12 minutes ago, Vulture said:

 

 

“Surgery aims to create more space for the tendons underneath the acromion, to prevent them from impinging against the bone. Surgery can also remove inflamed tissue from the bursa, or remove the bursa altogether if necessary (a new one will grow back)”

If bursectomy and debridement are the same thing, how is there such a thing as bursectomy with debridement? Bursectomy is the removal of the bursa itself. Debridement is the removal of tissue that inflames or infects the bursa, ie bone Spurs, cartilage and damaged tissue. In the above quote the former is debridement, the latter is bursectomy.

https://www.findacode.com/newsletters/aha-coding-clinic/icd/bursectomy-irrigation-debridement-I232019.html

“A patient was admitted with infected prepatellar bursitis of the right knee. An irrigation, debridement and bursectomy were performed.”

if debridement and bursectomy are the same thing, why are they listed separately here? Poor guy is going to be double billed for same procedure

 

Correct. So in this case the debridement was the bursa so it was a bursectomy. 

Just now, ptatc said:

Correct. So in this case the debridement was the bursa so it was a bursectomy. 

Come on man. Debridement is removal of objects around the bursa and bursectomy is removal of the bursa itself, as I’ve clearly shown. You actually believed Rodon has no bursa, when I’ve shown that even if he had bursa removed, it would have grown back, which you incorrectly claimed doesn’t happen.

1 hour ago, ptatc said:

I would be more worried about the shoulder holding up from the removal of the bursa than the UCL reconstruction. Especially since he still uses that awful stand up follow through. 

1 hour ago, ptatc said:

True. But not having whatever tissue was removed there makes it more difficult to maintain the shoulder stability thus having a healthy shoulder. Giving him a long term deal or a substantial monetary deal is a risky investment. 

1 hour ago, ptatc said:

Bursa does not grow back. It is a Balloon like pocket of fluid that cushions the tendon from rubbing on the bone.

 

17 minutes ago, Vulture said:

https://www.mercy.com/health-care-services/orthopedics-sports-medicine-spine/specialties/foot-ankle/treatments/foot-bursectomy-or-surgical-removal

“A bursectomy is a surgical procedure in which the doctor removes one or more of these painful sacs from the space around your heel. As a you heal, new bursae form in its place. The new bursae are less likely to become irritated. That helps you move without pain.”

 

9 minutes ago, Vulture said:

Come on man. Debridement is removal of objects around the bursa and bursectomy is removal of the bursa itself, as I’ve clearly shown. You actually believed Rodon has no bursa, when I’ve shown that even if he had bursa removed, it would have grown back, which you incorrectly claimed doesn’t happen.

No debridement is the removal of tissue. In this case it was the bursa. There is no other tissue around it that could have been removed. Any substantial removal of a bursa will not grow back. Maybe just a little part or a tiny one, but I still don't buy that. There is no referenced article from will show that. 

Yes, he does not have a  a full bursa in that shoulder.

Edited May 26, 20214 yr by ptatc

1 minute ago, Vulture said:

 

 

Sourcing something from a a page that explains it for patients is not a reliable source. Find research that explains it and I'll buy it but I've never seen it.

Just now, ptatc said:

No debridement is the removal of tissue. In this case it was the bursa. There is no other tissue around it that could have been removed. Any substantial removal of a bursa will not grow back. Maybe just a little part or a tiny one, but I still don't buy that. There is no referenced article from will show that. 

Yes, he does not have a bursa in that shoulder. Maybe a nlbit of scar tissue where is was .

I can’t believe you’re still claiming bursa doesn’t grow back. Mercy hospital not a good enough source? The tissue removed in debridement can include cartilage and bone Spurs or infected material around the bursa

Just now, ptatc said:

Sourcing something from a a page that explains it for patients is not a reliable source. Find research that explains it and I'll buy it but I've never seen it.

You actually want me to provide more sources that the well known fact bursae regrow???

23 minutes ago, Vulture said:

I can’t believe you’re still claiming bursa doesn’t grow back. Mercy hospital not a good enough source? The tissue removed in debridement can include cartilage and bone Spurs or infected material around the bursa

No mercy hospital page for patients does not count. Again they speak to the patients in generalities. Here is an article on Bursa surgery. Granted it's in the ankle but it's what I could find right now. Look at the top of page 1207 where it says that there was one case in 60 where a abnormal bursa grew back and it is listed as a complication. If they grow back it's more of a scar tissue type not a true bursa and it won't function normally.

The tissue can include the tissues you listed but the report on Rodon's surgery was that the rotator cuff (muscles, tendons) and the labrum (cartilage) was normal. So the bursa is the only option left when dealing with a chronic bursitis.

bursa.pdf

27 minutes ago, Vulture said:

You actually want me to provide more sources that the well known fact bursae regrow???

yes.  because you won't find much. Read the research report I posted about how the bursa reoccurrence is abnormal and is removed. 

