29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction

Name of the Procedure:

Arthroscopically Aided Anterior Cruciate Ligament (ACL) Repair/Augmentation or Reconstruction

Summary

The procedure involves using an arthroscope and specialized instruments to repair or reconstruct a torn ACL in the knee. An arthroscope is a small camera that allows the surgeon to see inside the joint without making large incisions. This minimally invasive procedure aims to restore knee stability and function.

Purpose

The procedure addresses ACL tears, which can cause knee instability, pain, and impaired function. The goal is to restore the normal mechanics of the knee, allowing for a return to sports and daily activities, and to prevent further injury.

Indications

• Persistent knee pain or instability
• Inability to perform sports or physical activities due to an ACL tear
• Physical examinations indicating ACL tear
• MRI confirming a torn ACL Patients typically considered for this procedure are those with active lifestyles or athletes who require a stable knee for their activities.

Preparation

• Patients may be instructed to fast for 8-12 hours prior to the procedure.
• Adjustments to medications, especially blood thinners, may be necessary.
• Preoperative assessments such as MRI scans and physical examinations are conducted.
• Patients are advised to arrange for post-procedure transportation and have a recovery plan.

Procedure Description

1. The patient is administered either general anesthesia or regional anesthesia.
2. Small incisions are made around the knee.
3. An arthroscope is inserted into one incision to allow internal visualization of the knee joint.
4. Specialized instruments are inserted through other small incisions to repair or reconstruct the ACL.
   • Repair may involve suturing the torn ligament.
   • Reconstruction involves grafting tissue, often from the patient’s hamstring or patellar tendon, to replace the torn ACL.
5. The graft is secured using screws or other fixation devices.
6. The incisions are closed with sutures or staples.

Duration

The procedure typically takes about 1.5 to 2 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection at the incision site
• Blood clots
• Knee stiffness or loss of motion
• Graft failure or re-tear
• Nerve or blood vessel damage

Benefits

• Restored knee stability
• Improved knee function and strength
• Ability to return to sports and daily activities
• Reduced risk of future knee injuries

Recovery

• Patients typically go home the same day.
• Use of crutches and a knee brace is usually required initially.
• Physical therapy begins shortly after surgery to aid in recovery.
• Full recovery and return to sports may take 6-12 months, depending on the individual.
• Follow-up appointments to monitor progress.

Alternatives

• Nonsurgical treatments such as physical therapy.
• Knee bracing.
• Avoidance of high-demand activities.
• The pros of nonsurgical options include avoiding surgical risks, but they may not restore full knee stability or function, especially in active individuals.

Patient Experience

• During the procedure: Patients will be under anesthesia and should not experience pain.
• After the procedure: Mild to moderate pain and swelling, managed with prescribed pain medication.
• Continuous icing, elevation, and physical therapy are crucial for optimal recovery and comfort.