28103 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor, Talus or Calcaneus with Allograft

Summary

This procedure involves the surgical removal or scraping out (curettage) of a bone cyst or benign (non-cancerous) tumor located in the talus or calcaneus bones of the foot and replacing the removed tissue with an allograft (donor bone tissue).

Purpose

The procedure addresses deformities or discomfort caused by bone cysts or benign tumors in the talus or calcaneus. It aims to remove abnormal growths to alleviate pain, restore function, and prevent fractures or other complications.

Indications

• Persistent pain or discomfort in the foot.
• Swelling or a noticeable lump over the talus or calcaneus.
• Impaired mobility or difficulty walking.
• Recurring or growing bone cysts or benign tumors.
• Imaging studies showing significant bone lesions.

Preparation

• Patients may need to fast for at least 8 hours prior to the procedure.
• Medication adjustments, especially blood thinners, may be necessary.
• Pre-operative imaging studies (X-rays, MRI) to assess the location and size of the cyst or tumor.
• Blood tests to ensure healthy levels for surgery.

Procedure Description

1. Anesthesia: General anesthesia is typically administered to keep the patient asleep and pain-free.
2. Incision: A small incision is made over the affected area on the foot.
3. Excision/Curettage: The surgeon removes the cyst or tumor, scraping out the affected bone area.
4. Allograft Placement: Donor bone tissue is placed into the cavity to promote bone healing and structural integrity.
5. Closure: The incision is closed with sutures, and a dressing or cast is applied.

Duration

The procedure typically takes around 1 to 2 hours, depending on the complexity.

Setting

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

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection at the site of surgery.
• Reaction to anesthesia.
• Bleeding or blood clots.
• Graft rejection or failure.
• Damage to surrounding nerves or blood vessels.
• Recurrence of the cyst or tumor.

Benefits

• Relief from pain and discomfort.
• Improved foot function and mobility.
• Prevention of potential fractures or damage to the foot structure.
• Enhanced quality of life.

Recovery

• Post-operative care may include pain management with medications.
• Foot elevation to reduce swelling.
• Limited weight-bearing activities, using crutches or a walker as needed.
• Follow-up appointments for wound checks and imaging studies.
• Physical therapy may be recommended to restore full function.

Alternatives

• Observation and regular monitoring if the cyst or tumor is asymptomatic and not growing.
• Non-surgical treatments like aspiration (draining fluid from the cyst).
• Sclerotherapy to shrink the cyst or tumor.
• Pros and Cons: Surgical removal provides a definitive solution but comes with surgical risks, while non-surgical options may be less invasive but not as effective in eliminating the lesion.

Patient Experience

• During the procedure, under general anesthesia, the patient will not feel pain or be aware of the surgery.
• Post-procedure pain is managed with prescribed medications.
• Some discomfort, swelling, and limited mobility are expected initially.
• Gradual improvement in pain and function over weeks to months.

Pain management and comfort measures will be provided, including medications, ice packs, and possibly an orthopedic boot for support.