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A medial parapatellar arthrotomy was fashioned for flexion and visualization of her components. Soft tissues were removed to allow for visualization of her all poly tibia. This was removed from the tibia using an oscillating saw. This left the short peg and this was then removed using a high-speed bur as well as osteotomes. Excess cement was removed from the proximal tibia w/o difficulty.
Attention was turned to the patella which was also removed using the oscillating saw and then using the high-speed bur to take out the single central peg.
The femur was then fashioned with antibiotic cement...were placed and mixed and then placed on the distal femur. This was fashioned to allow it to be a partially articulating spacer. The proximal tibia was also fashioned with an antibiotic spacer.
At this point the quadriceps was repaired using a suture through the distal quadriceps. The four strands were brought through two bony tunnels, through the patella and sewn over the distal pole of the patella. This allowed for reapproximation of the patella to the distal quadriceps.
On the superbill we have 27091, 27380. I'd like to use 27488 instead of 27091 and do you think 27385 is a better descriptor for 27380?
Attention was turned to the patella which was also removed using the oscillating saw and then using the high-speed bur to take out the single central peg.
The femur was then fashioned with antibiotic cement...were placed and mixed and then placed on the distal femur. This was fashioned to allow it to be a partially articulating spacer. The proximal tibia was also fashioned with an antibiotic spacer.
At this point the quadriceps was repaired using a suture through the distal quadriceps. The four strands were brought through two bony tunnels, through the patella and sewn over the distal pole of the patella. This allowed for reapproximation of the patella to the distal quadriceps.
On the superbill we have 27091, 27380. I'd like to use 27488 instead of 27091 and do you think 27385 is a better descriptor for 27380?
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