Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty
CPT4 code
Name of the Procedure:
Total Knee Arthroplasty
Summary
Total knee arthroplasty, commonly known as knee replacement surgery, involves replacing a damaged or worn knee joint with an artificial joint made of metal, ceramic, or plastic. This procedure typically involves anesthesia to ensure the patient is pain-free during surgery.
Purpose
Total knee arthroplasty addresses issues such as severe arthritis or significant knee injuries. The goal is to alleviate pain, enhance knee functionality, and improve the patient's ability to perform daily activities.
Indications
- Severe knee pain or stiffness limiting everyday activities
- Chronic knee inflammation and swelling unresponsive to medications
- Knee deformity
- Failure of other conservative treatments (e.g., physical therapy, medications)
- Radiographic evidence of joint damage
Preparation
- Fasting 6-8 hours before surgery
- Adjustment or discontinuation of certain medications (e.g., blood thinners)
- Preoperative assessments including blood tests, EKG, and imaging studies
- Physical examination and anesthesiology consultation
Procedure Description
- Anesthesia: Administered by an anesthesiologist, who may use general anesthesia (patient is asleep) or regional anesthesia (epidural or spinal block, numbing below the waist).
- Incision: The surgeon makes an incision over the knee to access the joint.
- Removing Damaged Tissue: Damaged bone and cartilage are removed from the femur, tibia, and patella.
- Implanting Prosthesis: Metal and plastic components are positioned to recreate the surface of the joint.
- Closing the Incision: The incision is closed using stitches or staples, and a bandage is applied.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Total knee arthroplasty is performed in a hospital or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Assistants and scrub technicians
Risks and Complications
- Infection
- Blood clots
- Bleeding
- Loosening or wear of the prosthesis
- Nerve injury
- Allergic reaction to anesthesia
- Stiffness and reduced range of motion
Benefits
- Significant pain relief
- Enhanced mobility and function
- Improved quality of life
- Long-lasting results, with prostheses often lasting 15-20 years
Recovery
- Hospital stay ranging from a few days
- Isometric exercises and physical therapy begin immediately post-surgery
- Pain management with medications
- Use of mobility aids (e.g., walkers, crutches)
- Full recovery may take 3 to 6 months
- Regular follow-up visits to monitor progress
Alternatives
- Physical therapy and exercise
- Medications (anti-inflammatory drugs, corticosteroids)
- Knee braces or orthotic support
- Arthroscopic knee surgery (for less severe cases)
- Partial knee replacement Alternative treatments are often less invasive but may not provide as comprehensive relief as total knee arthroplasty.
Patient Experience
Patients may feel groggy after anesthesia and will experience postoperative pain managed with medications. Movement will initially be limited, but physical therapy will assist in regaining strength and mobility. Comfort measures include ice packs, elevation, and prescribed pain relief.