Wiki ? Revision or Removal of TKA for Infection

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jruplis

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I have a doctor that states he did a Revision TKA, part of staged procedure for infection...

His notes indicate that he removed the original components and replaced with all-polyethylene components.

Is this a revision or an explant?
Patient has allergies to Penicillin, Sulfa, Vancomycin, Levaquin, and Rifampin, which complicated the procedure


OP Note::
We immediately did a complete synovectomy. Immediately we lifted and separated the entire synovium along the medial gutter, cleared the medial gutter, came about the suprapatellar pouch, came down to latter gutter, and then came around the patella completely removing all the synovial tissue. Then, we popped up the tibial polyethylene and looked to the back, cleared the back and used a flexible osteotome to work around the femoral component carefully and then popped off the femoral component, used a flexible osteotome to work around tibial component, popped off tibial component, same on the patellar component. Then I removed cement from all 3. There was osteolysis underneath all 3 components. After removing all cement, we removed any cystic collections, fluid collections, and cleaned back of knee vigorously.
After an adequate clean out and aggressive debridement, we chose to cement into place an all-polyethylene tibial component and femoral component for temporary use while we treat the patient with antibiotics............




Any assistance is appreciated

Jackie Ruplis CPC
 
This is not a revision TKA

A revision TKA would mean to pull out the implants, and then replace them with permanent components. He's not doing that.

You can Google the information from AAOS which outlines this. Your doc should believe AAOS (however mine did not).

Since the implants have infection they are being pulled out, and an antibiotic spacer is being put in. It's usually there for about 6-8 weeks. After the infection is gone, the doc will pull out the antibiotic spacer and put in new implants.

I think the code your looking for is 27488.
 
Orthocoderpgu said:
A revision TKA would mean to pull out the implants, and then replace them with permanent components. He's not doing that.

You can Google the information from AAOS which outlines this. Your doc should believe AAOS (however mine did not).

Since the implants have infection they are being pulled out, and an antibiotic spacer is being put in. It's usually there for about 6-8 weeks. After the infection is gone, the doc will pull out the antibiotic spacer and put in new implants.

I think the code your looking for is 27488.
Click to expand...

Thank you. That is what I thought as well.
 
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