Arthroscopy, shoulder, surgical; biceps tenodesis

CPT4 code

Name of the Procedure:

Summary

Arthroscopy of the shoulder with biceps tenodesis is a minimally invasive surgical procedure used to inspect and treat issues within the shoulder joint. This involves relocating the attachment of the biceps tendon to alleviate pain and restore function.

Purpose

The procedure addresses chronic shoulder pain and dysfunction due to biceps tendonitis, tears, or instability. The goal is to reduce pain, improve shoulder function, and prevent further tendon damage.

Indications

Persistent biceps tendonitis
Partial or complete biceps tendon tears
Shoulder instability
Failed conservative treatments like physical therapy or medications

Preparation

Fasting for at least 8 hours before surgery.
Adjustments to medications, particularly blood thinners.
Pre-operative diagnostics such as an MRI or X-rays to assess the condition of the shoulder.

Procedure Description

Anesthesia: General or regional anesthesia is administered.
Arthroscopy: Small incisions are made around the shoulder to insert a camera (arthroscope) and surgical instruments.
Examination: The shoulder joint is examined to confirm the extent of the biceps tendon issue and other associated problems.
Tenodesis: The surgeon detaches the biceps tendon from its original location and reattaches it to the humerus bone using sutures or anchors.
Closure: Incisions are closed with sutures or adhesive strips and the area is bandaged.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital or an outpatient surgical center.

Personnel

Orthopedic Surgeon
Anesthesiologist
Surgical Nurse
Scrub Technician

Risks and Complications

Infection
Bleeding
Nerve injury
Stiffness or loss of motion
Re-rupture of the tendon
Pain that persists or returns

Benefits

Reduced shoulder pain
Improved strength and range of motion
Enhanced shoulder stability
Lower risk of re-injury compared to non-surgical treatments

Recovery

Use of a sling to immobilize the shoulder for several weeks.
Pain management through prescribed medications.
Gradual physical therapy to restore movement and strength.
Full recovery may take 3 to 6 months, depending on individual circumstances.

Alternatives

Conservative treatments: physical therapy, anti-inflammatory medications, corticosteroid injections.
Biceps tenotomy: a simpler procedure which involves cutting the damaged tendon without reattachment, suitable for less active patients.
Risks and benefits vary; non-surgical options may result in less definitive pain relief and potential recurrence of symptoms.

Patient Experience

Minimal discomfort during the procedure due to anesthesia.
Post-operative pain managed with medications.
Some swelling and stiffness expected initially.
Gradual improvement in functionality and reduction in pain over time with consistent rehabilitation efforts.