Introduction to Shoulder, Arm, and Elbow Surgery

Common shoulder, arm, and elbow complaints disrupt the harmony of musculoskeletal structures in these areas. Athletes, for example, perform repetitive motions such as swinging a club or hitting a ball that can create strain on their ligaments and joints. The wearing down of cartilage in joints is a common occurrence in the sports world; it is also an affliction shared by many elderly patients, who suffer from similar erosion of joint functionality by way of natural aging and arthritis. Surgical procedures are also performed on the shoulder, arm, and elbow to remove debris such as bone fragments, or to tighten loose ligaments that cause instability. On a more serious and technically complex level, some conditions may even require full reconstruction or the replacement of existing organic structures with man-made substitutes.

 

 

 

Total shoulder replacement for arthritis is an ever more common procedure, with several thousand operations performed in 2003 in the US, according to Medicare numbers. According to data from the Arthritis Foundation, the average cost of a total shoulder replacement is $10,351.

 

Arthroscopy goes for a less invasive route, using microcameras and small incisions to work on joints and examine problem areas. However, the convenience of these technologies is offset by higher costs, usually hovering in the tens of thousands.

 

Bankart procedures are used to reattach and tighten torn ligaments, and often recommended after shoulder dislocation. Rotator cuff surgeries do a similar job in restoring full mobility and arm movement to damaged tendons and muscles. The price of either of these surgeries varies among different facilities and depends upon the amount of repair work needed.

 

Lesser costs include fees for fractures of the various large and small bones of the shoulder, arm, and elbow that require surgical solutions. The proximal humerus, in particular, is prone to fractures. These operations may start in the thousands, though keep in mind that the complexity and location of each fracture is different.

 

 

Dealing with problems that inhibit proper manipulation and rotation of your shoulder, elbow, and arms is crucial to your overall well-being. As much, treatments are usually covered by insurance. The question is whether your specific surgery is seen as a medical necessity.

 

In some cases, for example, the preferred treatment that a insurance company typically covers might be non-surgical: physical therapy and drug treatments, for example. If, however, your physician strongly recommends a surgical procedure instead, have him or her draft a Letter of Medical Necessity. This should detail the reasons behind the operation you want, the potential health benefits to you, and other previous attempts that you have made to correct your condition. A strong appeal and plenty of medical documentation may be enough to convince your insurance company to see things your way.  

 

If, however, insurance will not cover your operation—or if it only covers a portion—look to other payment options. Your surgeon’s office should be able to offer plenty of ways to make the cost of surgery feasible, such as through private loans. In addition, if your shoulder, elbow, or arm injury was work-related, you should file a worker’s compensation claim.