CPT® Code 29867

1. Indications

The procedure described by CPT® Code 29867 is indicated for the treatment of specific conditions affecting the knee joint, particularly those involving damage to the articular cartilage. The following are the primary indications for performing this procedure:

• Chondral Defects - These are injuries or lesions affecting the cartilage that covers the ends of the bones in the knee joint, which can lead to pain and impaired function.
• Osteochondral Defects - This refers to damage that involves both the cartilage and the underlying bone, often resulting from trauma or degenerative conditions.
• Weight-Bearing Surface Damage - The procedure is specifically indicated for defects located on the weight-bearing surfaces of the knee, which are critical for normal joint function and mobility.

2. Procedure

The procedure for CPT® Code 29867 involves several detailed steps to ensure effective treatment of the knee joint defects. The following outlines the procedural steps:

• Step 1: Arthroscopic Inspection - The procedure begins with the insertion of an arthroscope into the knee joint, allowing the surgeon to visualize the internal structures. This inspection is essential for identifying the specific areas of cartilage damage and assessing the extent of the injury.
• Step 2: Debridement of the Damaged Area - Once the damaged areas are identified, the surgeon performs debridement, which involves the careful removal of unhealthy or damaged tissue from the defect site. This step prepares the area for the implantation of the allografts.
• Step 3: Preparation of Allografts - Osteochondral allografts, which are sourced from a bone bank, are prepared to fit the specific dimensions of the defect in the articular surface. This preparation is crucial for ensuring proper integration of the grafts.
• Step 4: Placement of Allografts - The prepared allografts are then placed into the defect. Depending on the size and nature of the defect, one or more allografts may be utilized. The surgeon ensures that the grafts are securely positioned within the defect.
• Step 5: Stabilization and Range of Motion Check - After the allografts are placed, the surgeon checks the stability of the grafts and assesses the range of motion of the knee to ensure that the allografts are properly integrated and stable.
• Step 6: Closure of Incisions - Upon completion of the procedure, the arthroscope and any surgical instruments are removed. The portal incisions made during the procedure are then closed to complete the surgical intervention.

3. Post-Procedure

After the completion of the arthroscopic procedure using CPT® Code 29867, patients typically undergo a recovery period that may involve specific post-operative care. It is essential to monitor the knee for any signs of complications, such as infection or graft failure. Patients are often advised to follow a rehabilitation program that includes physical therapy to restore range of motion and strength in the knee. The expected recovery time can vary based on the extent of the procedure and the individual patient's healing process. Regular follow-up appointments are important to assess the integration of the allografts and to ensure optimal recovery outcomes.