CPT® Code 0347T

1. Indications

The placement of interstitial device(s) in bone for radiostereometric analysis (RSA) is indicated for the following conditions:

• Joint Replacement Surgery This procedure is performed during joint replacement surgeries to monitor the interaction between the implant and the surrounding bone over time.
• Assessment of Implant Stability RSA is utilized to evaluate the stability of orthopedic implants, providing data on their positioning and integration within the bone structure.
• Longitudinal Studies The procedure is indicated for patients involved in longitudinal studies assessing the performance and longevity of joint implants.

2. Procedure

The procedure for the placement of interstitial device(s) in bone for radiostereometric analysis involves several key steps:

• Step 1: Preparation of the Bone Initially, the surgical site is prepared, and an incision is made to access the joint area where the implant will be placed. Using an awl or drill bit, the surgeon creates 5 to 9 holes in the cortical or sclerotic bone surrounding the implant site. This step is crucial as it allows for the proper placement of the tantalum beads.
• Step 2: Insertion of the Cannula After the holes are created, a steel cannula or trocar is inserted into the bone. This instrument serves as a guide for the subsequent placement of the tantalum beads, ensuring they are positioned accurately within the prepared holes.
• Step 3: Loading and Inserting Tantalum Beads The tantalum beads are then loaded into an introducer, which facilitates their insertion into the previously created holes. The beads are carefully placed to ensure they integrate well with the bone structure, providing a stable reference point for future analysis.
• Step 4: Conducting Radiostereometric Analysis Once the beads are in place, radiostereometric analysis (RSA) is performed. This involves taking two X-rays from different directions simultaneously. The images captured are used to create a three-dimensional representation of the implant's position, utilizing the tantalum beads as reference points to detect any changes in the implant's location over time.

3. Post-Procedure

After the procedure, patients may require monitoring to assess the integration of the tantalum beads and the overall stability of the implant. Follow-up X-rays may be scheduled to evaluate the positioning of the implant and the effectiveness of the RSA. Patients are typically advised on post-operative care, including pain management and activity restrictions, to ensure optimal recovery and healing. The precise nature of the RSA allows for ongoing assessment of the implant's performance, which can inform future clinical decisions regarding patient care.