Debridement

Overview
Reviewed by Dr. Ken Alleyne

The tip of the shoulder blade (scapula) that forms the roof of the shoulder joint is known as the acromion. Where this bone meets the collarbone (clavicle) is known as the acromioclavicular (or AC) joint. Normally, the tendons of the shoulder and the fluid-filled sac known as the bursa have plenty of room underneath the AC joint. However, overuse of the shoulder may lead to bursitis, tendonitis, collectively known as impingement. Impingement causes the tissues underneath the AC joint to be pinched against the bone, causing irritation and pain. Additionally, arthritis can develop in the shoulder as a result of overuse (Arthrosis) or autoimmune attack (Rheumatoid Arthritis). Physical therapy, medication, or cortisone injections are most often prescribed for shoulder pain; however, if these methods fail to provide relief, arthroscopic surgery may be necessary.

Debridement is the removal of tissue that has been damaged by arthrosis, rheumatoid arthritis, overuse, or by other means. During this procedure, any degenerated, infected, or stray tissue inside the shoulder is removed to prevent infection and to gain more space inside the joint for the bones and tissues to move. The procedure is usually performed arthroscopically. Debridement generally accompanies other, more substantial procedures. The patient may be discharged following the procedure, or may remain in the hospital for one to two days.

Detailed Description
Specialist

Orthopedic surgeon
Procedure
Before the Procedure:

The patient's medical history and any possible allergies to medication are determined. The surgeon may order X Rays, an MRI, CT Scan, or EMG to look into the joint before the procedure. The patient is dressed in a hospital gown and anesthetized either locally or generally.

During the procedure:

A number of half-inch incisions will be made to allow the arthroscope to enter the shoulder joint. A sterile saline solution will be pumped into the joint both to cleanse it and to expand it for better visualization. The surgical staff may also pump air into the joint to create more room to see inside the joint. While watching a monitor that shows a magnified image of the inside of the shoulder, the surgeon guides the arthroscope to perform a number of procedures within the joint.

The surgeon may use a motorized tool to remove any frayed, degenerated, rough, or damaged ends on the tissues and bone that surround the shoulder joint. This is known as debridement, and it is usually the first surgical step in an arthroscopic or open procedure. The patient may be discharged following the procedure, or may remain in the hospital for one to two days.

Recovery:

As debridement is usually part of a larger operation, recovery will most often depend upon the major procedure.

Complications/Risks:

• Blood clots (very rare)
  
• Surgical wound infection
  
• Reaction to anesthesia
  
• Risk of developing arthritis
  
• Weakening of muscles
  
• Stiffness
  
• Neurovascular injury