28070 Synovectomy; intertarsal or tarsometatarsal joint, each

Name of the Procedure:

Synovectomy; intertarsal or tarsometatarsal joint, each.

Summary

A synovectomy is a surgical procedure where the lining of a joint, known as the synovium, is removed. Specifically, this procedure targets the intertarsal or tarsometatarsal joints in the foot.

Purpose

The procedure aims to relieve pain and improve joint function by removing inflamed or diseased synovial tissue. It is typically performed to treat conditions like arthritis that do not respond to non-surgical treatments.

Indications

• Persistent pain in the intertarsal or tarsometatarsal joints.
• Chronic inflammation of the synovium due to arthritis.
• Failure of conservative treatments like medications and physical therapy.
• Swelling, stiffness, and reduced mobility in the affected foot joints.

Preparation

• Patients may need to fast for a certain period before the surgery.
• Adjustments to medication, particularly blood thinners, may be necessary.
• Pre-operative blood tests, imaging studies, and a thorough physical examination will be conducted.

Procedure Description

1. The patient is administered anesthesia; this could either be general or regional, depending on the case.
2. A small incision is made near the affected joint(s).
3. Special surgical tools are used to remove the inflamed or diseased synovium.
4. The surgeon may use arthroscopy, a minimally invasive technique with a camera.
5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes between 1 to 2 hours, depending on the extent of the synovectomy.

Setting

The surgery is usually performed in a hospital's surgical center or an outpatient clinic.

Personnel

• An orthopedic surgeon or a foot and ankle specialist.
• An anesthesiologist.
• Nursing staff and surgical technicians.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Nerve damage leading to numbness or tingling.
• Recurrence of symptoms or development of arthritis in the joint.
• Blood clots.

Benefits

• Relief from chronic pain and inflammation.
• Improved mobility and joint function.
• Enhanced quality of life, with benefits often noticeable within a few weeks post-surgery.

Recovery

• Rest and elevation of the foot for the initial days post-surgery.
• Use of crutches or a walker to avoid putting weight on the foot.
• Physical therapy to regain strength and mobility.
• Follow-up appointments to monitor healing.
• Full recovery typically takes several weeks to a few months.

Alternatives

• Conservative measures like anti-inflammatory medications, physical therapy, and corticosteroid injections.
• Joint fusion surgery, which is more invasive.
• Pros and cons: Conservative treatments avoid surgery but may not provide long-term relief. Fusion surgery provides permanent stabilization but eliminates joint movement.

Patient Experience

During the procedure, the patient will not feel pain due to anesthesia. Post-surgery, there may be discomfort, swelling, and limited mobility initially. Pain management includes prescribed medications. Patients can expect a gradual return to normal activities following the recovery guidelines provided by their healthcare team.