Arthroscopy, subtalar joint, surgical; with synovectomy
CPT4 code
Name of the Procedure
Arthroscopy, subtalar joint, surgical; with synovectomy
Common names: Subtalar Arthroscopy with Synovectomy
Summary
Subtalar arthroscopy with synovectomy is a minimally invasive surgical procedure used to diagnose and treat problems within the subtalar joint, found in the ankle. Through small incisions, cameras, and specialized tools, the surgeon can visualize and remove inflamed or damaged synovial tissue.
Purpose
The procedure is intended to alleviate pain, improve joint function, and treat conditions like synovitis, which is inflammation of the synovial membrane. It aims to restore mobility and reduce inflammation within the joint.
Indications
- Persistent ankle pain unresponsive to non-surgical treatments.
- Diagnosed synovitis of the subtalar joint.
- Degenerative joint disease or arthritis.
- Recurrent instability of the ankle.
- Joint stiffness and reduced range of motion.
Preparation
- Patients may be required to fast for several hours before the procedure.
- Adjustments to medications, particularly blood thinners, should be discussed with the doctor.
- Pre-operative evaluations may include blood tests, imaging studies (like X-rays or MRI), and a full medical history assessment.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incisions: Small incisions are made near the ankle to insert the arthroscope and surgical instruments.
- Inspection: The arthroscope, equipped with a camera, allows for a detailed view of the subtalar joint.
- Synovectomy: Using specialized tools, the surgeon removes inflamed or damaged synovial tissue.
- Closure: Incisions are closed with sutures or adhesive strips, and the area is bandaged.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
This procedure is usually performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Surgical nurse
- Anesthesiologist
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Nerve damage
- Persistent or recurrent inflammation
- Adverse reactions to anesthesia
Benefits
- Relief from pain and inflammation.
- Improved joint mobility and function.
- Shorter recovery time compared to open surgery.
- Minimally invasive with smaller incisions and less scarring.
Recovery
- Post-procedure care includes rest, ice, compression, and elevation (RICE protocol).
- Pain management may involve medications and physical therapy.
- Limited weight-bearing on the affected foot, often using crutches.
- Follow-up appointments to monitor healing.
- Full recovery typically takes several weeks to a few months.
Alternatives
- Non-surgical treatments such as physical therapy, medications, and orthotic devices.
- Other surgical options like open synovectomy.
- Steroid injections to reduce inflammation.
- Pros of alternatives: Less invasive options available for mild cases.
- Cons: May not provide the same level of relief and permanent solution as surgery.
Patient Experience
- During the procedure, the patient will be under anesthesia and should not feel pain.
- Post-surgery, some pain and swelling are expected, which can be managed with medications and rest.
- Physical therapy may be recommended to aid in the recovery of joint function and strength.