27638 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft

Name of the Procedure:

Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft
Common Names: Bone cyst removal, benign tumor excision, tibia/fibula surgery with allograft

Summary

This procedure involves surgically removing a bone cyst or benign tumor from the tibia or fibula. An allograft, which is bone tissue taken from a donor, is used to fill the space left after the cyst or tumor is removed, promoting healing and structural stability.

Purpose

The procedure addresses the presence of bone cysts or benign tumors in the tibia or fibula, which can cause pain, weakness, or fractures. The goal is to remove the abnormal growth and restore the structural integrity of the bone using donor bone tissue (allograft).

Indications

• Persistent pain or discomfort in the affected leg
• Weakness or instability in the tibia or fibula
• Risk of fracture or actual fracture due to the presence of the cyst or tumor
• No response to conservative treatments

Preparation

• Fasting for at least 8 hours prior to surgery
• Discontinuation or adjustment of certain medications, such as blood thinners
• Pre-operative physical examination and blood tests
• Imaging studies like X-rays or MRIs to evaluate the cyst or tumor

Procedure Description

1. Anesthesia: The patient is given general anesthesia for painless and unconscious procedure.
2. Incision: A surgical incision is made over the site of the cyst or tumor.
3. Removal: The surgeon carefully excises or curettes (scrapes out) the bone cyst or tumor.
4. Allograft Placement: The space left by the removed cyst or tumor is filled with healthy bone tissue from a donor.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Tools Used: Scalpels, curettes, bone graft material, surgical sutures, or staples.

Duration

The procedure typically takes about 1 to 2 hours, depending on the size and location of the cyst or tumor.

Setting

The procedure is performed in a hospital's operating room or a specialized surgical center.

Personnel

• Surgeon: Specialist in orthopedic surgery
• Anesthesiologist: Administers anesthesia and monitors the patient
• Nurses and Surgical Technicians: Assist during the surgery
• Radiology Technicians: Provide imaging support if needed

Risks and Complications

• Common Risks: Infection, bleeding, pain at the surgical site
• Rare Risks: Rejection of the allograft, nerve damage, failure of the graft to integrate properly with the host bone

Benefits

• Relief from pain and discomfort
• Restoration of bone strength and stability
• Reduced risk of fractures
• Improved overall function and mobility

Benefits are generally realized within a few weeks to months as the bone heals and integrates with the allograft.

Recovery

• Post-Procedure Care: Wound care, pain management, possibly wearing a cast or brace
• Recovery Time: Typically 6 to 12 weeks for initial healing, with full recovery possibly taking up to 6 months
• Restrictions: Limited weight-bearing activities initially, gradual return to normal activities
• Follow-up: Regular visits to the surgeon for monitoring and X-rays to ensure proper healing

Alternatives

• Observation: Monitoring the cyst or tumor without immediate surgery, if asymptomatic
• Aspiration: Draining the cyst if applicable, though less definitive than excision
• Other Graft Options: Using autografts (patient's own bone) or synthetic materials

Each alternative has its own pros and cons regarding effectiveness, recovery time, and risk of recurrence.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, there may be some pain and discomfort at the surgical site, managed with pain medications. Patients may experience swelling and limited mobility initially but can expect gradual improvement as the bone heals. Regular follow-up ensures proper recovery and addresses any complications promptly.