From Wheeless Textbook of Orthopaedics:

Elements of bursectomy:
- needs to be compulsive and complete for appropriate visualization;
- there needs to be complete removal down to the subdeltoid space;
- there should be complete visualization 1 cm medial to both the anterior and posterior arthroscopic portals;
- OR descriptions bursal proliferation and inflammation, hemorrhaging in CA ligament, hypertrophy and fraying of CA
ligament, acromial spur formation;
- bursa is sometimes debrided after the acromioplasty, since it tends to bleed more (disrupting the case);
- take special when debriding around the AC joint since bleeding is especially troublesome;
- rotate the arm internally and externally to expose different parts of the bursa;
- downward traction generally increases the working space available for the subacromial space.
- use of a radiofrequency device before a motorized shaver is used for bursectomy can help to minimize bleeding;
- methodically sweep the shaver along the bursa;

Now how can a debridement be sometimes performed during a bursectomy procedure, prior to exposing different parts of the bursa and subsequently the shaving of the bursa, if they are the same thing? How can an “element” of something be the thing itself?

5 minutes ago, ptatc said:

No mercy hospital page for patients does not count. Again they speak to the patients in generalities. Here is an article on Bursa surgery. Granted it's in the ankle but it's what I could find right now. Look at the top of page 1207 where it says that there was one case in 60 where a abnormal bursa grew back and it is listed as a complication. If they grow back it's more of a scar tissue type not a true bursa and it won't function normally.

The tissue can include the tissues you listed but the report on Rodon's surgery was that the rotator cuff (muscles, tendons) and the labrum (cartilage) was normal. So the bursa is the only option left when dealing with a chronic bursitis.

bursa.pdf

So you think claiming bursa regrow is a generality? Do you still actually believe like you did twenty minutes ago that bursa do not regrow and mercy hospital is lying or what? Whatever, you clearly simply to refuse to admit you’re wrong

2 minutes ago, Vulture said:

From Wheeless Textbook of Orthopaedics:

Elements of bursectomy:
- needs to be compulsive and complete for appropriate visualization;
- there needs to be complete removal down to the subdeltoid space;
- there should be complete visualization 1 cm medial to both the anterior and posterior arthroscopic portals;
- OR descriptions bursal proliferation and inflammation, hemorrhaging in CA ligament, hypertrophy and fraying of CA
ligament, acromial spur formation;
- bursa is sometimes debrided after the acromioplasty, since it tends to bleed more (disrupting the case);
- take special when debriding around the AC joint since bleeding is especially troublesome;
- rotate the arm internally and externally to expose different parts of the bursa;
- downward traction generally increases the working space available for the subacromial space.
- use of a radiofrequency device before a motorized shaver is used for bursectomy can help to minimize bleeding;
- methodically sweep the shaver along the bursa;

Now how can a debridement be sometimes performed during a bursectomy procedure, prior to exposing different parts of the bursa and subsequently the shaving of the bursa, if they are the same thing? How can an “element” of something be the thing itself?

Because the debridement is the removal of tissue. The bursectomy is the removal of part or all of the bursa. So in this case the debridement was the bursa. In the case of when you do this surgery and the rotator cuff and the labrum are fine the only thing left to debride is the bursa.

Would you feel better if I said that IN THIS CASE the debridement and bursectomy is the same thing but not in all cases?

3 minutes ago, Vulture said:

So you think claiming bursa regrow is a generality? Do you still actually believe like you did twenty minutes ago that bursa do not regrow and mercy hospital is lying or what? Whatever, you clearly simply to refuse to admit you’re wrong

That's because I'm not wrong. The research clearly shows that a bursa regrowing is an abnormal situation not a common or desired one. 

I hate to tell you this but physicians and hospitals do not always spend the time to tell you the exact truth to everything. They modify it so it is more easily understandable for everyone. The more accurate statement for what you posted probably would have been "something may grow back there and it may be ok but not really the same and might be functional."  Do you think they want to put that on their website?

Believe what you want but I'll take the research as opposed to a non-referenced website.

Nothing in that document supports your claim that bursae don’t regrow.

7 minutes ago, ptatc said:

Because the debridement is the removal of tissue. The bursectomy is the removal of part or all of the bursa. So in this case the debridement was the bursa. In the case of when you do this surgery and the rotator cuff and the labrum are fine the only thing left to debride is the bursa.

Would you feel better if I said that IN THIS CASE the debridement and bursectomy is the same thing but not in all cases?

Dude it clearly states the debridement is SOMETIMES performed prior to the removal of the bursa. You have got to be just fucking with me at this point

Edited May 26, 20214 yr by Vulture

4 minutes ago, Vulture said:

Nothing in that document supports your claim that bursae don’t regrow.

Dude it clearly states the debridement is SOMETIMES performed prior to the removal of the bursa. You have got to be just fucking with me at this point

I have no idea what this means. Not every procedure is done for every condition. Let's go over the facts

1. The reports are he had a debridement.

2. Reports are the rotator cuff and labrum were normal

2a. If those were normal what was debrided?

