Description of Event or Problem · 1
PT HAD ACUTE INCIDENT OF LOSS OF RANGE OF MOTION & SEVERE PAIN. PREOPERATIVE DIAGNOSIS: POSSIBLE SYNOVITIS, POSSIBLE FAILED ABSORBABLE IMPLANT, RIGHT SHOULDER. POSTOPERATIVE DIAGNOSIS: FAILED SYNOVIAL IMPLANT. PROCEDURE PERFORMED: ARTHROSCOPY WITH REMOVAL OF IMPLANT. GLENOHUMERAL SYNOVECTOMY AND DEBRIDEMENT. FINDINGS: THERE WAS MARKED SYNOVITIS IN THE GLENOHUMERAL JOINT. THERE WERE SEVERAL PIECES OF FRAGMENTED, ABSORBABLE IMPLANT THROUGHOUT THE JOINT. THE GLENOID LABRUM WAS WELL-HEALED AND IN POSITION. THERE WAS A MILD CHONDROMALACIA OF THE PATELLA. PROCEDURE: WITH THE PT SUPINE ON THE OPERATING TABLE, THE SHOULDER WAS RUN THROUGH RANGE OF MOTION. THE PT WAS PLACED IN LATERAL DECUBITUS POSITION AND THE ARM WAS PLACED IN TRACTION AND ABDUCTION. THE SHOULDER WAS PREPPED AND DRAPED IN STERILE MANNER AND THE ARTHROSCOPE WAS INTRODUCED POSTERIORLY INTO THE GLENOHUMERAL JOINT WITH INFLOW THROUGH THE SCOPE. THE INSTRUMENTATION WAS THROUGH THE ANTEROSUPERIOR PORTAL. THE JOINT WAS INSPECTED IN STANDARD MANNER AND FOUND TO HAVE A FRAGMENTED TACK AND A LOT OF SYNOVITIS, ESPECIALLY ANTERIORLY. THE GLENOID WAS WELL-HEALED. SOME OF THE IMPLANT PIECES WERE SEEN. THERE WERE CLEAR PIECES OF FRAGMENTED IMPLANT AND SOME WERE GRASPED WITH A GRASPER. SOME WERE REMOVED WITH THE SHAVER. THE INTRA-ARTICULAR SHAVER WAS PLACED INTO THE JOINT. DEBRIDEMENT WAS DONE. THE GLENOHUMERAL JOINT WAS DEBRIDED. THE GRASPERS WERE REINSERTED SEVERAL TIMES TO GET THE PIECES. INSTRUMENTS WERE USED THROUGH A POSTERIOR PORTAL WITH THE SCOPE ANTERIORLY AND THE ANTERIOR ASPECT WAS INSPECTED. THERE WERE STILL SOME SMALL PIECES ANTERIORLY AND THEY WERE SUCKED OUT WITH THE SHAVER. A 70 DEGREE SCOPE WAS USED AS WELL TO CHECK THE MEDIAL RECESS. WHEN THIS HAD BEEN DONE AND ADEQUATE DEBRIDEMENT HAD BEEN PERFORMED, THE INSTRUMENTS WERE REMOVED. THE WOUNDS WERE SUTURED. THE PT WAS TAKEN TO THE RECOVERY ROOM IN GOOD CONDITION.