CPT® Code 0349T

1. Indications

Radiostereometric analysis (RSA) is indicated for various clinical scenarios where precise measurement of skeletal movement or implant position is necessary. The following conditions may warrant the use of this procedure:

• Assessment of Growth Plate Integrity RSA can be utilized to evaluate the condition of growth plates, which are critical for proper bone development in pediatric patients.
• Stability of Total Joint Replacement Implants This analysis helps in monitoring the stability and positioning of implants used in total joint replacements, ensuring they are functioning as intended.
• Evaluation of Spinal Fusions RSA is effective in assessing the stability and success of spinal fusion procedures, providing insights into the healing process.
• Kinematic Studies The procedure can be employed for kinematic studies of the knee, spine, and shoulder, allowing for detailed analysis of joint movement and function.

2. Procedure

The procedure for radiostereometric analysis (RSA) involves several key steps to ensure accurate imaging and assessment. The following outlines the procedural steps:

• Step 1: Patient Preparation The patient is positioned appropriately to allow for optimal imaging of the upper extremities, specifically the shoulder, elbow, and wrist. This may involve adjusting the patient's posture and ensuring that the area of interest is accessible for X-ray imaging.
• Step 2: Implantation of Tantalum Beads If not already in place, tantalum beads are implanted into the bone surrounding the area of interest. These beads serve as reference points for the analysis and can be inserted directly into the bone or mounted in a fixed position, such as within a spinal cage.
• Step 3: X-ray Imaging Two X-ray images are taken simultaneously from different angles. This dual imaging technique is essential for creating the three-dimensional representation needed for accurate analysis of skeletal movement and implant positioning.
• Step 4: Image Analysis The obtained X-ray images are processed to create a three-dimensional model. This model is then analyzed to detect any movement of the skeletal structures or changes in the position of the implants, providing critical data for the clinician.

3. Post-Procedure

After the radiostereometric analysis (RSA) procedure, the patient may be monitored briefly to ensure there are no immediate complications from the implantation of tantalum beads or the imaging process. The results of the RSA will be analyzed and documented, providing essential information regarding the stability of implants or the integrity of growth plates. Follow-up appointments may be scheduled to discuss the findings and any necessary further interventions or monitoring. Patients are typically advised on any specific post-procedure care related to the implanted beads, including activity restrictions or signs of complications to watch for.