CPT® Code 27540

Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed

The procedure described by CPT® Code 27540 pertains to the open treatment of fractures located at the intercondylar spine(s) and/or tuberosity of the knee. The intercondylar spine, also known as the intercondylar eminence or tibial spine, is characterized by two upward projections situated centrally on the proximal surface of the tibia, positioned between the lateral and medial condyles. This anatomical feature plays a crucial role in the stability of the knee joint. The tibial tuberosity, on the other hand, is a prominent projection found on the anterior aspect of the proximal tibia, serving as the attachment point for the patellar ligament, which is essential for knee extension. In cases of intercondylar tibial spine fractures, the surgical approach involves making an incision over the anterior medial aspect of the knee. This allows for access to the medial joint capsule, which is then incised to evacuate any hematoma present. The fracture site is meticulously exposed, cleared of any debris, and subsequently reduced to restore proper alignment. To secure the fracture fragments, various internal fixation methods may be employed, including the use of sutures, wires, screws, or pins. Following the reduction, anatomical alignment is confirmed through radiographic imaging. For tibial tuberosity fractures, the surgical procedure begins with an incision over the anterior medial knee, directly above the proximal tibia. Similar to the intercondylar spine procedure, the fracture site is exposed and cleared of debris before reduction. Fractures that do not involve the articular surface are typically stabilized using one or two screws that are inserted through the tibial tubercle into the proximal tibia. In contrast, fractures that do involve the articular surface necessitate an anterior medial arthrotomy to allow for proper access and treatment. After reducing the fracture, temporary wire fixation is applied, and alignment is again verified radiographically before the application of permanent screw fixation to ensure stability and proper healing.