29806 Arthroscopy, shoulder, surgical; capsulorrhaphy

Name of the Procedure:

Arthroscopy, Shoulder, Surgical; Capsulorrhaphy

• Common name: Shoulder Arthroscopy with Capsulorrhaphy
• Technical term: Arthroscopic Stabilization of the Shoulder

Summary

Arthroscopy of the shoulder with capsulorrhaphy is a minimally invasive surgical procedure used to repair and tighten the ligaments in the shoulder joint. It involves the use of a small camera (arthroscope) and specialized surgical instruments to address shoulder instability and related issues.

Purpose

The primary purpose of this procedure is to treat shoulder instability, which can occur due to dislocations, excessive laxity, or injuries to the shoulder ligaments. The goals are to restore stability, reduce pain, and improve shoulder function and range of motion.

Indications

• Recurrent shoulder dislocations
• Chronic shoulder instability
• Labral tears or Bankart lesions
• Failure of conservative treatments, such as physical therapy and medications
• Patients actively engaged in sports or physical activities that worsen instability

Preparation

• Fasting for at least 6-8 hours before the procedure
• Adjusting or pausing certain medications as advised by the physician
• Pre-operative imaging, such as MRI or X-rays, to assess shoulder joint condition
• Blood tests and physical examination to ensure patient suitability for surgery

Procedure Description

1. Anesthesia: The patient is administered general anesthesia or regional anesthesia, ensuring they are pain-free during the procedure.
2. Incisions: Small incisions are made around the shoulder to insert the arthroscope and surgical instruments.
3. Arthroscopy: A camera is inserted into the shoulder joint, projecting images onto a monitor to guide the surgeon.
4. Repair and Tightening: The surgeon locates any damaged areas, such as torn ligaments, and uses specialized instruments to repair and tighten these structures to stabilize the shoulder.
5. Closing Incisions: The instruments are removed, and the small incisions are closed with sutures or surgical tape.

Duration

The procedure typically takes 1 to 2 hours.

Setting

• Hospital operating room
• Outpatient surgical center

Personnel

• Orthopedic surgeon specialized in shoulder procedures
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians
• Post-operative care team

Risks and Complications

• Infection at the incision sites
• Bleeding or hematoma formation
• Nerve or blood vessel damage
• Shoulder stiffness or reduced range of motion
• Recurrence of shoulder instability

Benefits

• Improved shoulder stability and reduced risk of dislocation
• Relief from pain and discomfort
• Enhanced shoulder function and range of motion
• Faster recovery compared to open surgery due to minimally invasive technique

Recovery

• Use of a sling or immobilizer for several weeks to protect the shoulder
• Physical therapy to regain strength and flexibility
• Gradual return to regular activities, typically within 4-6 months
• Regular follow-up appointments to monitor healing progress

Alternatives

• Physical therapy and rehabilitation to strengthen shoulder muscles
• Open surgical procedures for more severe cases
• Non-surgical treatments, such as corticosteroid injections, for pain management
• Pros: Non-surgical alternatives may avoid surgical risks
• Cons: Non-surgical methods may not provide the same level of stability as the arthroscopic procedure

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel anything. Post-operatively, they may experience pain or discomfort, managed with prescribed pain medications. Swelling and bruising around the shoulder are common. Follow-up care includes wound management, physical therapy, and gradual resumption of activities, ensuring a smooth recovery process.