29823 Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular si

Name of the Procedure:

Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule).

Summary

Arthroscopy is a minimally invasive surgical procedure used to diagnose and treat problems in the shoulder joint. Extensive debridement involves cleaning or removing damaged tissues from three or more different structures within the shoulder.

Purpose

• Medical Condition: This procedure addresses issues such as torn cartilage, damaged tendons, or bone spurs in the shoulder.
• Goals/Outcomes: The aim is to reduce pain, improve mobility, and restore function to the injured shoulder.

Indications

• Chronic shoulder pain not relieved by non-surgical treatments.
• Symptoms of impingement, such as limited range of motion or catching sensation.
• Shoulder instability or dislocation.
• Bursitis, tendinitis, or rotator cuff tears.

Preparation

• Pre-Procedure Instructions: Patients may be advised to fast for 8-12 hours before the procedure.
• Medication Adjustments: Some medications, particularly blood thinners, may need to be stopped.
• Diagnostic Tests: MRI or X-ray evaluations of the shoulder are typically conducted beforehand.

Procedure Description

1. The patient is given anesthesia (general or regional block).
2. Small incisions are made around the shoulder area.
3. An arthroscope (a small camera) and surgical instruments are inserted through these incisions.
4. The surgeon visualizes the joint on a monitor and removes or repairs damaged tissue.
5. Structures like the humeral bone, glenoid bone, articular cartilage, biceps tendon, labrum, or articular capsule are addressed as needed.
6. The incisions are closed with stitches, and a bandage is applied.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Surgeons: Orthopedic surgeons specializing in shoulder procedures.
• Nurses: Operating room (OR) nurses and recovery room nurses.
• Anesthesiologists: Administer anesthesia and monitor the patient during surgery.

Risks and Complications

• Common Risks: Infection, bleeding, and swelling.
• Rare Risks: Nerve damage, blood clots, or complications from anesthesia.
• Management: Risks are managed through careful surgical technique and post-operative care.

Benefits

• Expected Benefits: Reduced pain, improved shoulder function, and increased mobility.
• Realization Time: Benefits can typically be noticed within a few weeks to a few months post-surgery.

Recovery

• Post-Procedure Care: Ice application, pain medication, and physical therapy.
• Recovery Time: Patients may return to light activities in about 2 weeks, with full recovery taking around 3-6 months.
• Restrictions: Avoid heavy lifting and intensive shoulder use until cleared by your physician.
• Follow-Up: Regular follow-up appointments to monitor healing.

Alternatives

• Other Treatments: Physical therapy, corticosteroid injections, or alternative surgical procedures.
• Pros and Cons: Non-invasive treatments may offer temporary relief but could fail to address severe conditions. Alternative surgeries may have different risk profiles and recovery times.

Patient Experience

• During the Procedure: Patients will be under anesthesia and won’t feel pain.
• Post-Procedure: Mild to moderate pain and discomfort, managed with pain relief measures.
• Pain Management: Prescription pain medications, over-the-counter pain relief, and physical therapy to ensure comfort and aid recovery.