28020 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint

Name of the Procedure:

Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint

Summary

An arthrotomy is a surgical procedure involving an incision into a joint, specifically the intertarsal or tarsometatarsal joints in the foot, to examine, drain, or remove loose or foreign bodies.

Purpose

Arthrotomy aims to address joint pain, swelling, or dysfunction caused by infection, inflammation, loose bone fragments, or foreign bodies. The primary goal is to relieve symptoms, improve joint function, and prevent further damage.

Indications

• Chronic or severe joint pain and swelling
• Presence of loose bone or cartilage fragments
• Joint infection or inflammation not resolved by other treatments
• Identification of foreign bodies within the joint
• Limited range of motion or joint instability

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Pre-procedure diagnostics might include X-rays, MRI, or CT scans to assess the joint condition.

Procedure Description

1. The patient is positioned appropriately, and anesthesia (general or regional) is administered.
2. An antiseptic solution is applied to the targeted foot area to prevent infection.
3. The surgeon makes an incision over the intertarsal or tarsometatarsal joint.
4. The joint is explored, and any loose bone fragments, cartilage pieces, or foreign bodies are identified and removed.
5. If needed, the joint is drained of excess fluid or pus.
6. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

Arthrotomies are performed in hospitals or surgical centers equipped with necessary surgical facilities.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse or scrub technician
• Operating room staff

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Joint stiffness or reduced range of motion
• Damage to surrounding nerves or blood vessels
• Adverse reactions to anesthesia

Benefits

• Relief from pain and swelling
• Improved joint function and mobility
• Removal of infection, loose fragments, or foreign bodies
• Prevention of further joint damage

Recovery

• Post-procedure instructions may include keeping the foot elevated, using ice packs, and taking prescribed pain medication.
• Physical therapy might be recommended for rehabilitation.
• Recovery time varies from a few weeks to several months, depending on the extent of the procedure and patient's overall health.
• Follow-up appointments are necessary to monitor healing and progress.

Alternatives

• Non-surgical treatments such as rest, physical therapy, medications, and joint injections.
• Arthroscopy, a minimally invasive procedure, might be an option for certain conditions.

Patient Experience

• During the procedure, patients will be under anesthesia and should not feel pain.
• Post-procedure discomfort is managed with pain medications.
• Some swelling and restricted movement are expected initially.
• Most patients can return to normal activities gradually, following their doctor's guidelines.

Pain management and comfort measures are provided to ensure a smooth recovery process.