks and recovery time.
Patient Experience
During the procedure, patients under local or regional anesthesia may feel pressure but no pain; those under general anesthesia will be asleep. Post-procedure can involve mild to moderate pain, managed with medications. Recovery involves gradual return to normal activities and adherence to physical therapy for optimal outcomes.