Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
CPT4 code
Name of the Procedure:
Repair, secondary, disrupted ligament, ankle, collateral (e.g., Watson-Jones procedure)
Summary
The Watson-Jones procedure is a surgical technique used to reconstruct and repair torn or severely damaged ligaments in the ankle. This procedure is particularly focused on the collateral ligaments that provide stability to the ankle joint.
Purpose
The primary purpose of the Watson-Jones procedure is to stabilize the ankle after a significant ligament injury. This helps to restore normal function, reduce pain, and prevent further damage. The goals include improved ankle stability, reduced risk of recurrent injuries, and enhanced overall mobility.
Indications
This procedure is indicated for patients who have experienced severe ankle trauma resulting in disrupted collateral ligaments, particularly those who have not responded to conservative treatment such as bracing, physical therapy, or medication. It is often recommended for athletes or individuals with highly active lifestyles who require reliable ankle stability.
Preparation
Patients may be instructed to fast for several hours before the surgery. Medication adjustments, especially blood thinners, may be necessary. Preoperative imaging tests, such as X-rays or MRI scans, are often required to assess the extent of the ligament damage.
Procedure Description
- Anesthesia: The patient is placed under general anesthesia or a regional nerve block.
- Incision: A small incision is made near the affected ligament.
- Harvesting of Tendons: Tendons from the patient’s body or a donor are used to reconstruct the damaged ligament.
- Attachment: The harvested tendons are stitched or anchored to the bone, mimicking the natural ligament alignment.
- Closure: The incision is closed with sutures, and a sterile bandage is applied.
Tools and equipment include surgical scalpels, sutures, tendon grafts, and anchors for tendon attachment.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
This surgery is usually performed in a hospital or a specialized surgical center.
Personnel
The procedure involves a team including an orthopedic surgeon, anesthesiologist, surgical nurses, and possibly a surgical technologist.
Risks and Complications
- Infection
- Blood clots
- Nerve damage
- Persistent pain or stiffness
- Failure to achieve desired stability
- Rarely, complications from anesthesia
Complications are managed with medications, physical therapy, or, in some cases, additional surgical intervention.
Benefits
Expected benefits include a more stable ankle, reduced pain, and decreased risk of future injuries. Patients typically notice improvement within a few weeks to months post-surgery.
Recovery
Post-procedure care includes rest, elevation of the foot, and application of ice to reduce swelling. The patient may need to use crutches or a brace initially and undergo physical therapy. Full recovery can take several months, and activities may be restricted during this period.
Alternatives
- Conservative treatments such as bracing, physical therapy, and medications.
Other surgical options like arthroscopic ligament repair.
Pros of the Watson-Jones procedure include long-term stability and effectiveness in severe cases. Cons include the risks associated with surgery and a longer recovery period compared to non-surgical options.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel any pain. Post-operatively, pain management includes medications, and comfort measures such as ice packs and elevation of the ankle. Most patients experience some discomfort and swelling, which gradually improves with healing and physical therapy.