CPT® Code 24360

The procedure described by CPT® Code 24360 refers to an arthroplasty of the elbow that utilizes a membrane, such as a fascial graft, to repair damaged or deteriorated articular cartilage and joint surfaces. This surgical intervention is indicated for patients experiencing significant joint dysfunction due to conditions affecting the elbow, such as arthritis or trauma. The procedure begins with a skin incision made over the elbow joint, either on the medial or lateral side of the olecranon process, which is the bony prominence of the ulna at the elbow. The surgical team carefully dissects the soft tissues to expose the underlying structures, ensuring that the ulnar nerve is identified and protected throughout the operation. During the procedure, the lateral epicondyle of the humerus is exposed, and the interval between the anconeus muscle and the flexor carpi ulnaris is incised to allow for mobilization of the triceps muscle. The anconeus is then elevated from the lateral aspect of the proximal ulna to gain access to the elbow joint. The surgical approach continues with dissection of the tissue off the lateral epicondyle, followed by external rotation and flexion of the elbow to facilitate access to the posterior joint capsule. The posterior joint capsule is opened, exposing the roof of the olecranon, and the medial collateral ligament is released from the epicondyle to further enhance visibility and access to the joint surfaces. Once all joint surfaces are adequately exposed, any deteriorated articular cartilage and bone are meticulously removed. A fascial graft is harvested to cover the joint surfaces, providing a supportive layer that aids in the healing process. After the graft is placed, ligaments and tendons, including the triceps, are reattached to restore the structural integrity of the elbow. In some cases, a subcutaneous pocket may be created for the ulnar nerve, positioned between the subcutaneous fat and fascia near the medial epicondyle to protect the nerve during recovery. Finally, the fascia and skin are closed in layers, and the arm is fully extended and placed in a splint to stabilize the joint during the initial healing phase.