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Lengthening of hamstring tendon; single tendon

CPT4 code

Name of the Procedure:

Lengthening of Hamstring Tendon; Single Tendon

Summary

The lengthening of the hamstring tendon procedure involves surgically extending a hamstring muscle tendon to relieve tightness and improve flexibility. This procedure is often done on one tendon and helps in enhancing the range of motion in the leg.

Purpose

The medical condition or problem it addresses:
  • Hamstring tightness
  • Muscle contractures
  • Limited range of motion in the knee or hip
The goals or expected outcomes of the procedure:
  • Increased flexibility
  • Improved leg and knee function
  • Reduction of pain and discomfort
  • Enhanced mobility and ability to perform daily activities

Indications

Specific symptoms or conditions that warrant the procedure:
  • Chronic hamstring tightness
  • Muscle contractures due to cerebral palsy or other neuromuscular disorders
  • Reduced flexibility causing difficulty in walking or standing
Patient criteria or factors that make the procedure appropriate:
  • Persistent tightness that does not respond to physical therapy
  • Diagnosis by an orthopedic specialist indicating surgery as the best option
  • Patients in good health to tolerate anesthesia and surgery

Preparation

Pre-procedure instructions for the patient:
  • Fasting for 6-8 hours prior to surgery
  • Adjustments to regular medications as advised by the healthcare provider
  • Arranging transportation home post-surgery
Any diagnostic tests or assessments required beforehand:
  • Physical examination
  • Imaging studies, such as X-rays or MRI to assess the tendon and muscle condition
  • Blood tests to evaluate overall health

Procedure Description

Detailed step-by-step explanation of what the procedure involves:
  1. The patient is administered anesthesia for comfort.
  2. An incision is made near the site of the tight tendon.
  3. The surgeon carefully identifies and isolates the hamstring tendon.
  4. The tendon is gently lengthened, often by making small cuts and stretching.
  5. The incision is closed with sutures.
Tools, equipment, or technology used:
  • Surgical instruments such as scalpels, retractors, and sutures
  • Anesthesia equipment
Anesthesia or sedation details, if applicable:
  • General anesthesia or regional anesthesia (e.g., spinal or epidural)

Duration

How long the procedure typically takes:

  • Usually about 1 to 2 hours

Setting

Where the procedure is performed:

  • Hospital or outpatient surgical center

Personnel

Healthcare professionals involved:

  • Orthopedic surgeon
  • Anesthesiologist
  • Surgical nurses
  • Surgical assistants

Risks and Complications

Common and rare risks associated with the procedure:
  • Infection at the incision site
  • Bleeding or hematoma
  • Nerve damage
  • Muscle weakness
  • Risk of tendon re-contracture
Possible complications and their management:
  • Management with antibiotics for infection
  • Physical therapy for muscle recovery
  • Additional surgery in rare cases of severe complications

Benefits

Expected benefits and how soon they might be realized:
  • Improved flexibility and reduced tightness
  • Better leg function and movement
  • Pain relief

Recovery

Post-procedure care and instructions:
  • Rest and limit physical activities for several weeks
  • Follow-up appointments to monitor healing
  • Physical therapy for gradual rehabilitation
Expected recovery time and any restrictions or follow-up appointments:
  • Full recovery in about 6 to 12 weeks
  • Avoid strenuous activities until advised by a physician

Alternatives

Other treatment options available:
  • Physical therapy and stretching exercises
  • Orthotic devices
  • Botulinum toxin (Botox) injections
Pros and cons of alternatives compared to the described procedure:
  • Non-surgical alternatives may have fewer risks but might be less effective for severe cases
  • Surgery can provide a more permanent solution but comes with surgical risks

Patient Experience

What the patient might feel or experience during and after the procedure:
  • Mild to moderate pain post-surgery, managed with pain medications
  • Discomfort and stiffness initially, improving with physical therapy
  • Sensation of increased flexibility as healing progresses
Pain management and comfort measures:
  • Prescription pain relief medications
  • Ice packs to reduce swelling
  • Gradual introduction to movement and therapeutic exercises

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