Name of the Procedure:

Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block

Summary

Capsulorrhaphy is a surgical procedure aimed at tightening the joint capsule of the shoulder (glenohumeral joint) to address instability, specifically at the posterior (back) part of the joint. It may include the addition of a bone block to provide extra stability.

Purpose

The procedure addresses shoulder instability, recurrent dislocations, or subluxations due to loosened or torn joint capsules. The goal is to restore stability to the shoulder, reduce pain, and improve function.

Indications

• Recurrent shoulder dislocations
• Posterior shoulder instability
• Failed conservative treatments (e.g., physical therapy)
• History of traumatic shoulder injury
• Specific diagnostic findings from imaging tests like MRI

Preparation

• Fasting for 8-12 hours prior to surgery
• Adjustments to current medications (e.g., blood thinners might need to be stopped)
• Preoperative physical examination and diagnostic imaging tests (e.g., MRI, X-rays)

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made at the shoulder’s posterior side.
3. The surgeon exposes the glenohumeral joint and examines the joint capsule.
4. The joint capsule is tightened through sutures, and if necessary, a bone block is placed and secured to enhance stability.
5. Any torn or damaged tissues are repaired.
6. The incision is closed with sutures and covered with a sterile dressing.

Duration

The procedure typically takes 1.5 to 3 hours, depending on the complexity and if a bone block is used.

Setting

The procedure is performed in a hospital or a surgical center equipped with the necessary facilities for orthopedic surgeries.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician
• Post-operative care staff

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Stiffness or decreased range of motion in the shoulder
• Failure to improve shoulder stability
• Recurrent instability or dislocation

Benefits

• Improved shoulder stability
• Reduced pain and discomfort
• Enhanced shoulder function and mobility
• High success rate in preventing future dislocations

Recovery

• Immobilization of the shoulder with a sling for 4-6 weeks
• Gradual physical therapy to restore range of motion and strength
• Avoiding heavy lifting or strenuous activities for up to 6 months
• Follow-up appointments to monitor healing and progress

Alternatives

• Physical therapy and rehabilitation
• Arthroscopic surgery options
• Shoulder bracing or supports
• Less invasive surgical techniques might have a shorter recovery but vary in effectiveness

Patient Experience

• The patient will feel no pain during the procedure due to anesthesia.
• Postoperative pain managed with prescribed painkillers.
• Initial discomfort due to immobilization, with gradual improvement through physical therapy.
• Long-term positive outcomes typically realized within 6 months post-surgery.