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Repair, primary, disrupted ligament, ankle; collateral

CPT4 code

Name of the Procedure:

Repair, primary, disrupted ligament, ankle; collateral

Summary

A surgical procedure to repair a torn or disrupted ligament on the outer or inner sides (collateral ligament) of the ankle. This surgery aims to restore stability and function to the ankle joint.

Purpose

This procedure addresses torn or disrupted collateral ligaments in the ankle. It aims to restore stability, reduce pain, and improve function by repairing the damaged ligament, thus preventing further ankle instability and potential future injuries.

Indications

  • Persistent ankle pain and swelling.
  • Chronic ankle instability despite non-surgical treatments.
  • Recurrent ankle sprains.
  • Diagnostic imaging (e.g., MRI) confirming a torn or disrupted collateral ligament.
  • Failure to respond to conservative treatments such as physical therapy or bracing.

Preparation

  • Fasting for at least 8 hours before surgery.
  • Adjustment of medications as directed by the healthcare provider.
  • Preoperative assessment including blood tests, EKG, and imaging studies if required.
  • Arranging transportation, as the patient will not be able to drive post-procedure.

Procedure Description

  1. The patient is given anesthesia, typically general or regional.
  2. A small incision is made over the injured ligament.
  3. The surgeon identifies and debrides the damaged portions of the ligament.
  4. The ligament is then meticulously repaired, often with stitches or special anchors.
  5. Surrounding tissues are repaired as needed.
  6. The incision is closed with sutures, and a sterile dressing is applied.
  7. The ankle may be immobilized with a splint or cast to protect the repaired ligament.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the repair.

Setting

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

Personnel

  • Orthopedic surgeon
  • Surgical nurses
  • Anesthesiologist
  • Possibly a physician assistant or surgical technician

Risks and Complications

  • Infection at the surgical site.
  • Bleeding or blood clots.
  • Nerve damage or altered sensation.
  • Incomplete healing or persistent instability.
  • Scar tissue formation.
  • Reaction to anesthesia.

Benefits

  • Restoration of ankle stability.
  • Decreased pain and swelling.
  • Improved ankle function and mobility.
  • Reduced risk of future ankle injuries.
  • Return to normal activities and sports over time.

Recovery

  • Initial immobilization with a splint or cast.
  • Gradual weight-bearing as directed by the surgeon.
  • Physical therapy to restore strength and mobility.
  • Pain management with prescribed medications.
  • Recovery time varies but generally ranges from 6 weeks to several months.
  • Follow-up appointments for progress evaluation and suture removal.

Alternatives

  • Conservative treatment with physical therapy and bracing.
  • Ankle arthroscopy for less invasive ligament repair.
  • Platelet-rich plasma (PRP) injections.
  • Pros and cons should be discussed with a healthcare provider, considering the severity of the ligament injury and patient lifestyle.

Patient Experience

Patients may experience discomfort and swelling post-surgery. Pain management includes prescribed medications and ice application. Initial limitations on weight-bearing and mobility aid use, such as crutches, are common. Gradual improvement is expected, with full recovery depending on adherence to rehabilitation protocols and the severity of the initial injury.

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