23460 Capsulorrhaphy, anterior, any type; with bone block

Name of the Procedure:

Capsulorrhaphy, anterior, any type; with bone block

Summary

Capsulorrhaphy is a surgical procedure used to repair and stabilize the shoulder joint by tightening the joint capsule. This specific version includes the use of a bone block to further secure the joint and prevent dislocation.

Purpose

The procedure addresses shoulder instability, often caused by recurrent shoulder dislocations. The goal is to stabilize the shoulder joint by reinforcing it with a bone block, which helps prevent further dislocations and improves shoulder function.

Indications

• Recurrent shoulder dislocations
• Shoulder instability not improved by conservative treatments
• Chronic shoulder pain due to instability
• Individuals with high physical demands requiring stable shoulder joint

Preparation

• Patients may be advised to fast for several hours before the procedure.
• Adjustments to medications, especially blood thinners, may be necessary as instructed by the physician.
• Preoperative assessments might include imaging studies like MRI or CT scans, and blood tests.

Procedure Description

1. The patient is administered general anesthesia or regional anesthesia.
2. An incision is made in the anterior part of the shoulder.
3. The joint capsule is accessed and any necessary repairs are made.
4. A bone block, typically harvested from the patient's own pelvis or another site, is positioned and secured to the shoulder joint to enhance stability.
5. The joint capsule is then tightened around the bone block.
6. The incision is closed with sutures and a sterile dressing is applied.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

Common risks include:

• Infection
• Bleeding
• Pain
• Stiffness
• Blood clots

Rare complications may involve:

• Nerve damage
• Failure of the bone block to integrate properly
• Recurrence of shoulder instability

Benefits

• Increased shoulder stability
• Reduced likelihood of future dislocations
• Improved shoulder function and range of motion
• Relief from chronic shoulder pain

Recovery

• Post-procedure care includes wearing a sling and avoiding shoulder movements for several weeks.
• Pain management involves prescribed medications.
• Physical therapy is crucial and usually begins after a few weeks.
• Full recovery and return to normal activities can take several months.

Alternatives

• Non-surgical treatments like physical therapy and medications
• Minimally invasive arthroscopic surgery
• Alternative surgical techniques without the use of a bone block

Pros and cons should be discussed with a healthcare provider to determine the best option for the patient.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there might be discomfort and swelling, which will be managed with medications. Continuous support and follow-up care are essential for effective recovery and optimal outcomes.