Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive
CPT4 code
Name of the Procedure:
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive. Common Name: Ankle Arthroscopy for Debridement
Summary
Ankle arthroscopy with debridement is a minimally invasive surgical procedure where a camera and specialized tools are inserted into the ankle joint to clean out damaged tissue, bone spurs, and other debris.
Purpose
This procedure is performed to address chronic pain, swelling, and limited movement in the ankle joint caused by conditions such as arthritis, ligament injuries, or cartilage damage. The goal is to improve joint function and relieve pain.
Indications
- Persistent ankle pain and swelling not relieved by conservative treatments (rest, physical therapy, medications)
- Restricted range of motion in the ankle joint
- Ankle injuries including ligament tears or cartilage damage
- Bone spurs causing discomfort
Preparation
- Patients are often required to fast for at least 8 hours before the procedure.
- Adjustments to current medications, particularly blood thinners, will be advised.
- Preoperative assessments may include blood tests, imaging studies (X-rays, MRI), and a physical examination.
Procedure Description
- The patient is positioned, usually lying on their back.
- General or regional anesthesia is administered.
- Small incisions are made around the ankle joint.
- An arthroscope (a small camera) is inserted through one incision, providing a view of the joint interior on a monitor.
- Special surgical instruments are inserted through additional incisions to remove damaged tissue, bone spurs, and other debris.
- The joint is rinsed out to ensure all debris is cleared.
- Incisions are closed with sutures, and a sterile dressing is applied.
Duration
Typically, the procedure lasts between 1 to 2 hours.
Setting
The procedure is usually performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Surgical nurses
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Infection at the surgical site
- Blood clots
- Nerve damage
- Thrombophlebitis
- Joint stiffness or decreased range of motion
Benefits
- Pain relief
- Improved joint function and mobility
- Enhanced quality of life
- Faster recovery compared to open surgery
Recovery
- Patients may go home the same day or after a brief hospital stay.
- Instructions will include the use of crutches to avoid weight-bearing on the ankle for several weeks.
- Pain management will involve prescribed medications, ice application, and elevation of the leg.
- Physical therapy may be recommended to regain strength and mobility.
- Follow-up appointments will be necessary to monitor progress.
Alternatives
- Conservative management with medications, physical therapy, or injections
- Open ankle surgery for more severe cases
- Pros: Non-invasive options may involve less risk and shorter recovery time.
- Cons: Conservative treatments may not provide long-term relief if underlying issues persist.
Patient Experience
During the procedure, general or regional anesthesia ensures that the patient feels no pain. Post-procedure, some pain and swelling are expected, which can be managed with prescribed pain medications and care instructions. The patient may experience discomfort while adjusting to mobility restrictions but should gradually notice improvement in symptoms over weeks to months.