August 6, 2020

Question:
I am new in orthopaedics and am reviewing an operative note. The patient had a total knee arthroplasty five years prior to this surgery. The patient presented with patellofemoral knee pain and was taken to the OR for a chondroplasty and partial synovectomy were performed. The post-operative diagnosis, other than S/P knee arthroplasty was patellofemoral chondromalacia. Is it possible to have chondromalacia after a total knee arthroplasty?

Answer:

Thank you for your question and interest in understanding the pathology. Your scenario states the patient had a total knee arthroplasty but does not reference whether the surgeon included patellar resurfacing. If the patella was not resurfaced, chondromalacia may be present in the patellofemoral compartment, supporting the chondroplasty. Report 29877 regardless of payor as this is the only reportable service. A partial synovectomy, (CPT code 29875), has a separate procedure designation and is not reportable in addition to the chondroplasty.

*This response is based on the best information available as of 08/06/20.