27692 Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (List separately in addition to code for primary procedure)

Name of the Procedure:

Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (List separately in addition to code for primary procedure)

Summary

This procedure involves relocating a tendon to a new position to improve function or relieve pain. It includes shifting the attached muscle to align with the new tendon pathway. For additional tendons, this can be billed separately from the main procedure.

Purpose

The procedure is performed to restore function to a muscle or group of muscles that have been impaired due to injury, disease, or congenital conditions. The main goal is to improve movement, strength, and alleviate pain.

Indications

• Conditions like tendonitis, tendon rupture, or severe muscle atrophy.
• Nervous system disorders that affect muscle function.
• Traumatic injuries resulting in tendon or muscle damage.
• Congenital anomalies affecting tendon placement or muscle function.

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Adjustments to medications, especially blood thinners, as advised by the physician.
• Pre-operative diagnostic tests such as MRI or ultrasound to map the tendons and muscles.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: The surgeon makes an incision over the affected area.
3. Tendon Identification: The targeted tendon is identified and detached from its original location.
4. Redirection: The tendon, along with its muscle, is redirected or rerouted to a new position.
5. Attachment: The tendon is securely attached to the new location and tested for proper tension and function.
6. Closure: The incision is sutured, and a sterile dressing is applied.

Duration

The procedure typically takes 1-3 hours, depending on the number of tendons involved and the complexity of the rerouting.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon or specialist
• Anesthesiologist
• Surgical nurses
• Support staff

Risks and Complications

• Infection
• Blood clots
• Nerve damage
• Incomplete recovery of movement or strength
• Scar tissue formation affecting movement

Benefits

• Improved muscle function and strength
• Reduction or elimination of pain
• Enhanced ability to perform daily activities
• Correction of deformities or functional limitations

Recovery

• Post-procedure care includes wound dressing, possible use of a splint or brace.
• Physical therapy begins shortly after surgery to enhance recovery.
• Recovery time varies but generally lasts between 6-12 weeks.
• Restrictions on heavy lifting or strenuous activity until advised by the surgeon.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Conservative treatments such as physical therapy or medications.
• Orthotic devices to support weakened tendons or muscles.
• Injection therapies, including corticosteroids or platelet-rich plasma (PRP).

Patient Experience

• Mild to moderate pain immediately after the procedure, managed with prescribed pain medications.
• Swelling and bruising around the surgical site.
• Gradual improvement in function and reduction in pain as healing progresses.
• Comprehensive pain management strategies and supportive care to ensure patient comfort.