Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)
CPT4 code
Name of the Procedure:
Arthroscopy, Knee, Surgical; for Removal of Loose Body or Foreign Body (e.g., Osteochondritis Dissecans Fragmentation, Chondral Fragmentation)
Summary
Arthroscopy of the knee is a minimally invasive surgical procedure where a small camera (arthroscope) and specialized instruments are used to diagnose and treat issues within the knee joint. This particular procedure focuses on the removal of loose bodies or foreign objects that can cause pain or impede joint movement.
Purpose
Medical Condition:
This procedure addresses conditions such as osteochondritis dissecans fragmentation and chondral fragmentation where loose cartilage or bone fragments are present in the knee joint.
Goals:
- Remove loose bodies causing joint pain or mobility issues.
- Relieve symptoms such as pain, swelling, and stiffness.
- Improve knee joint function and patient mobility.
Indications
- Persistent knee pain and swelling unresponsive to non-surgical treatment.
- Locking or "catching" sensation in the knee joint.
- Detection of loose bodies through MRI or X-ray imaging.
- Reduced range of motion due to foreign bodies or fragments within the joint.
Preparation
- Patients may need to fast for at least 6-8 hours before the procedure.
- Medication adjustments might be necessary, particularly if the patient is on blood thinners or has other health conditions.
- Pre-operative imaging tests like MRI or X-rays may be required to pinpoint the location of the loose bodies.
Procedure Description
- Anesthesia: The procedure typically begins with either general anesthesia or regional/local anesthesia.
- Incision: Small incisions (portals) are made around the knee joint.
- Insertion of Arthroscope: An arthroscope (a small camera) is inserted through one of the incisions to provide a clear view inside the knee.
- Inspection and Removal: Specialized instruments are used to locate and remove any loose bodies or foreign fragments.
- Closure: The instruments are removed, and the incisions are closed with sutures or steri-strips.
Duration
The procedure generally takes about 30 minutes to an hour, depending on the complexity and number of loose bodies.
Setting
The procedure is typically performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses and Technicians
Risks and Complications
- Common Risks: Infection, bleeding, and blood clots.
- Rare Risks: Damage to surrounding structures (nerves, blood vessels), persistent pain, or stiffness. If complications arise, additional treatment or surgery might be required.
Benefits
- Significant pain relief soon after the procedure.
- Improved knee joint function and mobility.
- Ability to resume normal activities relatively quickly.
Recovery
- Post-procedure Care: Rest, ice application, elevation, and prescribed pain medication.
- Physical Therapy: Essential for regaining movement and strength.
- Recovery Time: Typically, patients recover within 6-8 weeks, but full rehabilitation may take several months.
- Follow-up: Regular appointments for progress assessment and potential imaging.
Alternatives
- Non-Surgical Options: Physical therapy, medication, and knee injections.
- Surgical Alternatives: More invasive procedures if arthroscopy is not sufficient.
- Pros and Cons: Non-surgical options are less invasive but might not remove loose bodies, while more invasive surgeries carry higher risks and longer recovery times.
Patient Experience
- During Procedure: Minimal discomfort due to anesthesia.
- After Procedure: Mild to moderate pain, which is manageable with medication. Swelling and limited movement initially, improving with physical therapy.
Pain management strategies will be in place to ensure comfort during the initial recovery phase.