Arthrotomy, wrist joint; with synovectomy
CPT4 code
Name of the Procedure:
Arthrotomy, Wrist Joint; with Synovectomy
Summary
Arthrotomy with synovectomy is a surgical procedure where the wrist joint is opened to remove inflamed or diseased synovial tissue. This helps relieve pain and improve joint function.
Purpose
The procedure is aimed at treating chronic inflammation of the synovial membrane, often seen in conditions like rheumatoid arthritis or persistent synovitis. The goal is to reduce pain, improve joint mobility, and prevent further joint damage.
Indications
- Chronic wrist pain caused by rheumatoid arthritis
- Persistent synovitis unresponsive to medication
- Joint swelling and stiffness
- Reduced wrist function affecting daily activities
Preparation
- Fasting may be required for a certain number of hours before the procedure
- Discontinuation or adjustment of certain medications, as advised by the doctor
- Preoperative blood tests and imaging studies, such as X-rays or MRI
Procedure Description
- Anesthesia: The patient is given general or regional anesthesia.
- Incision: A surgical incision is made over the wrist joint.
- Joint Exposure: The wrist joint is carefully exposed.
- Synovectomy: The inflamed or diseased synovial tissue is identified and removed using surgical instruments.
- Closure: The incision is closed with sutures or staples and dressed with sterile bandages.
Tools and equipment include surgical knives, forceps, retractors, and possibly an arthroscope for visualization.
Duration
The procedure typically takes about 1 to 2 hours, depending on the extent of the synovectomy.
Setting
The procedure is usually performed in a hospital or surgical center setting.
Personnel
- Orthopedic surgeon
- Surgical nurses
- Anesthesiologist
- Surgical technologist
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma
- Nerve or blood vessel damage
- Stiffness or reduced range of motion
- Adverse reaction to anesthesia
Benefits
- Relief from pain and inflammation
- Improved wrist joint function and mobility
- Prevention of further joint damage
- Benefits are often realized within weeks to a few months post-surgery
Recovery
- Immobilization of the wrist with a splint or cast for several weeks
- Pain relief with prescribed medications
- Physical therapy to restore strength and range of motion
- Follow-up appointments to monitor healing
- Full recovery typically takes 2 to 3 months
Alternatives
- Medication management (NSAIDs, corticosteroids)
- Physical therapy
- Arthroscopic synovectomy (less invasive)
- Joint replacement surgery in severe cases
Pros and cons of alternatives should be weighed with a healthcare provider.
Patient Experience
During the procedure, the patient is under anesthesia and should not feel pain. Post-surgery, there might be some discomfort and swelling, which can be managed with pain medications and anti-inflammatory drugs. Rehabilitation and physical therapy are crucial for a successful recovery.