Tenodesis; of distal joint, each joint
CPT4 code
Name of the Procedure:
Tenodesis; of distal joint, each joint
- Common name: Tenodesis surgery
- Medical term: Distal joint tenodesis
Summary
Tenodesis is a surgical procedure that involves attaching a tendon to a bone to stabilize a distal joint. This helps to restore normal function and alleviate pain or instability in the joint.
Purpose
- Medical Condition: Addresses issues such as tendon injuries, chronic joint instability, and certain forms of arthritis that affect the distal joints (e.g., fingers or wrists).
- Goals: To stabilize the joint, reduce pain, improve joint function, and prevent further joint degeneration.
Indications
- Joint instability due to tendon injury or rupture
- Chronic pain from tendinopathy or arthritis
- Specific cases of rheumatoid or osteoarthritis affecting distal joints
- Failed conservative treatments, including physical therapy or medications
Preparation
- Pre-procedure Instructions: May need to fast for several hours before the procedure if general anesthesia is used. Adjustments to medications, especially blood thinners, may be necessary.
- Diagnostic Tests: Imaging studies like X-rays or MRIs to assess the condition of the joint and surrounding tissues. Preoperative blood tests may also be required.
Procedure Description
- Anesthesia: Local, regional, or general anesthesia is administered depending on the patient's condition and the joint involved.
- Incision and Exposure: A small incision is made near the affected joint to access the tendon and bone.
- Tendon Fixation: The tendon is reattached to the bone using sutures, screws, or other fixation devices.
- Closure: The incision is closed with sutures or staples and a sterile dressing is applied.
- Immobilization: The joint may be immobilized in a splint or cast to ensure proper healing.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity and the number of joints involved.
Setting
Performed in a hospital operating room or an outpatient surgical center.
Personnel
- Surgeon: Orthopedic or hand surgeon
- Nurses: Assist with surgery and patient care
- Anesthesiologist: Administers anesthesia and monitors the patient
Risks and Complications
- Common Risks: Infection, bleeding, and pain at the surgical site
- Rare Complications: Nerve damage, tendon re-rupture, and poor wound healing
- Management: Antibiotics for infection, pain management strategies, and physical therapy for rehabilitation
Benefits
- Improved joint stability
- Reduction in pain
- Enhanced joint function
- Long-term relief and prevention of further joint damage
- Benefits typically realized within a few weeks to months post-surgery
Recovery
- Post-procedure Care: Keep the incision clean and dry, follow-up with the surgeon for wound checks and suture removal.
- Recovery Time: Several weeks to a few months, depending on the extent of surgery and patient’s adherence to rehabilitation.
- Restrictions: Limited use of the joint initially, gradual return to normal activities with physical therapy guidance
Alternatives
- Non-surgical Options: Physical therapy, corticosteroid injections, and use of splints or braces
- Surgical Alternatives: Different types of tendon repair or reconstruction surgeries
- Pros and Cons: Non-surgical options are less invasive but may not provide long-term relief. Surgical alternatives can also be effective but carry similar risks and recovery profiles.
Patient Experience
- During Procedure: Depending on the type of anesthesia, the patient may be awake (with local) or asleep (with general or regional anesthesia). They should expect minimal discomfort.
- After Procedure: Some pain and swelling around the surgical site, which can be managed with prescribed pain medications and ice. Instructions for at-home care and signs of complications to watch for will be provided.
By providing a comprehensive and clear overview of the Tenodesis procedure, patients can better understand what to expect and make informed decisions about their healthcare.