Open treatment of patellar dislocation, with or without partial or total patellectomy
CPT4 code
Name of the Procedure:
Open Treatment of Patellar Dislocation
- Common Name: Surgical Reduction of Knee Cap Dislocation
- Medical Terms: Patellar Realignment Surgery, Open Patellar Reduction, Patellar Stabilization Surgery
Summary
Open treatment of patellar dislocation is a surgical procedure to correct and stabilize the kneecap (patella) that has moved out of its normal position. This surgery can involve either partial or total removal of the kneecap (patellectomy) if necessary.
Purpose
Patellar dislocation can cause significant pain, instability, and difficulty in moving the knee. The primary goals of this procedure are to reposition the dislocated patella, repair or reconstruct damaged tissues, and restore normal knee function while preventing future dislocations.
Indications
- Recurrent patellar dislocations
- Severe initial dislocation involving bone or tissue damage
- Chronic knee instability or pain unresponsive to conservative treatments
- Individualized based on patient factors like age, activity level, and overall health
Preparation
- Fasting 8-12 hours before surgery
- Discontinuation of certain medications (e.g., blood thinners) as advised by the surgeon
- Preoperative diagnostic tests, such as X-rays, MRI, or CT scans, to assess the extent of dislocation and associated damage
- Physical examination to ensure the patient is fit for surgery
Procedure Description
- Administration of general or regional anesthesia.
- An incision is made along the affected knee.
- The surgeon repositions the dislocated patella into its proper place.
- Damaged ligaments, tendons, or cartilage are repaired or reconstructed.
- If necessary, a partial or total patellectomy is performed to remove damaged parts of the kneecap.
- The knee joint is stabilized using sutures, grafts, or other fixation techniques.
- The incision is closed with sutures and a sterile bandage is applied.
Duration
The procedure typically takes 1 to 3 hours, depending on the complexity of the case.
Setting
This surgery is generally performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Surgical Technicians
- Physical Therapist (post-operative care)
Risks and Complications
- Infection
- Blood clots
- Persistent knee pain or stiffness
- Re-dislocation or instability
- Nerve or blood vessel damage
- Adverse reactions to anesthesia
Benefits
- Relief from pain and discomfort
- Improved knee stability and function
- Reduced risk of future dislocations
- Quicker return to normal activities and sports
Recovery
- Hospital stay may range from a few hours to a couple of days.
- Pain management using prescribed medications.
- Physical therapy to regain strength and range of motion.
- Crutches or knee braces may be required for initial mobility.
- Full recovery typically takes 3-6 months, with gradual return to normal activities.
- Follow-up appointments to monitor healing and progress.
Alternatives
- Non-surgical treatments like physical therapy, bracing, and activity modification.
- Minimally invasive arthroscopic surgery.
- Each alternative comes with varying success rates and may not completely prevent future dislocations.
Patient Experience
- During the procedure, anesthesia ensures the patient is free from pain.
- Post-procedure, the knee may be swollen and painful, which can be managed with medications.
- Physical therapy will be integral to recovery, emphasizing gradual rebuilding of strength and flexibility.
- Most patients will need support such as crutches temporarily and will have activity restrictions during the early stages of recovery.