Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening
CPT4 code
Name of the Procedure:
Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening.
Summary
An Arthrotomy with posterior capsular release is a surgical procedure performed on the ankle to relieve stiffness and improve mobility. It may also involve lengthening the Achilles tendon if it is tight.
Purpose
This procedure addresses conditions like ankle stiffness, limited range of motion, and severe pain caused by scar tissue or contractures in the posterior capsule of the ankle joint. The goals are to enhance ankle mobility, reduce pain, and improve overall function.
Indications
- Chronic ankle stiffness
- Persistent ankle pain
- Limited range of motion
- Previous non-responsive treatment
- Tight or shortened Achilles tendon
Preparation
- Fasting for 8-12 hours prior to surgery
- Adjusting or stopping certain medications as advised by your surgeon
- Pre-operative imaging studies like X-rays or MRI scans
- Blood tests and a physical examination
- Arranging for transportation post-surgery
Procedure Description
- Anesthesia is administered, commonly general or regional.
- An incision is made at the back of the ankle.
- The posterior capsule of the ankle joint is exposed and released.
- If needed, the Achilles tendon is lengthened by making small cuts to allow it to stretch.
- Any scar tissue is removed to improve joint mobility.
- Incisions are closed with sutures, and a dressing is applied.
- The ankle may be immobilized temporarily in a cast or splint.
Duration
The procedure typically takes about 1 to 2 hours, depending on the complexity.
Setting
This surgery is performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurse
- Operating Room Technician
Risks and Complications
- Infection
- Bleeding
- Blood clots
- Nerve damage
- Delayed wound healing
- Recurrence of stiffness
Benefits
- Improved ankle mobility
- Pain relief
- Enhanced functional ability
- Potential to resume normal activities within a few months
Recovery
- Pain management with prescribed medications
- Keeping the surgical site clean and dry
- Physical therapy to regain strength and flexibility
- Gradual return to weight-bearing activities
- Full recovery might range from 3 to 6 months, depending on individual progress
Alternatives
- Physical therapy
- Steroid injections
- Orthotic devices
- Less invasive procedures such as arthroscopy
Patient Experience
Patients may experience some pain and discomfort post-surgery, which can be managed with pain relief medications. Swelling and temporary immobility are common. Physical therapy plays a crucial role in recovery, aimed at gradual improvement of strength and flexibility.