Suture of infrapatellar tendon; primary
CPT4 code
Name of the Procedure:
Suture of Infrapatellar Tendon; Primary
Common Names: Infrapatellar Tendon Repair, Patellar Tendon Stitching
Summary
This procedure repairs a tear or rupture in the infrapatellar tendon, located just below the kneecap, by stitching the damaged ends back together. It is typically performed to restore knee function and mobility.
Purpose
Medical Condition Addressed: Rupture or severe injury to the infrapatellar tendon.
Goals and Outcomes: To reattach the torn tendon, restore knee stability, and improve overall leg function.
Indications
- Severe pain and swelling below the kneecap
- Inability to straighten the knee
- Significant weakness in the leg
- Partial or complete rupture of the infrapatellar tendon confirmed via diagnostic imaging
- Patients with acute tendon injury who are otherwise in good health
Preparation
- Fasting for at least 6-8 hours prior to the procedure
- Medication review and possible adjustments
- Preoperative physical examination and diagnostic imaging such as MRI or ultrasound
- Signing of informed consent forms
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A surgical incision is made over the infrapatellar tendon.
- Exposure: The tendon is carefully exposed.
- Debridement: Any damaged or frayed tendon tissue is cleaned and trimmed.
- Suturing: The torn ends of the tendon are brought together and stitched using strong, non-absorbable sutures.
- Closure: The incision is closed using sutures or staples, and the area is bandaged.
Tools/Technology Used: Scalpels, sutures, surgical scissors, retractors
Duration
Typically, the procedure takes about 1-2 hours to complete.
Setting
The procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurse
- Surgical technologist
Risks and Complications
- Infection at the incision site
- Blood clots
- Anesthesia-related complications
- Re-rupture of the tendon
- Persistent pain or stiffness
- Delayed healing
Benefits
- Improves knee stability and function
- Reduces pain and swelling
- Enables return to normal activity levels
- High success rate for complete tendon healing
Recovery
- Initial immobilization with a brace or cast
- Pain management with medications
- Physical therapy starting a few weeks after surgery
- Gradual increase in knee activity over several months
- Regular follow-up appointments to monitor healing
Expected Recovery Time: 6-12 months, with restrictions on weight-bearing activities and sports until cleared by the surgeon.
Alternatives
- Non-surgical management (immobilization and guided physical therapy)
- Platelet-rich plasma (PRP) injections
- Functional bracing
Pros of Alternatives: Less invasive, quicker initial recovery.
Cons of Alternatives: Lower likelihood of completely restoring tendon function, higher risk of re-injury.
Patient Experience
During the Procedure: The patient will be under anesthesia and will not feel pain.
After the Procedure: Pain and swelling are expected; managed with medications. Discomfort from immobilization and limited activities is common.
Pain Management: Pain medications, ice packs, and elevation post-surgery help manage discomfort.
Comfort Measures: Patients may experience discomfort due to immobilization, which can be alleviated with the use of crutches, proper positioning, and supportive devices.