29891 Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect

Name of the Procedure:

Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect

Summary

This procedure is a minimally invasive surgery where a small camera and instruments are inserted into the ankle joint to repair osteochondral defects (damaged cartilage and underlying bone) of the talus and/or tibia by excising the defect and drilling the area to stimulate healing.

Purpose

The purpose of this procedure is to address osteochondral defects in the ankle that cause pain, swelling, or instability. The goal is to remove damaged tissue and stimulate the growth of new, healthy cartilage to improve joint function and reduce pain.

Indications

• Persistent ankle pain unrelieved by non-surgical treatments
• Ankle swelling and instability
• Diagnosed osteochondral defect(s) of the talus and/or tibia
• Failed conservative treatments like physical therapy, medications, or injections

Preparation

• Fasting for at least 8 hours before the procedure
• Stopping certain medications as directed by a physician
• Preoperative imaging studies (e.g., MRI, X-ray) to assess the defect
• Pre-surgical clearance and assessment by a primary care provider or cardiologist if necessary

Procedure Description

1. The patient is administered regional or general anesthesia.
2. Small incisions are made around the ankle joint.
3. An arthroscope (a small camera) is inserted into the joint to provide a visual guide.
4. Surgical instruments are used to excise (remove) the damaged cartilage and bone tissue.
5. Microfracture or drilling techniques are applied to the defect site to stimulate new cartilage growth.
6. The instruments are removed, and the incisions are closed with sutures or surgical tape.
7. A sterile dressing is applied, and the ankle may be immobilized.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve damage
• Stiffness or loss of motion in the ankle
• Prolonged pain or swelling
• Incomplete healing or recurrence of the defect

Benefits

The primary benefits are reduced pain, improved ankle function, and increased stability. Many patients experience relief within several weeks to months after surgery.

Recovery

• Initial rest and elevation of the ankle
• Use of crutches or a walker to avoid weight-bearing for several weeks
• Physical therapy to restore strength and mobility
• Follow-up appointments to monitor healing
• Complete recovery typically takes 3 to 6 months, depending on the individual case

Alternatives

• Non-surgical treatments like physical therapy, braces, or orthotics
• Medications (e.g., anti-inflammatory drugs, pain relievers)
• Intra-articular injections (corticosteroids or hyaluronic acid)
• Open surgical procedures for more severe cases

Patient Experience

Patients will feel numbness from the anesthesia during the procedure and may experience pain and discomfort as the anesthesia wears off, managed by prescribed pain medications. Swelling and bruising are common and gradually subside with proper post-operative care. Physical therapy is generally required to support a full recovery.

This markdown text provides an informative and comprehensive overview of the arthroscopy procedure for the ankle.