25441 Arthroplasty with prosthetic replacement; distal radius

Name of the Procedure:

Arthroplasty with prosthetic replacement; distal radius (Wrist joint prosthetic replacement)

Summary

Arthroplasty with prosthetic replacement of the distal radius is a surgical procedure that involves replacing the damaged distal part of the radius bone, which is a key bone in the wrist, with a prosthetic implant. This helps restore function and relieve pain in the wrist joint.

Purpose

This procedure addresses issues such as severe arthritis, fractures, or other conditions leading to significant damage of the distal radius. The goals are to alleviate pain, improve wrist stability and function, and enhance the patient's quality of life by restoring the range of motion.

Indications

• Severe arthritis affecting the distal radius
• Irreparable fractures of the distal radius
• Chronic wrist pain unresponsive to conservative treatments
• Loss of wrist function or instability
• Prior unsuccessful wrist surgeries

Preparation

• Fasting typically required for 8-12 hours prior to surgery.
• Adjustment or temporary discontinuation of certain medications, particularly blood thinners.
• Preoperative diagnostic tests such as X-rays or MRI scans to assess the extent of damage.
• Pre-surgical physical examination and medical clearance.

Procedure Description

1. The patient is administered either general anesthesia or regional anesthesia to numb the surgical area.
2. An incision is made over the wrist joint to access the distal radius.
3. The damaged portions of the distal radius are carefully removed.
4. The prosthetic implant is positioned and secured in place.
5. The incision is then closed with sutures.
6. A sterile dressing is applied to the surgical site.

Duration

The procedure typically takes about 1-2 hours, depending on the complexity and extent of the damage.

Setting

The procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists
• Post-operative care team

Risks and Complications

• Infection at the surgical site
• Blood clots
• Prosthetic implant failure or complications
• Nerve or blood vessel damage
• Scar tissue formation limiting range of motion
• Persistent pain or stiffness

Benefits

• Significant pain relief in the wrist joint
• Improved wrist function and strength
• Enhanced quality of life and ability to perform daily activities
• Restoration of normal or near-normal wrist motion

Recovery

• Initial immobilization of the wrist with a splint or cast.
• Pain management through prescribed medications.
• Gradual physical therapy to restore mobility and strength.
• Typical recovery time ranges from several weeks to a few months.
• Follow-up appointments to monitor healing and prosthetic function.

Alternatives

• Non-surgical treatments (e.g., medications, physical therapy, wrist braces).
• Other surgical options (e.g., wrist fusion, partial arthroplasty).
  • Pros of alternatives: Lower immediate risk and less invasive.
  • Cons of alternatives: May not provide as significant or lasting improvements in function and pain relief.

Patient Experience

• During the procedure, the patient will feel no pain due to effective anesthesia.
• Initial post-operative period may include discomfort, managed with pain relief measures.
• Gradual improvement in wrist function and reduction in pain over the recovery period.
• Regular follow-up visits to ensure optimal recovery and prosthetic integration.