Tenodesis; of proximal interphalangeal joint, each joint
CPT4 code
Name of the Procedure:
Tenodesis of Proximal Interphalangeal Joint (PIP Joint Tenodesis)
Summary
PIP Joint Tenodesis is a surgical procedure to stabilize the proximal interphalangeal joint (the middle joint of a finger) by attaching a tendon or ligament to a bone. This helps restore function and relieve pain in the affected joint.
Purpose
This procedure addresses instability, chronic pain, or deformity of the proximal interphalangeal joint, typically due to arthritis, injury, or certain congenital conditions. The goal is to stabilize the joint, reduce pain, and improve overall hand function.
Indications
- Chronic pain in the PIP joint.
- Joint instability or subluxation.
- Deformities or malalignment of the PIP joint.
- Failure of conservative treatments like splinting or physical therapy.
- Conditions like rheumatoid arthritis or severe osteoarthritis affecting the PIP joint.
Preparation
- The patient may need to fast for several hours before the procedure.
- Medications may need to be adjusted, particularly blood thinners.
- Diagnostic imaging like X-rays or MRI might be required to assess the joint condition.
Procedure Description
- The patient is typically given regional or general anesthesia.
- An incision is made over the affected PIP joint.
- The tendon or ligament is identified and prepared for attachment.
- Using surgical tools, the tendon or ligament is anchored to the bone to stabilize the joint.
- The incision is closed with sutures, and a bandage is applied.
Duration
The procedure usually takes about 1-2 hours, depending on the complexity and the number of joints treated.
Setting
PIP Joint Tenodesis is typically performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Surgical nurses
- Anesthesiologist or nurse anesthetist
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Nerve damage
- Stiffness or loss of motion in the joint
- Failure of the tendon to properly attach and heal
Benefits
- Stabilized joint
- Reduced pain
- Improved hand function
- Better quality of life These benefits are often realized within a few weeks to months following the procedure.
Recovery
- The patient will need to follow specific post-operative care instructions.
- A splint or cast may be required to immobilize the finger.
- Physical therapy is often necessary to restore movement and strength.
- Full recovery typically takes several weeks to a few months, with regular follow-up appointments to monitor progress.
Alternatives
- Non-surgical options such as physical therapy, splinting, or medication.
- Arthrodesis (joint fusion) of the PIP joint.
- Joint replacement (arthroplasty) for severe cases. Each alternative has its pros and cons, and suitability depends on the specific condition and patient's overall health.
Patient Experience
- The patient may feel discomfort or pain post-procedure, managed with medications.
- Swelling and stiffness in the finger are common initially.
- Physical therapy sessions will help regain movement and strength.
- Gradual improvement in finger function and pain relief is expected during the recovery period.