dmk0916
New
I'm hoping to get help with the following procedure:
4th & 5th tarstmetatarsal joint arthroplasty with interposition of an Orthrosphere.
....Attention was placed towards the second and third MP joints. Incision was made, significant amount of fibrotic scar tissue. The MP joints were exposed and mobilized. The joints were significantly fibrotic. I removed any excess bone. Decision at that point was for removing more bone, and since the right medical Orthrosphere product was there, to try to just place an interposition spacer, with the thought being even though it might fail and need to be removed because of the long term forces, if it allowed the fibrous capsule or structure to fill in around the area with a spacer, it would allow some motion and would prevent arthrofibrosis in the future. And if it went on to heal and didn't bother the patient, then it would act like an interposition arthroplasty and allow some motion. I uesd the two-size burs and then an oscillation bur on each end, both the articular surface of the proximal phalanx, as well as articular surface of the metatarsal head. Trial was performed and I used an 11 Orthrosphere on the 2nd and a 10 Orthrosphere on the 3rd. Overall they felt stable......
I am leaning towards 28264 twice, once for each joint. Any help would be greatly appreciated.
Thanks.
4th & 5th tarstmetatarsal joint arthroplasty with interposition of an Orthrosphere.
....Attention was placed towards the second and third MP joints. Incision was made, significant amount of fibrotic scar tissue. The MP joints were exposed and mobilized. The joints were significantly fibrotic. I removed any excess bone. Decision at that point was for removing more bone, and since the right medical Orthrosphere product was there, to try to just place an interposition spacer, with the thought being even though it might fail and need to be removed because of the long term forces, if it allowed the fibrous capsule or structure to fill in around the area with a spacer, it would allow some motion and would prevent arthrofibrosis in the future. And if it went on to heal and didn't bother the patient, then it would act like an interposition arthroplasty and allow some motion. I uesd the two-size burs and then an oscillation bur on each end, both the articular surface of the proximal phalanx, as well as articular surface of the metatarsal head. Trial was performed and I used an 11 Orthrosphere on the 2nd and a 10 Orthrosphere on the 3rd. Overall they felt stable......
I am leaning towards 28264 twice, once for each joint. Any help would be greatly appreciated.
Thanks.