27356 Excision or curettage of bone cyst or benign tumor of femur; with allograft

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor of Femur with Allograft

Summary

This procedure involves the surgical removal or scraping out (curettage) of a cyst or non-cancerous tumor located in the femur (thigh bone). Following the excision, an allograft, or bone graft from a donor, is used to fill the space and promote bone healing.

Purpose

Medical Condition or Problem:

The procedure addresses bone cysts, benign tumors, or other non-cancerous bone lesions that can cause pain, swelling, or potential fractures.

Goals or Expected Outcomes:

To remove the abnormal lesion, alleviate symptoms, restore the structural integrity of the bone, and promote healing with the use of an allograft.

Indications

• Persistent pain or swelling in the thigh
• Radiographic evidence of a bone cyst or benign tumor in the femur
• Risk of pathologic fracture or damage to surrounding tissues
• Patient is in good general health and has no contraindications for surgery

Preparation

Pre-procedure Instructions:

• Fasting for 6-8 hours prior to surgery
• Medication adjustments as advised by the physician
• Arranging for transportation and post-procedure care at home

Diagnostic Tests:

• X-rays, MRI, or CT scans to evaluate the lesion
• Blood tests, including coagulation profile
• Pre-operative clearance from a primary care physician or specialist

Procedure Description

1. Anesthesia is administered (typically general anesthesia).
2. The surgeon makes an incision over the femur at the site of the lesion.
3. The cyst or tumor is carefully excised or curetted out.
4. An allograft is placed into the cavity left by the excision to aid in bone regeneration.
5. The surgical site is closed with sutures or staples.
6. A sterile dressing is applied.

Tools and Equipment:

• Scalpel, curettes, and surgical instruments
• Bone graft materials (allograft)
• Imaging tools for accurate localization
• Sutures and dressings

Anesthesia:

General anesthesia is usually required.

Duration

Typically, the procedure takes 1-2 hours.

Setting

The procedure is performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Pain and swelling

Rare Risks:

• Graft rejection
• Damage to nearby blood vessels or nerves
• Non-union or delayed healing

Management:

Most complications can be managed with medications, physical therapy, or additional surgical interventions if necessary.

Benefits

• Relief from pain and swelling
• Preventive measure against fractures
• Restoration of bone stability
• Improved functional mobility

Recovery

Post-procedure Care:

• Pain management with prescribed medications
• Instructions for wound care and activities
• Physical therapy as needed
• Follow-up appointments for monitoring and imaging

Expected Recovery Time:

• Initial recovery: 1-2 weeks for wound healing
• Full recovery: 6-12 months for bone healing and graft integration

Restrictions:

• Limited weight-bearing activities initially
• Gradual return to normal activities guided by the physician

Alternatives

Other Treatment Options:

• Observation with periodic imaging
• Sclerotherapy or injection of sclerosing agents
• Surgical excision without bone graft

Comparison:

• Observation is less invasive but may not address symptoms or prevent fractures.
• Sclerotherapy is less invasive but may not be as effective for larger lesions.
• Surgical excision without a bone graft may lead to longer healing times or structural issues.

Patient Experience

During the Procedure:

• Procedure is performed under general anesthesia, so the patient will be asleep and pain-free.

After the Procedure:

• Pain and discomfort managed with medications
• Mild swelling and bruising expected at the surgical site
• Physical therapy for rehabilitation and strengthening

Overall, patients can expect a period of rest and gradual return to normal activities, with regular follow-ups to ensure proper healing and integration of the allograft.