27443 Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy

Name of the Procedure:

Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy

Summary

Arthroplasty of the knee involving the femoral condyles or tibial plateau(s), along with debridement and partial synovectomy, is a surgical intervention to repair damaged knee joint surfaces. It includes cleaning out debris (debridement) and removing part of the inflamed synovium (partial synovectomy) to improve joint function and relieve pain.

Purpose

This procedure addresses knee pain and dysfunction caused by conditions such as osteoarthritis, rheumatoid arthritis, or traumatic injury. The main goals are to reduce pain, improve mobility, and enhance the overall function of the knee joint.

Indications

• Severe knee pain that limits daily activities
• Joint stiffness and swelling
• Chronic knee inflammation unresponsive to medical treatment
• Significant cartilage damage or wear
• Unsuccessful conservative treatments like physical therapy or medication

Preparation

• Pre-operative fasting for typically 12 hours before surgery
• Adjustments to current medications, especially blood thinners
• Pre-surgical physical exam and imaging studies like X-rays or MRIs
• Blood tests and possibly a pre-operative anesthesia evaluation

Procedure Description

1. The patient is given regional or general anesthesia.
2. An incision is made over the knee joint.
3. Damaged joint surfaces on the femoral condyles or tibial plateau(s) are exposed.
4. Debridement is performed to clean out damaged tissue, cartilage, and bone debris.
5. Partial synovectomy involves removing inflamed synovial tissue.
6. The joint is checked for stability and function.
7. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The surgery is performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technologists
• Post-operative care team

Risks and Complications

• Infection
• Blood clots
• Bleeding
• Nerve or blood vessel injury
• Joint stiffness or reduced range of motion
• Reaction to anesthesia
• Chronic pain or incomplete resolution of symptoms

Benefits

Patients can expect reduced knee pain, improved mobility, and better joint function. The majority of benefits are generally observed within a few months post-surgery.

Recovery

• Post-operative pain management with medications
• Physical therapy is initiated soon after surgery to improve mobility and strength
• Use of crutches or a knee brace may be required temporarily
• Follow-up appointments to monitor healing and recovery
• Full recovery typically occurs within 3 to 6 months, with gradual resumption of activities

Alternatives

• Non-surgical treatments like physical therapy, anti-inflammatory medications, and corticosteroid injections
• Full knee joint replacement for more severe cases
• Pros: Non-surgical options involve less risk and quicker initial recovery but may be less effective long-term
• Cons: Conservative treatments may not provide sufficient relief for advanced joint damage

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel pain. Post-operatively, there may be discomfort and swelling, which can be managed with medications. Physical therapy and gradual return to activity are crucial for recovery, and pain levels should gradually decrease over a few weeks to months.