23406 Tenotomy, shoulder area; multiple tendons through same incision

Name of the Procedure:

Tenotomy, shoulder area; multiple tendons through same incision

Summary

Tenotomy of the shoulder area involves making a small incision to cut multiple tendons. This helps to alleviate pain and improve mobility in patients with certain shoulder conditions.

Purpose

This procedure addresses conditions like tendonitis, rotator cuff injuries, and frozen shoulder that cause pain, restricted movement, or other issues in the shoulder. The goal is to relieve pain, restore function, and improve the quality of life for patients suffering from these conditions.

Indications

• Persistent shoulder pain not responding to conservative treatments
• Limited range of motion due to tendonitis or frozen shoulder
• Rotator cuff injuries or tears
• Patients who have not improved with physical therapy or medication

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments, especially if the patient is on blood thinners.
• Diagnostic tests like MRI or ultrasound to precisely identify the damaged tendons.

Procedure Description

1. The patient is given anesthesia, usually regional or general, to ensure they are comfortable.
2. The surgeon makes a small incision in the shoulder area.
3. Through this incision, the surgeon locates and carefully cuts the affected tendons.
4. The incision is closed with sutures, and a dressing is applied.
   • The procedure involves surgical tools like scalpels and specialized instruments to handle and cut the tendons precisely.

Duration

The procedure typically takes about 30 to 60 minutes, depending on the number of tendons involved.

Setting

Tenotomy is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

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

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Nerve damage
• Incomplete pain relief or recurrence of symptoms
• Scar tissue formation

Benefits

• Relief from chronic shoulder pain
• Improved range of motion
• Enhanced ability to perform daily activities
• Benefits often realized within a few weeks post-surgery, with continued improvement over several months.

Recovery

• Post-procedure, the arm may be immobilized in a sling.
• Pain management with prescribed medications.
• Physical therapy is usually recommended to restore strength and flexibility.
• Full recovery generally takes several weeks to a few months.
• Follow-up appointments are essential to monitor healing and progress.

Alternatives

• Conservative treatments like physical therapy, anti-inflammatory medications, and corticosteroid injections.
• Arthroscopic surgery, which is less invasive but may not be as effective for multiple tendon issues.
• Each alternative has its pros and cons, with varying effectiveness, recovery times, and potential risks.

Patient Experience

• The patient is under anesthesia during the procedure, so they should not feel pain.
• Post-surgery, some discomfort or pain can be managed with medications.
• Physical therapy and proper care are crucial for a smooth recovery.
• Activity restrictions will be advised to ensure proper healing, gradually returning to normal activities as per doctor’s guidelines.