CPT® Code 23800

Arthrodesis of the shoulder, specifically the glenohumeral joint, is a surgical procedure aimed at fusing the joint to alleviate pain and restore function. This procedure is particularly relevant for patients suffering from severe joint conditions, such as arthritis or instability, where conservative treatments have failed. The surgery involves a deltopectoral approach, which is a surgical technique that allows access to the shoulder joint by making an incision along the deltopectoral interval. This approach facilitates the identification and retraction of the cephalic vein and the conjoint tendon, which are critical structures in the shoulder region. The procedure requires careful dissection and manipulation of the subscapularis tendon and the joint capsule to gain access to the glenohumeral joint. Once the joint is exposed, it is dislocated to allow for the removal of cortical bone from the joint surfaces, including the acromion, glenoid fossa, and humeral head. This preparation is essential for achieving a successful fusion. If an autograft is indicated, bone is harvested either locally or from a remote site, such as the iliac crest, to facilitate the fusion process. The graft is then placed into the joint space, and the humerus is repositioned into the joint socket. The procedure also involves specific positioning of the humerus to ensure proper contact with the acromion, followed by the application of fixation devices to stabilize the joint during the healing process. The use of a shoulder spica cast post-surgery is crucial for immobilization, promoting optimal recovery and fusion of the joint.