Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited
CPT4 code
Name of the Procedure:
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited
Summary
Arthroscopy of the ankle is a minimally invasive surgical procedure used to examine and treat issues within the ankle joints, specifically the tibiotalar and fibulotalar joints. This procedure involves debridement, which is the removal of damaged tissue or debris to improve joint function and alleviate pain.
Purpose
Arthroscopy of the ankle is used to address problems such as joint damage, loose cartilage, bone spurs, or inflamed synovial tissue. The goals of the procedure are to reduce pain, improve mobility, and prevent further joint damage.
Indications
- Persistent ankle pain that does not improve with conservative treatment
- Limited range of motion in the ankle
- Swelling or inflammation of the ankle joint
- Presence of loose bodies or bone spurs within the joint
- Diagnosed osteoarthritis or post-traumatic arthritis in the ankle
Preparation
- Fasting for at least 6-8 hours prior to the procedure
- Discontinuation of certain medications as advised by the physician
- Blood tests and imaging studies (e.g., X-rays, MRI) to evaluate the joint condition
- Pre-operative consultation to discuss anesthesia and obtain informed consent
Procedure Description
- The patient is given regional or general anesthesia to ensure comfort.
- Small incisions are made around the ankle joint.
- A fiber-optic camera (arthroscope) is inserted to provide a clear view of the joint interior.
- Special surgical instruments are used to remove (debride) damaged tissue, loose cartilage, and bone spurs.
- The joint is irrigated with fluid to clear away debris.
- The incisions are closed with sutures or surgical tape, and a sterile bandage is applied.
Duration
The procedure typically takes around 30 to 90 minutes, depending on the extent of the debridement required.
Setting
Arthroscopy of the ankle is usually performed in an outpatient surgical center or hospital operating room.
Personnel
- Orthopedic surgeon specializing in foot and ankle procedures
- Anesthesiologist or nurse anesthetist
- Surgical nurses and technologists
Risks and Complications
- Infection at the incision site
- Blood clots
- Damage to nerves or blood vessels
- Persistent pain or swelling
- Limited range of motion or stiffness
- Risks related to anesthesia
Benefits
- Relief from chronic ankle pain
- Improved joint function and mobility
- Reduced inflammation and swelling
- Minimally invasive with smaller incisions, resulting in quicker recovery
Recovery
- Instructions for wound care and activity restrictions will be provided.
- Use of crutches or a supportive boot for a few days to weeks.
- Physical therapy may be necessary to regain strength and motion.
- Follow-up appointments to monitor healing and assess outcomes.
- Full recovery can take several weeks to a few months, depending on the extent of the procedure and individual patient factors.
Alternatives
- Conservative treatments such as physical therapy, medications, or steroid injections
- Open surgical procedures for more severe or complex cases
- Pros of alternatives: Less invasive, initial lower risk
- Cons of alternatives: May not be effective for advanced or persistent conditions
Patient Experience
- Minimal discomfort during the procedure due to anesthesia
- Some pain, swelling, and stiffness post-procedure, managed with pain medication and ice
- Possible need for crutches and limited weight-bearing initially
- Gradual improvement in symptoms over several weeks to months with adherence to post-operative care instructions