CPT® Code 0396T

Deleted

1. Indications

The intra-operative use of a kinetic balance sensor during knee replacement arthroplasty is indicated for the following conditions:

• Total Knee Arthroplasty (TKA) - This procedure is performed for patients requiring knee replacement due to severe osteoarthritis, rheumatoid arthritis, or other degenerative joint diseases that result in significant pain and functional impairment.

2. Procedure

The procedure involves several critical steps to ensure the accurate placement and stability of the knee implant:

• Step 1: Preparation and Standard Cuts - The surgeon begins by making standard surgical cuts to the distal femur and proximal tibia. These cuts are essential for creating a stable foundation for the prosthetic components.
• Step 2: Insertion of Trial Spacer - A trial spacer embedded with microelectronic sensors is then inserted into the knee joint. This spacer is crucial for measuring alignment and pressure during the procedure.
• Step 3: Activation of Sensors - Once the trial spacer is in place, the sensors are activated to begin collecting data on the alignment and congruency of the prosthetic components.
• Step 4: Patellar Preparation - The surgeon proceeds to cut the patella and applies a patellar button, which is part of the overall knee replacement system.
• Step 5: Stabilization and Assessment - A pin is placed to stabilize the joint, and the knee is taken into extension. The tibial baseplate is then rotated until the medial and lateral femoral contact points are parallel, as indicated by the graphic user interface (GUI).
• Step 6: Prevention of Malrotation - A second pin is placed to prevent any malrotation of the knee joint during the procedure.
• Step 7: Load Measurement and Feedback - The knee is assessed in full extension, mid flexion, and at 90 degrees of flexion. Load measurements are taken from the GUI and transmitted wirelessly to a computer software program, which provides real-time feedback to the surgeon as the prosthesis is manipulated within the joint space.
• Step 8: Soft Tissue Release - Soft tissue release of the ligaments is performed by making multiple small punctures with a needle or blade, progressively stretching the ligaments until optimal intercompartmental pressures are achieved.
• Step 9: Final Load Measurements - The soft tissue pocket, which includes muscle, tendon, and ligaments, is fashioned, and final load measurements are calculated and recorded prior to cementing the prosthesis in place.
• Step 10: Closure - The procedure concludes with the standard closure of the incision, ensuring that the surgical site is properly sealed.

3. Post-Procedure

After the procedure, standard post-operative care is implemented, which may include monitoring for any signs of complications, managing pain, and initiating rehabilitation protocols to restore function. Patients are typically advised on weight-bearing restrictions and may require physical therapy to aid in recovery and improve mobility. Follow-up appointments are essential to assess the healing process and the performance of the knee implant.