Name of the Procedure:

Arthrotomy with Biopsy; Intertarsal or Tarsometatarsal Joint

Summary

Arthrotomy with biopsy is a surgical procedure where an incision is made into the intertarsal or tarsometatarsal joint in the foot to obtain a tissue sample. This procedure helps diagnose or treat joint-related issues.

Purpose

Arthrotomy with biopsy is performed to diagnose conditions affecting the foot's joints, such as infections, arthritis, or tumors. The primary goal is to obtain a tissue sample for microscopic examination to guide further treatment.

Indications

• Persistent joint pain or swelling not explained by non-invasive imaging.
• Suspected joint infections.
• Inflammatory or degenerative joint diseases.
• Tumors or abnormal growths within the joint.
• Unexplained joint abnormalities identified through imaging.

Preparation

• Fasting for at least 6 hours before the procedure.
• Stopping certain medications as advised by the physician.
• Pre-procedural blood tests and imaging studies like X-rays or MRIs.
• Consultation with the anesthesiologist regarding anesthesia options.

Procedure Description

1. The patient is positioned comfortably, and the affected foot is sterilized.
2. Local, regional, or general anesthesia is administered depending on the case.
3. A surgical incision is made over the joint to expose it.
4. Tissues and structures are carefully examined, and a biopsy sample is taken.
5. The joint is irrigated to reduce infection risk.
6. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes between 45 minutes to 1 hour, depending on the complexity and extent of the biopsy.

Setting

Performed in a hospital's surgical suite, outpatient surgical center, or specialized orthopedic clinic.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)
• Operating room technician

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Nerve or blood vessel damage.
• Joint stiffness or limited mobility post-procedure.
• Rarely, allergic reaction to anesthesia.

Benefits

• Accurate diagnosis leading to appropriate treatment.
• Relief from unexplained joint pain after treatment planning.
• Opportunity to identify and manage severe conditions early.

Recovery

• Keep the foot elevated and apply ice packs to reduce swelling.
• Limited weight-bearing on the affected foot for several weeks.
• Pain management with prescribed medications.
• Follow-up appointments for suture removal and biopsy result discussion.
• Gradual return to normal activities as advised by the physician.

Alternatives

• Non-surgical options like physical therapy or medication adjustments.
• Imaging-guided needle biopsy, though it may not be as diagnostic.
• Arthroscopy for less invasive joint examination, but may not allow extensive biopsy.

Patient Experience

• Mild to moderate discomfort is expected post-procedure.
• Localized pain and swelling at the incision site.
• Efficacious pain management through prescribed medications.
• Gradual improvement in symptoms with adherence to recovery guidelines.