Name of the Procedure:

Ligamentous Reconstruction (Augmentation), Knee; Extra-Articular

Summary

Ligamentous reconstruction (augmentation) of the knee, specifically extra-articular, involves repairing or reinforcing the ligaments located outside the knee joint. This type of surgery is aimed at providing additional stability to the knee, particularly for patients who have suffered ligament injuries that do not respond well to traditional methods.

Purpose

The primary goal of this procedure is to stabilize the knee, prevent excessive movement, and restore function. It addresses conditions such as chronic knee instability, recurrent knee dislocations, or injuries to the knee ligaments that affect the stability and normal function of the knee.

Indications

• Chronic knee instability
• Recurrent dislocations or subluxations of the knee
• Ligament injuries, particularly those involving the lateral or medial collateral ligaments
• Previous ligament reconstruction failures
• Athletes or individuals with physically demanding activities suffering from recurrent knee issues

Preparation

• Patients may be required to fast for several hours before the procedure.
• Medications might need adjustment, particularly blood thinners.
• Diagnostic tests such as MRI or X-ray to assess the extent of ligament damage.
• Pre-operative consultations to discuss procedure details and anesthesia options.

Procedure Description

1. The patient is placed under general anesthesia or regional anesthesia.
2. An incision is made over the knee to expose the affected ligament.
3. Torn or damaged ligament fibers are repaired or augmented using grafts, which may be autografts (from the patient's own body) or allografts (donor tissue).
4. The graft is securely anchored to the bone using screws or other fixation devices.
5. The incision is closed with sutures or staples, and the knee is bandaged.
6. The knee may be placed in a brace or splint to immobilize it initially.

Duration

The procedure typically takes 1-2 hours, depending on the complexity of the ligament damage and the specific techniques used.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Physical therapist (post-procedure rehabilitation)

Risks and Complications

• Infection
• Blood clots
• Anesthesia-related complications
• Graft failure or re-tearing
• Stiffness or loss of range of motion in the knee
• Persistent pain or instability

Benefits

• Improved stability of the knee joint
• Enhanced ability to perform daily activities and sports
• Reduced risk of further knee injuries
• Long-term improvement in knee function

Recovery

• Initial post-operative care involves rest, ice, compression, and elevation (RICE).
• Physical therapy is crucial for regaining strength and mobility.
• Patients may need to use crutches or a knee brace during the initial recovery phase.
• Recovery time can vary but typically ranges from 6 to 12 months for complete healing.

Alternatives

• Physical therapy and rehabilitation without surgery
• Arthroscopic ligament repair
• Non-surgical bracing and lifestyle modifications
• Pros of alternatives: Non-invasive, quicker initial recovery.
• Cons of alternatives: May not provide lasting stability or adequately address severe ligament damage.

Patient Experience

• During the procedure, patients will be under anesthesia and will not feel pain.
• Post-operatively, patients might experience pain, swelling, and discomfort, which can be managed with pain medications and ice.
• Physical therapy may cause mild discomfort but is important for recovery.
• Gradual improvement in knee stability and function can be expected with adherence to rehabilitation protocols.