CPT® Code 25825

Arthrodesis, commonly known as joint fusion, is a surgical procedure aimed at alleviating pain and restoring stability to the wrist joint. This procedure is particularly beneficial for patients suffering from various conditions such as rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, spastic flexion contracture, degenerative scaphoid nonunion, or those who have experienced failure of wrist arthroplasty. The surgery involves making an incision along the midline of the posterior wrist, extending from the distal forearm to the proximal metacarpal area. During the procedure, the surgeon exposes the radiocarpal joint and the distal radioulnar joint (DRUJ) by carefully releasing the retinaculum, which is a fibrous band that holds the tendons in place. This release is performed from the ulnar side to the radial side, ensuring that the surrounding nerves, specifically the radial and ulnar nerves, are protected using vessel loops. The surgical team retracts the tendons to gain access to the joint surfaces, where articular cartilage is meticulously removed using specialized instruments such as a rongeur or bur. Following this preparation, the procedure may involve the use of internal fixation devices to immobilize the joint, and in the case of CPT® Code 25825, a bone graft is harvested, typically from a local source. The graft, which may consist of cortical bone chips or morcellized cancellous bone, is then placed into the joint space and secured with pins or wires. Finally, the surgical site is closed in layers, and the wrist is immobilized in a cast to promote healing and stability post-surgery.