# Patellar Resurfacing Post TKA



## Sara82 (Feb 9, 2011)

Im leaning towards CPT 27486, but not really sure and would really like some other opinions. Brief report below. Thanks so much for your help in advance!


POSTOPERATIVE DIAGNOSIS:
Patellofemoral pain, right knee arthroplasty.

OPERATION PERFORMED:
1.  Conversion of an unresurfaced patella to a patellar
resurfacing for a right knee arthroplasty.
2.  Synovectomy.


DESCRIPTION OF OPERATION:
 A midline skin incision was made in line with the patient's previous skin
incision.  Medial parapatellar arthrotomy was then performed.  We
elevated off the medial tibia around the deep MCL, also elevated
anterolaterally.  We debrided scar from the undersurface of the
patellar and quad tendons to facilitate exposure.  The medial and
lateral gutters were stuck down, and these were recreated by
excising synovium and scar from the gutters as well as the
suprapatellar pouch to provide exposure.  The patient had an
unresurfaced patella component.  The femoral and tibial
components were well fixed.  The poly had no discernible wear.
 The patella was somewhat scarred in laterally.  We had to
perform a lateral release to free it up.  We were then able to
cut the undersurface of the patella.  It was prepared for a
standard plus LCS all-poly patellar component.  The knee was
irrigated copiously.  We then cemented on a standard plus
patellar component.


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