Patellectomy or hemipatellectomy
CPT4 code
Name of the Procedure:
Patellectomy or Hemipatellectomy
Common name(s): Partial or Complete Kneecap Removal
Summary
A Patellectomy is a surgical procedure involving the removal of the patella (kneecap) either partially (hemipatellectomy) or completely. It's typically performed to relieve pain or restore function in a damaged or diseased knee.
Purpose
The procedure addresses severe knee problems such as fractures, chronic inflammation, or degeneration that do not respond to other treatments. The goals include reducing pain, preventing further damage, and improving knee function.
Indications
- Severe fractures of the patella that cannot be repaired
- Chronic patellar tendonitis unresponsive to conservative treatment
- Advanced arthritis of the patellofemoral joint
- Conditions like osteomyelitis (infection) of the kneecap
- Tumors affecting the patella
Preparation
- Patients may be advised to fast for 8-12 hours before surgery.
- Adjustments to medications, especially blood thinners.
- Preoperative assessments including blood tests, imaging (X-rays, MRI), and physical examinations.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A surgical cut is made over the knee.
- Accessing the Patella: Muscles and tissues are gently separated to expose the patella.
- Removal: The patella is partially or completely removed, depending on the type of patellectomy.
- Reconstruction: The remaining tissues are adjusted to maintain knee function and stability.
- Closure: The incision is stitched up, and a sterile bandage is applied.
Specialized surgical tools like scalpels, retractors, and possibly medical drills are utilized during the procedure.
Duration
Typically lasts between 1 to 2 hours.
Setting
Performed in a hospital or surgical center with appropriate facilities for orthopedic surgeries.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Common: Infection, blood clots, knee stiffness, swelling, limited range of motion.
- Rare: Chronic pain, nerve damage, instability of the knee.
Benefits
- Relief from chronic knee pain.
- Improved knee function and mobility.
- Prevention of further knee damage.
Benefits are typically noticed within weeks, depending on the extent of surgery and rehabilitation.
Recovery
- Hospital stay may last 1 to 2 days post-surgery.
- Pain management with prescribed medications.
- Physical therapy starts soon after surgery to aid recovery.
- Full recovery can take several months, with restrictions on weight-bearing activities.
- Follow-up appointments to monitor healing and progress.
Alternatives
- Conservative treatments like physical therapy, medications, or bracing.
- Arthroscopic surgery for less severe conditions.
- Total knee replacement if joint damage is extensive.
Each alternative has its pros and cons, often weighed against the patient's specific condition and overall health.
Patient Experience
- During the procedure, patients are under anesthesia and will not feel any pain.
- Post-surgery may include some pain and discomfort, manageable with medications.
- Physical therapy and rehabilitation are crucial, and patients may experience gradual improvements in pain and knee function during recovery.