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Removal of ankle implant

CPT4 code

Name of the Procedure:

Removal of Ankle Implant

  • Common Names: Ankle Hardware Removal, Ankle Implant Extraction
  • Technical Terms: Ankle Arthroplasty Explantation, Removal of Orthopedic Hardware

Summary

The removal of an ankle implant is a surgical procedure to take out hardware such as plates, screws, or other devices that were previously inserted to stabilize the ankle joint after injury or surgery.

Purpose

This procedure addresses complications or issues related to previously inserted ankle implants. It aims to relieve pain, resolve infection, correct hardware malfunction, or prepare for subsequent surgical interventions. The expected outcome is the elimination of symptoms caused by the implant and the restoration of ankle function.

Indications

  • Persistent pain or discomfort around the implant
  • Infection in the area surrounding the implant
  • Implant malfunction or rejection
  • Allergic reactions to the implant materials
  • Preparation for further reconstructive surgery
  • Successful healing of the original fracture or condition

Preparation

  • Pre-operative fasting (usually after midnight the night before the surgery)
  • Adjustment or pausing of certain medications (as directed by the surgeon)
  • Blood tests and imaging studies (e.g., X-rays) to assess implant position and surrounding anatomy
  • Pre-operative physical examination and medical history review

Procedure Description

  1. Administer anesthesia: typically either general anesthesia or regional (spinal/epidural) anesthesia.
  2. Clean and sterilize the surgical area.
  3. Make an incision over the site of the implant.
  4. Carefully remove the implant using specialized surgical tools.
  5. Inspect the surrounding bone and tissue for any issues or infections.
  6. Close the incision with sutures or staples.
  7. Apply a sterile dressing to the wound.

Duration

The procedure typically takes between 1 to 2 hours, depending on the complexity and location of the implant.

Setting

The procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

  • Orthopedic Surgeon
  • Anesthesiologist
  • Surgical Nurses
  • Operating Room Technicians

Risks and Complications

  • Infection
  • Bleeding
  • Nerve damage
  • Ankle instability or weakness
  • Blood clots
  • Adverse reaction to anesthesia
  • Delayed wound healing

Benefits

  • Relief from pain or discomfort caused by the implant
  • Resolution of infection or allergic reactions
  • Improved mobility and function of the ankle joint
  • Enhanced quality of life

Recovery

  • Follow post-operative instructions, including keeping the incision clean and dry.
  • Pain management typically involves prescribed medications.
  • Limitation of weight-bearing activities as advised.
  • Physical therapy may be recommended to restore function and strength.
  • Full recovery and return to normal activities may take several weeks to a few months.
  • Follow-up appointments to monitor healing and progress.

Alternatives

  • Non-surgical management, such as physical therapy or pain management.
  • Revision surgery with new implant placement.
  • Joint fusion or replacement, depending on the underlying condition.

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Post-operatively, pain and discomfort are managed with medications. Swelling and bruising around the incision site are common but temporary. The patient may experience restricted mobility initially, followed by gradual improvement with adherence to rehabilitation protocols.

Medical Policies and Guidelines for Removal of ankle implant

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