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Excision, prepatellar bursa

CPT4 code

Name of the Procedure:

Excision of the Prepatellar Bursa (Bursa Removal)

Summary

In layman's terms, excision of the prepatellar bursa is a surgical procedure to remove a small fluid-filled sac in front of the kneecap, which can become inflamed and cause pain.

Purpose

This procedure addresses prepatellar bursitis, which is the inflammation of the bursa located in front of the kneecap. The goal is to relieve chronic pain and reduce swelling that has not responded to other treatments.

Indications

The procedure is indicated for patients experiencing persistent knee pain and swelling due to prepatellar bursitis, especially when conservative treatments such as rest, ice, physical therapy, or medication have been ineffective.

Preparation

Patients may need to fast for several hours before the procedure and adjust any medications as advised by their healthcare provider. Preoperative assessments might include blood tests and imaging studies like X-rays or MRIs to evaluate the knee's condition.

Procedure Description

  1. The patient is positioned and the knee is sterilized.
  2. Anesthesia is administered (local or general, depending on the case).
  3. An incision is made over the prepatellar bursa.
  4. The inflamed bursa is carefully removed.
  5. The incision is closed with stitches or staples.
  6. A sterile bandage is applied.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

The healthcare team includes a surgeon, surgical nurses, and an anesthesiologist.

Risks and Complications

Common risks include infection, bleeding, and reaction to anesthesia. Rare complications may involve damage to surrounding tissues, persistent pain, or recurrence of symptoms. Any complications are managed based on their specific nature and severity.

Benefits

Patients can expect significant relief from pain and improvement in knee function soon after recovery. Reduced inflammation and easier movement can be realized within weeks.

Recovery

Post-procedure care includes resting the knee, keeping it elevated, and applying ice to reduce swelling. Patients may need to use crutches and attend follow-up appointments. Full recovery can take a few weeks, during which physical activity should be limited.

Alternatives

Other treatments include continued conservative management (rest, ice, and pain relievers), corticosteroid injections, or physical therapy. These alternatives might be less invasive but can be less effective if the bursa is significantly inflamed or infected.

Patient Experience

During the procedure, the patient won't feel pain due to the anesthesia. Postoperatively, there may be some discomfort and swelling, which can be managed with pain medication and ice packs. Most patients find the discomfort manageable and see improvement in their symptoms within a few weeks.

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