Case Competencies in Orthopaedic Surgery E-Book

Rachel Frank, Brian Forsythe, Matthew T. Provencher, Rachel M Frank, Matthew T Provencher

• Publisher: Elsevier
• Year: 2016
• eBook ISBN: 9780323428705
• Topic: Medicine
• Subtopic: Orthopedics

Case Competencies in Orthopaedic Surgery is a centralized, easy-access guide to preparing for cases most commonly encountered during training. Written by expert author teams consisting of both attending surgeons and residents, it follows a technique-based format and design that summarizes the surgical steps, from room set-up to closure, of all cases relevant to the 15 categories of "Orthopaedic Surgery Case Minimums" as determined by the ACGME.- Forty "technique-based chapters" boast an outline format with minimal text, high-definition intraoperative figures, and original illustrations.- Each chapter contains easy-to-use tables outlining the surgical steps, essential equipment, technical pearls, and common pitfalls of each case.- Includes coverage of today's hot topics in orthopaedic surgery, such as fractures, arthroscopy, arthroplasty, "bread and butter" pediatric cases, and basic subspecialty cases (spine, foot and ankle, oncology, hand, shoulder, and more).- Lists CPT and ICD 9/10 codes to help with case logging.

Chapter 1

Diagnostic Knee Arthroscopy

Surgical Technique

Rachel M. Frank, Bernard R. Bach Jr.

The ability to perform a basic diagnostic knee arthroscopy is a critical skill for orthopaedic surgeons. With few exceptions, knee arthroscopy is likely to be performed multiple times per year, regardless of the field in which an orthopaedic surgeon ultimately decides to specialize. In many instances, especially for surgeons who specialize in sports medicine or practice general orthopaedic surgery, knee arthroscopy is the cornerstone of the surgical practice. The surgical skills necessary for thorough, accurate, and efficient knee arthroscopy are typically developed early in residency training. With limitations in work hours, combined with the 2013 Accreditation Council for Graduate Medical Education (ACGME) implementation of skills training requirements for junior residents, development of excellent habits during initial training sessions is now, more than ever, imperative to build a foundation on which to expand one's ability to treat different knee pathologies arthroscopically. The purpose of this chapter is to provide up-to-date technical pearls for performing a thorough, accurate, and efficient diagnostic knee arthroscopy. Of note, many different techniques are used to effectively navigate through the knee, and the technique presented here represents just one of these techniques. As such, the authors wish to emphasize that the reader understand the importance of learning and developing a specific routine for performing a diagnostic knee arthroscopy in order to perform the procedure in a routine fashion for every single knee.

Case Minimum Requirements

• N = 30 (knee arthroscopy)

Commonly Used CPT Codes

• CPT Code: 29850—Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)

• CPT Code: 29851—Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)

• CPT Code: 29855—Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)

• CPT Code: 29856—Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)

• CPT Code: 29860—Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)

• CPT Code: 29866—Arthroscopy, knee, surgical; osteochondral autograft(s) (e.g., mosaicplasty; includes harvesting of the autograft[s])

• CPT Code: 29867—Arthroscopy, knee, surgical; osteochondral allograft (e.g., mosaicplasty)

• CPT Code: 29868—Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral

• CPT Code: 29870—Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)

• CPT Code: 29871—Arthroscopy, knee, surgical; for infection, lavage and drainage

• CPT Code: 29873—Arthroscopy, knee, surgical; with lateral release

• CPT Code: 29874—Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)

• CPT Code: 29875—Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection; separate procedure)

• CPT Code: 29876—Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)

• CPT Code: 29877—Arthroscopy, knee, surgical; débridement/shaving of articular cartilage (chondroplasty)

• CPT Code: 29879—Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture

• CPT Code: 29880—Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving)

• CPT Code: 29881—Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving)

• CPT Code: 29882—Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)

• CPT Code: 29883—Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)

• CPT Code: 29884—Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)

• CPT Code: 29885—Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including débridement ...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• Contributors
• Introduction
• Foreword
• Video Contents
• 1 Diagnostic Knee Arthroscopy: Surgical Technique
• 2 Diagnostic Shoulder Arthroscopy: Surgical Technique
• 3 Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft or Allograft
• 4 Total Hip Arthroplasty
• 5 Total Knee Arthroplasty
• 6 Open Reduction and Internal Fixation of Femoral Neck Fractures
• 7 Intertrochanteric Femur Fractures: Intramedullary Hip Screw
• 8 Intertrochanteric Femur Fractures: Sliding HIP Screw
• 9 Carpal Tunnel Release
• 10 Spine Decompression and Posterior Spine Fusion
• 11 Open Reduction Internal Fixation Bimalleolar Ankle Fracture
• 12 Ankle Arthrodesis
• 13 Hindfoot and Midfoot Fusion
• 14 Closed Reduction Forearm and Wrist (Adult)
• 15 Adult Distal Humerus Fractures: Open Reduction Internal Fixation
• 16 Intramedullary Nailing of Femoral Shaft Fractures
• 17 Tibial Shaft Fractures: Intramedullary Nailing
• 18 Pediatric Techniques: Supracondylar Humerus Fracture Percutaneous Fixation
• 19 Pediatric Techniques: Clubfoot Casting and Clubfoot Surgical Correction
• 20 Pediatric Techniques: Percutaneous Pinning for Slipped Capital Femoral Epiphysis
• 21 Epiphysiodesis for Limb Length Discrepancy and Angular Deformity
• 22 Oncology Techniques: Biopsy Principles and Techniques
• 23 Open Reduction and Internal Fixation of a Pathologic Humeral Shaft Fracture
• 24 Principles of Fracture Fixation: Plates/Screws and Intramedullary Nails
• 25 Skeletal Traction Pin Placement: Femoral, Tibial, and Calcaneal
• 26 Joint Aspiration and Injection: Shoulder, Elbow, Wrist, Hip, Knee, and Ankle
• 27 Compartment Syndrome: Four Compartment Leg Release Technique
• 28 Open Reduction Internal Fixation of Tibial Plateau Fractures
• 29 Anterior Shoulder Stabilization: Surgical Technique
• 30 Arthroscopic Rotator Cuff Repair
• 31 Hip Arthroscopy
• 32 Elbow Arthroscopy
• 33 Anterior Cervical Discectomy and Fusion
• 34 Proximal Humerus Fracture Fixation: Open Reduction Internal Fixation and Closed Reduction Percutaneous Pinning
• 35 Closed Reduction and Percutaneous Pinning of Metacarpal Fractures
• 36 Open Reduction and Internal Fixation of Distal Radius Fractures
• 37 Total Shoulder Arthroplasty
• 38 Midshaft Clavicle Fracture Open Reduction and Internal Fixation
• 39 Acromioclavicular Joint Reconstruction
• 40 Hip Hemiarthroplasty
• Index