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Knee Help....

  1. Question Knee Help....
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    Hello all,

    Post op dx: rt knee patella chondral defect, vastus medialis tear off
    the superior patella

    Procedure performed: Rt knee dx arthroscopy and open patella chondral
    defect repair and vastus plication

    Converted to open after diagnostic scope

    A medial incision was made, careful dissection. A 2-cm tear in the
    vastus muscle was noted. Careful dissection down to the capsule,
    exposing the medial aspect of the patella. The patella origin from the
    defect was curetted with a ring curette to a stable margin. The patella
    chondral fragment was then sized appropriately and debrided of all
    fibrinous tissue, easily able to replace back into its orgin. There was
    not a lot of other significant bony debris, although there was noted to
    be 2 sheared chondral flaps, which most likely came from the medial
    femoral condyle, as there was a shearing component to most medial aspect
    of the anterior distal part of the medial femoral condyle; minimal
    shearing at this point, no bony bed and full-thickness cartilage defect.
    Patella chondral defect was held w/ 4 OrthoSorb pins. Ethibond sutures
    were used to perform a pants-over-vest plication from the superolateral
    to interomedial, with care taken not to over-tighten due the chondral
    repair and cause excess stress on the chondral repair site.

    Thanks for any help on this one!!! :-)

  2. #2
    yuck!! I'm leaning towards unlisted but look at the lay description for 27422.

    Mary, CPC, COSC

  3. Default
    27418. I found that by going to the back of the CPT book under chondromalacia patella.
    That is the only code I found for open. Otherwise I would say unlisted 27599.
    Any other suggestions???

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