0SRC069
Replacement Knee Joint, Right to Cemented with Synthetic Substitute, Oxidized Zirconium on Polyethylene, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | S Lower Joints |
| Operation | R Replacement |
| Body Part | C Knee Joint, Right |
| Approach | 0 Open |
| Device | 6 Synthetic Substitute, Oxidized Zirconium on Polyethylene |
| Qualifier | 9 Cemented |
Operation Definition
Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part
Procedure Overview
Joint replacement in the lower extremities involves removing damaged or arthritic surfaces of a hip, knee, or ankle and implanting an artificial device that takes over the joint's function. Surgeons turn to this once medications, injections, and physical therapy no longer control the pain or stiffness of advanced osteoarthritis, rheumatoid arthritis, avascular necrosis, or a joint destroyed by prior trauma. The goal is restoring the ability to walk, climb stairs, and move without bone grinding on bone.
Implants are made of metal alloys, ceramic, or high-grade polyethylene, and a case can replace an entire joint (total) or a single compartment (partial). Recovery centers on physical therapy to build strength around the new joint; most patients regain substantial function within a few months, though the device will eventually wear and may need revision decades later.
Anatomy & Axis Detail
Knee Joint, Right
The knee joint replaced in this procedure is the tibiofemoral articulation, where the femoral condyles, tibial plateau, and often the patellar surface are resurfaced with metal and polyethylene components to relieve pain from advanced osteoarthritis, rheumatoid destruction, or post-traumatic degeneration. Total knee arthroplasty typically involves cutting and shaping the distal femur and proximal tibia to accept the prosthesis, with a plastic spacer substituting for the worn cartilage, and documentation should clarify whether the procedure is a total or unicompartmental replacement, since partial resurfacing of only the medial or lateral compartment may be captured differently. The right-sided designation matters for laterality tracking, particularly when a patient undergoes staged bilateral procedures.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Device: Synthetic Substitute, Oxidized Zirconium on Polyethylene
Synthetic Substitute, Oxidized Zirconium on Polyethylene describes an implant using an oxidized zirconium femoral or head component, a metal alloy treated to form a hard ceramic-like surface, articulating against a polyethylene liner. It is intended to offer wear characteristics between traditional metal-on-polyethylene and ceramic-on-polyethylene bearings. It is distinguished from those other combination substitutes by the specific oxidized zirconium material used on the hard-bearing surface.
Qualifier: Cemented
Cemented qualifies a joint replacement procedure by indicating that the prosthetic component was fixed to bone using bone cement rather than relying on bony ingrowth. It is distinguished from the Uncemented qualifier, with the choice affecting expected fixation strength, recovery timeline, and revision considerations.
Coding & Documentation
A coder assigns Replacement when the operative note documents removal of the native articular surface and insertion of a device meant to permanently substitute for it, not merely resurface it. Documentation should specify the joint, laterality, and whether the procedure was total or partial, since these drive qualifier selection. A common error is confusing partial resurfacing that leaves native bone intact with full Replacement, or missing that a revision arthroplasty swapping the entire prosthesis is still Replacement rather than Revision.