29822 Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of

Name of the Procedure:

Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures

• Common names: Shoulder Arthroscopy, Arthroscopic Shoulder Surgery
• Medical terms: Arthroscopic Shoulder Debridement

Summary

A shoulder arthroscopy is a minimally invasive surgical procedure used to examine and treat problems inside the shoulder joint. During a limited debridement, the surgeon removes damaged tissue or bone fragments from one or two specific structures in the shoulder.

Purpose

The procedure is designed to address shoulder pain, stiffness, or dysfunction caused by damaged or diseased tissue within the joint. Removing the damaged tissue can help improve joint function and alleviate pain.

Indications

• Persistent shoulder pain unresponsive to conservative treatments
• Limited range of motion in the shoulder
• Mechanical symptoms such as catching or locking
• Specific diagnoses such as rotator cuff tears, labral tears, or cartilage damage

Preparation

• Fasting for 6-12 hours prior to the procedure
• Medication adjustments as advised by the physician, especially if taking blood thinners
• Pre-operative diagnostic imaging such as MRI or X-rays
• Clinical evaluation and anesthesia consultation

Procedure Description

1. The patient is given regional or general anesthesia for comfort.
2. Small incisions are made around the shoulder joint.
3. An arthroscope (a small camera) is inserted to visualize the joint.
4. Specialized instruments are used to remove damaged tissue from specific areas such as the humeral bone, biceps tendon, or cartilage.
5. The incisions are closed with sutures or sterile strips.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Shoulder arthroscopy is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses or technicians
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Damage to surrounding structures such as nerves or blood vessels
• Stiffness or continued pain in the shoulder
• Adverse reactions to anesthesia

Benefits

• Relief from shoulder pain
• Improved range of motion and function of the shoulder joint
• Minimal scarring due to the small incisions

Recovery

• Post-procedure: Ice and pain medications to manage swelling and discomfort
• Physical therapy: Usually starts within a few days to regain motion and strength
• Recovery time: Typically 4-6 weeks for most activities, longer for strenuous use
• Follow-up: Scheduled appointments with the surgeon to monitor healing and progress

Alternatives

• Non-surgical treatments such as physical therapy, medications, or corticosteroid injections
• Open shoulder surgery for more extensive repair
  • Pros: Direct access and visualization for complex repairs
  • Cons: Longer recovery time, larger incisions, increased risk of complications

Patient Experience

During the procedure, the patient will be under anesthesia, so they will not feel pain. Post-operatively, they may experience tenderness, swelling, and limited mobility. Pain management includes prescribed medications and icing the area. Comfort measures include proper sling use and gradual reintroduction of activities as directed by the healthcare provider.