Reconstruction of dislocating patella; with patellectomy
CPT4 code
Name of the Procedure:
Reconstruction of dislocating patella with patellectomy; also known as Patellar Realignment Surgery with Patellectomy.
Summary
This surgical procedure involves realigning the patella (kneecap) and removing the patella to treat chronic dislocation, aiming to stabilize the knee and improve function.
Purpose
The procedure addresses chronic patellar dislocation, which causes pain, instability, and difficulty in performing daily activities. The goal is to realign the supporting structures of the knee, remove the patella if necessary, and restore normal knee function and stability.
Indications
- Recurrent patellar dislocations that do not respond to non-surgical treatments.
- Severe knee instability.
- Chronic pain due to patellar dislocations.
- Failed previous surgical interventions.
- Patients with a history of traumatic knee injuries.
Preparation
- Fasting typically required 8-12 hours before surgery.
- Adjustment of medications as instructed by the physician.
- Preoperative imaging tests such as X-rays or MRIs.
- Blood tests and overall health assessment.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: An incision is made around the knee to access the patella and surrounding structures.
- Patellectomy: The patella is carefully removed.
- Realignment: The surgeon reconstructs the soft tissues (tendons and ligaments) around the knee to align the patellofemoral joint properly.
- Closure: The incision is sutured closed, and the knee is bandaged.
Tools and Technology: Surgical instruments, imaging equipment, sutures.
Duration
The surgery usually takes 1 to 2 hours, depending on the complexity.
Setting
The procedure is performed in a hospital or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Common risks: Infection, blood clots, bleeding, and reaction to anesthesia.
- Rare risks: Nerve damage, issues with joint mobility, chronic pain, and need for additional surgeries.
Benefits
- Improved knee stability and function.
- Reduction in pain and discomfort.
- Enhanced ability to perform daily activities.
- Recovery of a more normal knee contour.
Recovery
- Initial hospital stay for observation and pain management.
- Physical therapy is typically required to regain knee strength and mobility.
- Recovery time ranges from 6 weeks to several months.
- Restrictions on weight-bearing activities and detailed post-operative care instructions will be provided.
- Follow-up appointments to monitor healing progress.
Alternatives
- Physical therapy and bracing.
- Less invasive surgical procedures like arthroscopy.
- Non-surgical options: Pain management and activity modification.
- Pros and Cons: Less invasive options may not fully address chronic instability, but they come with fewer immediate risks compared to an open surgery.
Patient Experience
- During the procedure: You will be under anesthesia, so you will not feel pain.
- After the procedure: Expect significant pain initially, managed with medications. Swelling and stiffness are common.
- Rehabilitation: Physical therapy will be crucial; expect gradual improvement in knee strength and function over time.