Synovectomy, tendon sheath, foot; flexor
CPT4 code
Name of the Procedure:
Synovectomy, tendon sheath, foot; flexor
Common name: Flexor Tendon Synovectomy of the Foot
Summary
A surgical procedure to remove inflamed or diseased synovial tissue from the flexor tendon sheath in the foot, which helps ease pain and restore function.
Purpose
This procedure addresses chronic synovitis or inflammation of the synovial membrane within the tendon sheath. The goal is to reduce pain, improve movement, and prevent further damage to the tendons and surrounding structures.
Indications
- Persistent pain and swelling in the foot despite conservative treatments
- Limited range of motion or function due to synovitis
- Diagnosed inflammatory joint diseases such as rheumatoid arthritis
- Synovial hypertrophy or nodules causing mechanical symptoms
Preparation
- Fasting for 8 hours before the procedure
- Adjustments to medications, especially blood thinners
- Pre-operative blood tests and imaging studies like X-rays or MRIs
- Discussion of anesthesia options with the anesthesiologist
Procedure Description
- The patient is positioned comfortably and given the appropriate anesthesia.
- An incision is made over the affected area of the foot.
- The surgeon carefully exposes the tendon sheath.
- Inflamed or hypertrophic synovial tissue is removed.
- The incision is closed with sutures, and a sterile dressing is applied.
Tools/Equipment: Surgical scalpel, forceps, scissors, suction device, sterile dressings
Anesthesia: Local, regional, or general anesthesia depending on case specifics
Duration
The procedure typically lasts about 1 to 2 hours.
Setting
Performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic surgeon or podiatric surgeon
- Anesthesiologist or nurse anesthetist
- Surgical nurses or technicians
Risks and Complications
- Infection
- Bleeding
- Nerve damage
- Recurrence of synovitis
- Scarring
- Adverse reactions to anesthesia
Benefits
- Reduced pain
- Improved range of motion
- Enhanced function and mobility
- Prevention of further joint damage Benefits are usually noticed within a few weeks post-surgery.
Recovery
- Keeping the foot elevated and limited movement initially
- Follow-up appointments for suture removal and progress assessments
- Gradually reintroducing weight-bearing activities
- Physical therapy may be recommended Recovery time varies but usually spans several weeks to a few months.
Alternatives
- Non-surgical treatments: physical therapy, anti-inflammatory medications, corticosteroid injections
- Arthroscopic synovectomy: a minimally invasive option with quicker recovery but may not be suitable for all cases Each alternative has its own pros and cons, typically balancing effectiveness with recovery time and potential risks.
Patient Experience
Patients might feel discomfort during the initial recovery phase, managed with pain medications. Swelling and restricted movement are common initially, but improvements are seen steadily. Pain management strategies and physical therapy will aid in smoother recovery.