Does anyone know if I can use 29879 for the above procedure or should I use unlisted 29999 or would this be considered part of 29882? Has anyone heard of bone marrow venting?
Op Report: Anterolateral portal established–Patellofemoral trochlear surfaces normal as well as medial lateral gutters. Medial joint line was entered. A valgus stress was applied. We saw the radial-type tear of the posterior horn & body junction of the medial meniscus. An anteromedial portal was established parallel to tibial plateau. We noted the superior articular edge of the tear was approximately 50% whereas the undersurface tear was nearly 100% of the meniscus. We used a shaver, rasp & needle to trephinate the capsular tissues. We also used a spinal needle 18-gauge to trephinate the medial collateral ligament to allow for a medial collateral ligament lengthening procedure so that we could enter the medial compartment without damaging the articular surfaces of the medial femoral condyle or tibial plateau. We then from both the anterolateral & anteromedial portal used a Arthrex scorpion device to place vertical mattress sutures across the radial tear. The sutures were tied with sliding & locking knots with alternating half hitches & post. A total of 4 sutures were inserted. There is anatomic approximation of the medial meniscus tear. The ACL & PCL were intact. The lateral meniscus, lateral femoral condyle & tibial plateau articular surfaces were normal. We then used a 45 degree awl to perform a bone marrow venting procedure of the lateral femoral condyle just anterior to the anterior cruciate ligament insertion site. Following this the water was turned off. There was bone marrow & blood extravasating from the bone. Wounds were closed, steri-strips applied & dressings applied.
Op Report: Anterolateral portal established–Patellofemoral trochlear surfaces normal as well as medial lateral gutters. Medial joint line was entered. A valgus stress was applied. We saw the radial-type tear of the posterior horn & body junction of the medial meniscus. An anteromedial portal was established parallel to tibial plateau. We noted the superior articular edge of the tear was approximately 50% whereas the undersurface tear was nearly 100% of the meniscus. We used a shaver, rasp & needle to trephinate the capsular tissues. We also used a spinal needle 18-gauge to trephinate the medial collateral ligament to allow for a medial collateral ligament lengthening procedure so that we could enter the medial compartment without damaging the articular surfaces of the medial femoral condyle or tibial plateau. We then from both the anterolateral & anteromedial portal used a Arthrex scorpion device to place vertical mattress sutures across the radial tear. The sutures were tied with sliding & locking knots with alternating half hitches & post. A total of 4 sutures were inserted. There is anatomic approximation of the medial meniscus tear. The ACL & PCL were intact. The lateral meniscus, lateral femoral condyle & tibial plateau articular surfaces were normal. We then used a 45 degree awl to perform a bone marrow venting procedure of the lateral femoral condyle just anterior to the anterior cruciate ligament insertion site. Following this the water was turned off. There was bone marrow & blood extravasating from the bone. Wounds were closed, steri-strips applied & dressings applied.