CCANTER
Networker
i was wanting to double check the cpt code. At first i though 23462 since it states latarjet. However i now feel the correct cpt code is 23460.
DESCRIPTION OF PROCEDURE:
The patient was taken to the OR and placed in supine position. General endotracheal intubation achieved without complication. The patient was placed in the beach-chair position, prepped and draped in normal fashion.
Standard anterior approach utilized. Skin flaps elevated. Retractor was inserted. The deltopectoral interval was utilized. Retractor was inserted, the shoulder externally rotated, exposing the conjoined tendon, which was reflected medially. The subscapularis was then taken down subperiosteally, tagging the proximal and distal edges. The tendon was reflected medially and a retractor inserted, exposing the anterior glenoid.
The guide was then inserted, placing the 2 parallel guidewires in the anteroinferior location. Over these guidewires, which measured 32 and 30, we overreamed and prepared the anterior glenoid for the graft. This was done x2, getting nice flush bleeding bone surface. The graft was then placed over the 2 guidewires. We overdrilled and placed 2 partially threaded 4.0 cannulated screws, which secured the graft to the anteroinferior aspect of the glenoid, greatly increasing stability and surface area. Stability was improved immediately.
We then performed a capsular shift with the subscapularis in the capsule. This was done with #2 Ethibond. We secured the interval proximally and inferiorly and crisscrossed the 2 wings of the subscapularis to tighten up the external rotation. The inferior wing was superiorly elevated.
Deltopectoral interval was then closed with 0 Monocryl, 2-0 Monocryl subcutaneous, and staples closed the skin. Sterile dressing was applied and a sling. The patient was taken to the recovery room in stable condition.
IMPLANTS:
An Arthrosurface Glenojet bone graft. The block size is 10 x 29. We have got two 4.0 headed compression screws, but it is an allograft.
DESCRIPTION OF PROCEDURE:
The patient was taken to the OR and placed in supine position. General endotracheal intubation achieved without complication. The patient was placed in the beach-chair position, prepped and draped in normal fashion.
Standard anterior approach utilized. Skin flaps elevated. Retractor was inserted. The deltopectoral interval was utilized. Retractor was inserted, the shoulder externally rotated, exposing the conjoined tendon, which was reflected medially. The subscapularis was then taken down subperiosteally, tagging the proximal and distal edges. The tendon was reflected medially and a retractor inserted, exposing the anterior glenoid.
The guide was then inserted, placing the 2 parallel guidewires in the anteroinferior location. Over these guidewires, which measured 32 and 30, we overreamed and prepared the anterior glenoid for the graft. This was done x2, getting nice flush bleeding bone surface. The graft was then placed over the 2 guidewires. We overdrilled and placed 2 partially threaded 4.0 cannulated screws, which secured the graft to the anteroinferior aspect of the glenoid, greatly increasing stability and surface area. Stability was improved immediately.
We then performed a capsular shift with the subscapularis in the capsule. This was done with #2 Ethibond. We secured the interval proximally and inferiorly and crisscrossed the 2 wings of the subscapularis to tighten up the external rotation. The inferior wing was superiorly elevated.
Deltopectoral interval was then closed with 0 Monocryl, 2-0 Monocryl subcutaneous, and staples closed the skin. Sterile dressing was applied and a sling. The patient was taken to the recovery room in stable condition.
IMPLANTS:
An Arthrosurface Glenojet bone graft. The block size is 10 x 29. We have got two 4.0 headed compression screws, but it is an allograft.