27637 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor, Tibia or Fibula; with Autograft (includes obtaining graft)

Summary

This procedure involves the surgical removal of a non-cancerous bone cyst or tumor located in the tibia (shinbone) or fibula (calf bone). The removal (excision) or scraping away (curettage) of the tumor is followed by filling the defect with a bone graft taken from another part of the patient's body (autograft).

Purpose

This procedure addresses bone cysts or benign tumors that may cause pain, swelling, or risk of fracture. The goals are to remove the tumor or cyst, alleviate symptoms, restore bone structure, and prevent future fractures.

Indications

• Persistent pain or swelling in the leg
• Structural weakness of the tibia or fibula bone
• Risk of bone fracture due to the cyst or tumor
• No response to non-surgical treatments

Preparation

• Fasting for 8 hours prior to surgery
• Adjustment of certain medications as advised by the physician
• Preoperative imaging studies like X-rays, MRI, or CT scans
• Blood tests and possibly a bone biopsy to confirm the diagnosis

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made over the affected area of the tibia or fibula.
3. The cyst or tumor is accessed and carefully excised or curetted.
4. A bone graft is harvested from another part of the patient’s body, typically the pelvis.
5. The autograft is placed into the defect created by the excision to support bone healing and regeneration.
6. The surgical site is closed with sutures, and a dressing is applied.

Duration

The procedure typically lasts 2 to 4 hours.

Setting

This procedure is performed in a hospital or specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding tissues or nerves
• Non-healing or delayed healing of the bone
• Graft rejection or failure
• Pain at the graft donor site

Benefits

• Relief from pain and swelling
• Strengthened bone structure
• Reduced risk of fracture
• Improved overall function and mobility

Recovery

• Pain management with medication
• Instructions on wound care and signs of infection
• Limited weight-bearing or activity restrictions for several weeks
• Follow-up appointments to monitor healing and remove sutures
• Physical therapy may be required to regain strength and mobility

Alternatives

• Observation and regular monitoring (if the cyst or tumor is asymptomatic)
• Non-surgical treatments such as medications or injections

• Other surgical options like bone graft substitutes or synthetic materials

  Pros and cons of alternatives:

• Non-surgical options may not be effective in all patients and do not remove the tumor or cyst.
• Synthetic grafts may not integrate as well as autografts but avoid the need for a donor site.

Patient Experience

• During the procedure, the patient will be under general anesthesia and won’t feel anything.
• Post-procedure, some pain and discomfort are expected, managed through medications.
• Activity limitations and gradual return to normal activities will be advised to ensure proper healing.