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Arthroplasty of the knee, specifically the tibial plateau, is a surgical procedure aimed at addressing degenerative joint disease affecting the knee joint. The knee joint comprises two primary components: the medial and lateral tibial plateaus, which articulate with the corresponding femoral condyles. This procedure is indicated when the articular surface of the proximal tibia, which includes the medial and lateral plateaus along with the intercondylar eminence, has deteriorated due to conditions such as osteoarthritis or other degenerative diseases. The surgery involves making an incision over the affected area of the knee, either on the anteromedial or anterolateral aspect, depending on which plateau is involved. During the operation, the joint capsule is incised to allow for inspection of the medial and/or lateral compartments. The preparation of the proximal tibial surface is critical, utilizing alignment rods to ensure the correct positioning of the joint components. If there are any contracted ligaments due to the degenerative process, they are released to restore proper function. A trial component is placed to assess the range of motion before the final tibial component, which includes a metal tray and spacer, is secured to the tibia using bone cement or screws. The procedure also includes debridement and partial synovectomy, where damaged tissues such as bone spurs and inflamed synovium are excised, ensuring a thorough approach to restoring knee function and alleviating pain.
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The procedure is indicated for patients suffering from degenerative joint disease affecting the knee, particularly when the medial or lateral tibial plateau is involved. The following conditions may warrant this surgical intervention:
The surgical procedure involves several critical steps to ensure successful arthroplasty of the tibial plateau:
After the procedure, patients can expect a recovery period that may involve physical therapy to regain strength and mobility in the knee. Post-operative care includes monitoring for any signs of infection, managing pain, and ensuring proper healing of the surgical site. Patients are typically advised on weight-bearing restrictions and may require assistive devices during the initial recovery phase. Follow-up appointments are essential to assess the success of the surgery and make any necessary adjustments to the rehabilitation plan.
| Short Descr | REVISION OF KNEE JOINT | Medium Descr | ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT | Long Descr | Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3C - Major procedure, orthopedic - Knee replacement | MUE | 1 | CCS Clinical Classification | 152 - Arthroplasty knee |
| 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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