Repair, primary, torn ligament and/or capsule, knee; cruciate
CPT4 code
Name of the Procedure:
Repair, primary, torn ligament and/or capsule, knee; cruciate
Common names: ACL Repair, PCL Repair, Cruciate Ligament Repair
Summary
A Cruciate Ligament Repair is a surgical procedure aimed at fixing a torn anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) in the knee. This procedure is crucial for restoring knee stability and function, particularly after an injury that severely compromises the knee's structural integrity.
Purpose
The procedure addresses a torn cruciate ligament in the knee. The goals include:
- Restoring knee stability
- Reducing pain
- Improving knee function and mobility
- Preventing further knee damage and degeneration
Indications
- Severe knee pain and instability that affects daily activities
- Confirmed tear of the ACL or PCL through imaging studies (e.g., MRI)
- Failure of conservative treatments like physical therapy
- Athletes or active individuals needing to return to high-demand sports
Preparation
- Patients may need to fast for 8-12 hours before the procedure.
- Medications such as blood thinners might need to be stopped beforehand.
- Pre-operative assessments typically include physical exams, imaging studies, and sometimes blood tests.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incisions: Small incisions are made around the knee for arthroscopic instruments.
- Repair Process: The torn ligament is identified, and either reattached with the help of sutures and anchors, or reconstructed using a graft from the patient (autograft) or a donor (allograft).
- Closure: The incisions are closed with sutures or surgical staples.
- Immobilization: The knee is often braced to protect the repair as it heals.
Tools: Arthroscope, sutures, anchors, graft materials
Anesthesia: General or regional anesthesia
Duration
Typically 1 to 2 hours
Setting
Usually performed in a hospital or an outpatient surgical center
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Possibly a surgical assistant
Risks and Complications
Common risks:
- Infection
- Blood clots
- Bleeding
- Knee stiffness or reduced range of motion
Rare risks:
- Chronic knee pain
- Graft rejection (if an allograft is used)
- Nerve or blood vessel damage
Benefits
- Improved knee stability and function
- Reduction in pain and swelling
- Return to normal activities or sports
- Prevention of further knee damage
Recovery
- Initial recovery involves icing, elevation, and wearing a knee brace.
- Physical therapy starts soon after surgery to aid in regaining strength and mobility.
- Full recovery can take 6-12 months, with restrictions on high-impact activities until cleared by the doctor.
- Follow-up appointments are necessary to monitor progress.
Alternatives
- Physical therapy (typically less effective for complete tears)
- Bracing and modified activity levels
- Non-surgical treatments (adequate for partial tears or low-demand individuals)
- Pros: Less invasive, lower initial costs, and fewer immediate risks
- Cons: May not fully restore knee stability and functionality
Patient Experience
- During the procedure: Under anesthesia, the patient will not feel pain or discomfort.
- After the procedure: Pain and swelling are managed with medications.
- Physical therapy is crucial for pain management and restoring mobility.
- The patient may experience some discomfort during physical therapy but will benefit from gradual improvement.
Note: Always consult with a healthcare provider for personalized medical advice and information about the procedure.