joanne71178
Guru
I want to make sure I am interpreting this OP note correctly. I am reading as the femoral component only was revised; 27138. The diagnosis is recurrent chronic instability, 996.41Am I reading this correctly? Thanks in advance!
' At surgery she was seen to be extremely unstable posteriorly, primarily die to extremely thick hypertropic synovium which surrounded the acetabular area of the hip arthroplasy and was producing g a great deal of synovial fluid. There was again hard rubbery synovial tissue anteriorly and inferiorly which was clearly levering out the large Wright Medical metallic head. It would appear that this was at least in part related to the metal-on-metal arthroplasty. For this reason, the metal femoral head was removed and, because of her recurrent instability, a Zimmer constrained liner with ring was carefully cemented into the existing well ingrown Wright Medical metal acetabular insert. The insert was carefully roughened in multiple line crossing gin every direction. Tis was accomplished with a series of diamond burs.
The Zimmer constrained polyethylene liner was also scored on it's posterior aspect with a metal bur for better cementing, stability and grip. The length of the left lower extremity was not increased. A large Hemovac tube was placed into the joint and brought out along the proximal lateral thigh and attached to the suction mechanism to be actually converted to a Orthofuser. The wound was closed in layers...........'
' At surgery she was seen to be extremely unstable posteriorly, primarily die to extremely thick hypertropic synovium which surrounded the acetabular area of the hip arthroplasy and was producing g a great deal of synovial fluid. There was again hard rubbery synovial tissue anteriorly and inferiorly which was clearly levering out the large Wright Medical metallic head. It would appear that this was at least in part related to the metal-on-metal arthroplasty. For this reason, the metal femoral head was removed and, because of her recurrent instability, a Zimmer constrained liner with ring was carefully cemented into the existing well ingrown Wright Medical metal acetabular insert. The insert was carefully roughened in multiple line crossing gin every direction. Tis was accomplished with a series of diamond burs.
The Zimmer constrained polyethylene liner was also scored on it's posterior aspect with a metal bur for better cementing, stability and grip. The length of the left lower extremity was not increased. A large Hemovac tube was placed into the joint and brought out along the proximal lateral thigh and attached to the suction mechanism to be actually converted to a Orthofuser. The wound was closed in layers...........'