Name of the Procedure:

Ligamentous reconstruction (augmentation), knee; intra-articular (open)

Summary:

Ligamentous reconstruction (augmentation) of the knee, also known as intra-articular open knee ligament reconstruction, is a surgical procedure to repair and strengthen damaged ligaments within the knee joint. The procedure involves creating a surgical opening to access and augment the injured ligaments.

Purpose:

This procedure addresses ligament injuries in the knee, such as torn anterior cruciate ligament (ACL) or other major knee ligaments. The goals are to restore knee stability, improve function, and reduce pain, allowing patients to return to regular activities and sports.

Indications:

• Chronic knee instability
• Torn ligaments (e.g., ACL, PCL)
• Knee pain associated with ligament damage
• Failure of conservative treatments like physical therapy and bracing

Preparation:

• Fasting from midnight before surgery
• Adjustments to medications as advised by the surgeon
• Preoperative diagnostic tests such as MRI or X-rays
• Preoperative consultation and clearance from a primary care physician

Procedure Description:

1. The patient is placed under general anesthesia.
2. An incision is made over the knee to access the joint.
3. Damaged ligament segments are identified and removed if necessary.
4. A graft, often sourced from the patient’s own tissue or a donor, is prepared.
5. The graft is positioned within the knee and secured to the bones using screws or other fixation devices.
6. The incision is closed with sutures or staples, and the area is dressed.

Duration:

The procedure typically takes 1.5 to 2 hours.

Setting:

It is performed in a hospital or a specialized outpatient surgical center.

Personnel:

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Surgical technologist

Risks and Complications:

• Infection
• Blood clots
• Graft rejection or failure
• Knee stiffness or loss of motion
• Pain or nerve damage

Benefits:

• Restored knee stability
• Improved movement and function
• Reduced pain
• Return to normal activities and sports, generally within 6 to 9 months post-surgery

Recovery:

• Use of crutches and a knee brace immediately after surgery
• Physical therapy starting shortly after surgery to regain motion and strength
• Gradual return to weight-bearing and regular activities
• Full recovery can take 6 to 12 months, with regular follow-up appointments

Alternatives:

• Non-surgical treatments like physical therapy, bracing, and activity modifications
• Minimally invasive arthroscopic ligament repair, if applicable
• Pros of alternatives: Less invasive, shorter initial recovery
• Cons of alternatives: May not provide the same level of stability and longer-term results

Patient Experience:

• Initial postoperative pain managed with medications
• Some discomfort and swelling around the knee
• Gradual improvement in knee stability and function with rehab
• Patients typically find significant improvements in their activity levels and a reduction in pain over time.