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VIOLYNPLA2

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Chesapeake, VA
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I'm confused as to whether i'm looking at a 29874, 29884 and what about the scar tissue debridement?

Diagnosis is Patella Clunk/TKA

Scope was inserted on the lateral side. Once we were inside the knee, it was
obvious there was a large clump of tissue looking like crab meat above the suprapatellar pole. There is clearly impinging of the trochlea box with the knee in flexion. This was taken out. A scecond portal was made along the medial side. This enabled us to bring in the ArthoCare wand. A combination of shavers and coagulation ablation was utilized to debride out the scar tissue back to an actual bony rim around the superior pole of the patella component. The scar tissue was heavily coagulated and taken back to a nice
smooth border removing all this tissue around the equator up to about 3 o'clock and 9 o'clock. It tracked much nicer and no longer had any impingement. The scope was withdrawn and the knee was injected with 0.5%
marcaine with epinephrine.

Your input is very important to me. I'm confused!!!!!!!!
 
ok, considered that but because the debridement was not of cartilage didn't think that it was appropriate but I guess this would be the best choice?
Thanks!!!!!!!!
 
I don't agree with 29877 because a chondroplasty was not performed. I would go with 29884 - it was a resection of scar tissue that was limiting range of motion.
 
The 29884 bundles with the 29877. According to the above, there was "crab meat" like tissue that was debrided. Even though there was scar tissue, I didnt see anywhere that indicated that there were actual adhesions.

Chondroplasty refers to surgery of the cartilage. Debridement of the unstable hyaline cartilage or partially fragmented cartilage is accomplished with a motorized suction cutter. This smoothes the roughened or damaged cartilage. Any loose bodies are removed.

My two cents
Mary
 
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