trose45116
Expert
anyone know what to bill for the IT BAND TENOTOMY?
Chronic left greater trochanteric bursitis.
POSTOPERATIVE DIAGNOSIS: Chronic left greater trochanteric bursitis.
PROCEDURE: Open IT band tenotomy and bursectomy.
ASSISTANT: Jason Ramsey, M.D.
INDICATIONS: This is a 72-year-old male who, about 7 years ago, had left total hip arthroplasty. He has also had right total hip arthroplasty. Recently, he has had lateral-sided hip pain and actually, over the last couple of years, he has come in intermittently for injections, which provided him with good but temporary relief. He had been through stretching and other methods and continued to have pain that would wake him at night from his bursitis. After discussion of the risks, benefits, and alternatives, the patient wished to proceed with surgery.
DESCRIPTION OF PROCEDURE: The patient was transferred to the operating room and after general anesthesia was induced, the patient was placed in a Vac-Pac in the right lateral decubitus position. Knees and ankles were well padded and an axillary roll was placed. The whole area of the previous hip incision was prepped and draped, including sterile incise drape. An approximately 2-1/2 inch long incision was made right over the apex of the trochanter and carried down through skin and subcutaneous tissue. There was some scarring between the subcutaneous tissue and the IT band. This was broken up. A cruciform incision was made in the IT band, leaving a centimeter or more both anteriorly and posteriorly still intact, but now one could pass a finger easily under the IT band with a little pressure. There was very thickened bursa here, and this was sharply excised. There was a small bony excrescence, which was removed both with a rongeur and then rounded off smoothly with a rasp. This whole area was thoroughly irrigated. The subcutaneous tissues were closed with 2-0 Vicryl, and the skin with 4-0 Monocryl and Steri-Strips, and a sterile dressing was applied. The patient tolerated this procedure well and there were no known complications. He was returned to the recovery room in stable condition.
Chronic left greater trochanteric bursitis.
POSTOPERATIVE DIAGNOSIS: Chronic left greater trochanteric bursitis.
PROCEDURE: Open IT band tenotomy and bursectomy.
ASSISTANT: Jason Ramsey, M.D.
INDICATIONS: This is a 72-year-old male who, about 7 years ago, had left total hip arthroplasty. He has also had right total hip arthroplasty. Recently, he has had lateral-sided hip pain and actually, over the last couple of years, he has come in intermittently for injections, which provided him with good but temporary relief. He had been through stretching and other methods and continued to have pain that would wake him at night from his bursitis. After discussion of the risks, benefits, and alternatives, the patient wished to proceed with surgery.
DESCRIPTION OF PROCEDURE: The patient was transferred to the operating room and after general anesthesia was induced, the patient was placed in a Vac-Pac in the right lateral decubitus position. Knees and ankles were well padded and an axillary roll was placed. The whole area of the previous hip incision was prepped and draped, including sterile incise drape. An approximately 2-1/2 inch long incision was made right over the apex of the trochanter and carried down through skin and subcutaneous tissue. There was some scarring between the subcutaneous tissue and the IT band. This was broken up. A cruciform incision was made in the IT band, leaving a centimeter or more both anteriorly and posteriorly still intact, but now one could pass a finger easily under the IT band with a little pressure. There was very thickened bursa here, and this was sharply excised. There was a small bony excrescence, which was removed both with a rongeur and then rounded off smoothly with a rasp. This whole area was thoroughly irrigated. The subcutaneous tissues were closed with 2-0 Vicryl, and the skin with 4-0 Monocryl and Steri-Strips, and a sterile dressing was applied. The patient tolerated this procedure well and there were no known complications. He was returned to the recovery room in stable condition.