The only thing left for a bursitis patient is the bursa. This is also a common procedure done for what Rodon had going on. 

 

Edit: Sorry I didn't see the first part. Yes it does. It clearly states that in only 1 of 60 was there a reoccurrence of the bursa and it was abnormal and needed to be removed. 

Edited May 26, 20214 yr by ptatc

10 minutes ago, Vulture said:

Nothing in that document supports your claim that bursae don’t regrow.

Dude it clearly states the debridement is SOMETIMES performed prior to the removal of the bursa. You have got to be just fucking with me at this point

I am not sure why you think your misunderstanding google searches is somehow more knowledge than a guy who has done this for a living for decades, but you are out over your skis here.  I have no idea why this is the hill you want to fight on, but this thread is a lot worse for it, and is quickly nearing personal attack status in some of the last few posts.

Rodon fucks

14 minutes ago, southsider2k5 said:

I am not sure why you think your misunderstanding google searches is somehow more knowledge than a guy who has done this for a living for decades, but you are out over your skis here.  I have no idea why this is the hill you want to fight on, but this thread is a lot worse for it, and is quickly nearing personal attack status in some of the last few posts.

Sorry. I will stop derailing the thread now.

27 minutes ago, southsider2k5 said:

I am not sure why you think your misunderstanding google searches is somehow more knowledge than a guy who has done this for a living for decades, but you are out over your skis here.  I have no idea why this is the hill you want to fight on, but this thread is a lot worse for it, and is quickly nearing personal attack status in some of the last few posts.

I was going to say earlier that it must be nice to have that kind of free time lol

48 minutes ago, southsider2k5 said:

I am not sure why you think your misunderstanding google searches is somehow more knowledge than a guy who has done this for a living for decades, but you are out over your skis here.  I have no idea why this is the hill you want to fight on, but this thread is a lot worse for it, and is quickly nearing personal attack status in some of the last few posts.

Really? Bursa do regrow, and debridement and bursectomy are two different things. Those are facts not personal. Why ptc claims that is not the case is beyond me, but here is further support:

“The edges of the released tissue are then

debrided with the mechanical shaver to expand the

decompressed area and to allow for placement of the

arthroscopic camera, mechanical shaver, and radio-

frequency devices to access the underlying greater

trochanteric bursa.

An extensive greater trochanteric bursectomy is then

performed”

Now how can bursectomy be performed after debridement if they are the same thing?

 

further: “Bursa will regrow.”

Fox J., Duquin T. (2017) Olecranon Bursitis. In: Eltorai A., Eberson C., Daniels A. (eds) Orthopedic Surgery Clerkship. Springer, Cham. https://doi.org/10.1007/978-3-319-52567-9_20

1 hour ago, ptatc said:

I have no idea what this means. Not every procedure is done for every condition. Let's go over the facts

1. The reports are he had a debridement.

2. Reports are the rotator cuff and labrum were normal

2a. If those were normal what was debrided?

The only thing left for a bursitis patient is the bursa. This is also a common procedure done for what Rodon had going on. 

 

Edit: Sorry I didn't see the first part. Yes it does. It clearly states that in only 1 of 60 was there a reoccurrence of the bursa and it was abnormal and needed to be removed. 

Reoccurrence means reoccurrence of the condition, not the regrowth of the bursa. “A return of symptoms as part of the natural progress of a disease.”

Edited May 26, 20214 yr by Vulture

51 minutes ago, ptatc said:

Sorry. I will stop derailing the thread now.

It's not you.

1 hour ago, ptatc said:

I have no idea what this means. Not every procedure is done for every condition. Let's go over the facts

1. The reports are he had a debridement.

2. Reports are the rotator cuff and labrum were normal

2a. If those were normal what was debrided?

 

1 hour ago, Vulture said:

From Wheeless Textbook of Orthopaedics:

Elements of bursectomy:

- bursa is sometimes debrided after the acromioplasty, since it tends to bleed more (disrupting the case);
- use of a radiofrequency device before a motorized shaver is used for bursectomy can help...

If debridement is sometimes performed prior to bursectomy, then they aren’t the same thing.

I already answered 2a

18 minutes ago, Vulture said:

Reoccurrence means reoccurrence of the condition, not the regrowth of the bursa. “A return of symptoms as part of the natural progress of a disease.”

Obviously you didn't read the article as this was not the context in which it was used. Recurrence in this case is the bursa reforming and it was removed. Some words have more than one meaning.

 

 

 

Edited May 26, 20214 yr by ptatc

3 minutes ago, Vulture said:

 

If debridement is sometimes performed prior to bursectomy, then they aren’t the same thing.

I already answered 2a

You did not answer 2a as you did not state what was debrided.

The bursa was debrided hence it was a bursectomy. In this case the bursa was the tissue that was debrided. The bursa is the only tissue other than the rotator cuff and the labrum In the subacromial space or suprahumeral space depending on which definition you want to use.