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Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral

CPT4 code

Name of the Procedure:

Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral

Summary

Arthrotomy with excision of semilunar cartilage, commonly known as a meniscectomy, is a surgical procedure where a surgeon removes part or all of a damaged meniscus from the knee. The meniscus is a piece of cartilage that acts as a cushion between the femur (thigh bone) and the tibia (shin bone).

Purpose

Medical Condition or Problem Addressed
  • Meniscus tears
Goals or Expected Outcomes
  • Relieve pain and swelling
  • Improve knee joint function
  • Prevent further joint damage

Indications

Symptoms or Conditions
  • Knee pain, swelling, and stiffness
  • Locking or catching sensation in the knee
  • Limited range of knee motion
Patient Criteria
  • Patients with confirmed meniscus tears via MRI or other imaging
  • Non-responsive to conservative treatments like physical therapy or medication

Preparation

Pre-procedure Instructions
  • Fasting for 8 hours before surgery
  • Temporary discontinuation of certain medications like blood thinners
Diagnostic Tests
  • MRI or X-ray of the knee
  • Blood tests and physical examination

Procedure Description

  1. Anesthesia: General or regional (spinal/epidural) anesthesia is administered.
  2. Incision: A small incision is made in the knee joint to expose the meniscus.
  3. Excision: Damaged parts of the meniscus are carefully removed using surgical instruments.
  4. Closure: The incision is closed with sutures or staples, and a sterile bandage is applied.
Tools and Equipment
  • Surgical knives and scissors
  • Arthroscope for visual guidance (if using minimally invasive techniques)
Anesthesia Details
  • Administered and monitored by an anesthesiologist

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

  • Orthopedic surgeon
  • Surgical assistants
  • Anesthesiologist
  • Nursing staff

Risks and Complications

Common Risks
  • Infection
  • Bleeding
  • Swelling and stiffness
Rare Risks
  • Damage to surrounding nerves or blood vessels
  • Blood clots
  • Adverse reaction to anesthesia
Management of Complications
  • Use of antibiotics for infection
  • Regular follow-up appointments

Benefits

  • Pain relief often within a few weeks
  • Increased knee stability and function
  • Rapid return to normal activities

Recovery

Post-procedure Care
  • Rest and elevation of the knee
  • Icing to reduce swelling
  • Physical therapy for rehabilitation
Recovery Time
  • Typically 4-6 weeks, with some restrictions on activities
Follow-up
  • Scheduled appointments to monitor healing progress

Alternatives

  • Physical therapy
  • Corticosteroid injections
  • Knee brace or support
  • Alternative surgical techniques like meniscus repair
Pros and Cons of Alternatives
  • Non-surgical options have lower risk but may be less effective in severe cases
  • Meniscus repair is less invasive but requires longer recovery

Patient Experience

During the Procedure
  • No pain felt due to anesthesia
  • Minimal awareness if under general anesthesia
After the Procedure
  • Mild to moderate pain managed with painkillers
  • Swelling and bruising around the knee
  • Discomfort for a few days, gradually improving with recovery
Pain Management and Comfort Measures
  • Prescription pain medications
  • Cold packs and elevation
  • Supportive care from medical staff and physical therapists

Medical Policies and Guidelines for Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial OR lateral

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