# trephination of medial meniscus



## trose45116 (Jan 19, 2009)

would this be coded as unlisted code 29999???? any suggestions


The patient was seen in the holding area.  He confirmed the right knee to be the operative extremity.  He was then taken to the OR where following induction of general anesthesia, a tourniquet was placed on the right thigh.  The right leg was prepped and draped in sterile fashion.  The leg was exsanguinated with an Esmarch bandage.  The tourniquet was inflated to 300 mmHg.   



An anterior portal was established.  The scope was placed into the joint, and the articular cartilage surfaces appeared normal throughout the joint. The ACL was normal.  The lateral meniscus was normal.  There was synovitis present in the anterior and medial aspect of the knee, and a two-compartment synovectomy was carried out using a synovial shaver.  With the arthroscope in the medial compartment, the medial meniscus was probed. It was noted to be quite soft, but was stable. No surface tears were appreciated, either superiorly or inferiorly.  No loose fragments were noted.  The meniscus appeared stable, so I did not think that using a meniscal arrow or suture such as a FasT-Fix or an inside-out repair would be of great benefit.  I thought that the most benefit would come from doing a meniscal trephination, so I performed this by introducing a spinal needle and using an outside-in technique and visualizing the spinal needle going through the meniscus in the areas of concern.  This was done several times, approximately 8 to 10 following which the meniscus was again probed, and it was not noted to be unstable.  



The scope was removed from the joint.  Marcaine was placed intra-articularly.  The incisions were closed with Monocryl.  Sterile dressings were applied, and the patient was awakened and taken to the recovery room in stable condition.  Sponge and needle counts were correct at the conclusion of the procedure.  Blood loss was minimal.


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## mbort (Jan 19, 2009)

unlisted it is


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## trose45116 (Jan 19, 2009)

Thanks thats what I thought.


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