24344 Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)

Name of the Procedure:

Reconstruction of the Lateral Collateral Ligament (LCL) of the elbow with tendon graft (includes harvesting of graft). Commonly referred to as LCL reconstruction or elbow ligament reconstruction.

Summary

LCL reconstruction of the elbow is a surgical procedure that involves repairing a damaged lateral collateral ligament with a tendon graft, which is often harvested from the patient’s own body. This surgery is performed to restore stability and function to the elbow.

Purpose

This procedure specifically addresses injuries or tears to the lateral collateral ligament of the elbow, which can impair the elbow's stability and function. The goal is to restore stability, alleviate pain, and enable the patient to return to normal activities or sports.

Indications

• Chronic elbow instability
• Torn or ruptured LCL
• Persistent pain or discomfort despite conservative treatment
• Recurrent elbow dislocations
• Patients who require strong elbow function, such as athletes

Preparation

1. Fasting for at least 8 hours prior to surgery.
2. Stopping certain medications, such as blood thinners, as advised by the doctor.
3. Pre-operative imaging tests (e.g., MRI) to assess the extent of the injury.
4. Pre-anesthetic evaluation to ensure patient is fit for surgery.

Procedure Description

1. Anesthesia: The patient is administered general anesthesia or a regional nerve block.
2. Incision: A small incision is made on the outer side of the elbow.
3. Harvesting Graft: A tendon graft is harvested, usually from the patient’s own forearm or hamstring.
4. Ligament Reconstruction: The damaged ligament is removed, and the tendon graft is positioned and secured with sutures and/or surgical anchors.
5. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The surgery is usually performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurse
• Scrub Technician

Risks and Complications

• Infection
• Bleeding
• Nerve damage or numbness
• Graft rejection or failure
• Stiffness or loss of motion
• Blood clots

Benefits

• Improved elbow stability
• Reduced pain
• Enhanced ability to perform daily activities or sports
• High success rate with return to pre-injury activity levels

Recovery

• Use of a brace or splint for initial support.
• Physical therapy starting a few weeks post-surgery to restore strength and flexibility.
• Avoiding heavy lifting and strenuous activities for several months.
• Full recovery typically takes 6 to 12 months, with regular follow-up appointments to monitor progress.

Alternatives

• Non-surgical treatments (e.g., physical therapy, bracing)
• Arthroscopic debridement (for minor injuries)
• PRP (Platelet-Rich Plasma) injections
• Pros and Cons: Non-surgical options might be less invasive and have shorter recovery times but may not provide the same level of stability and function as surgical intervention.

Patient Experience

During the procedure, the patient will be unconscious or sedated. Post-surgery, the patient might experience discomfort, pain, and swelling, managed with pain medications and anti-inflammatories. The use of a brace for immobilization and gradual engagement in physical therapy will aid in recovery. Initial pain and stiffness will gradually improve over weeks to months.