Wiki Knee Help

[jmkitchen]

Unlisted and compare to 29879?? Thoughts anyone??

It was not a repairable situation as it was only incomplete, therefore the decision was made to create vascular access channels using an #18 gauge spinal needle from outside the skin to inside, perforating the area of the torn segment of the medial meniscus so as to bring vascular access to the area of the incomplete meniscus tear.

 

[katums85]

Based on the information you have provided I am not sure what the doc was intending to do? More information is needed to give you appropriate information in regard to using unlisted or 29879.

 

[jmkitchen]

The rest of what I can provide is as follows. Unfortunately this provider uses a lot of what we call "canned dictation".,

OPERATION: EXAMINATION UNDER ANESTHESIA.
DIAGNOSTIC ARTHROSCOPY.
LEFT HAMSTRING ANTERIOR CRUCIATE LIGAMENT
RECONSTRUCTION.
CREATION OF VASCULAR ACCESS CHANNELS FOR
MEDIAL MENISCAL TEAR.


This is a 22 year-old male with a history of trauma to his knee. Preoperatively he complained of pain and giving way. His knee felt "loose". Because of the repetitive giving way and functional instability he is admitted for the procedure. Examination under anesthesia revealed 2+ Lachman and 2+ pivot shift. No laxity with varus or valgus stressing, full extension or 30 degrees of flexion. Negative posterior drawer, negative posterior sag. Diagnostic arthroscopy revealed no loose bodies in the lateral or the medial gutter. Patella captured the trochlea groove at 30 degrees of flexion. Grade I softening of the patella. The trochlea, both femoral condyles and tibial plateau were stable and left alone. The lateral meniscus, posterior cruciate ligament were stable to probing and visualization. There was an incomplete tear of the posterior horn of the medial meniscus measuring 8 mm in length. It was not a repairable situation as it was only incomplete, therefore the decision was made to create vascular access channels using an #18 gauge spinal needle from outside the skin to inside, perforating the area of the torn segment of the medial meniscus so as to bring vascular access to the area of the incomplete meniscus tear. Of note, after the access channels were created, the meniscus was assessed with a probe and it was still stable. It could not be displaced anteriorly. The anterior cruciate ligament was completely torn, it was a mop head type tear that was grossly unstable. Please note that the double looped hamstring tendons measured 8 mm in diameter. Excellent fixation was achieved proximally using a 35 Endobutton and distally using a 9 x 35 mm bioabsorbable interference screw.