29889 Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction

Name of the Procedure:

Arthroscopically Aided Posterior Cruciate Ligament (PCL) Repair/Augmentation or Reconstruction

Summary

Arthroscopically aided PCL repair or reconstruction is a minimally invasive surgical procedure where a small camera (arthroscope) and specialized instruments are used to repair, augment, or replace the posterior cruciate ligament of the knee.

Purpose

• Medical Condition: The procedure addresses injuries or tears to the posterior cruciate ligament.
• Goals/Expected Outcomes: The aim is to restore knee stability, improve function, reduce pain, and prevent further knee damage.

Indications

• Severe PCL injuries or tears
• Knee instability
• Pain and dysfunction despite conservative treatments
• Patients involved in activities requiring stable knee joints (e.g., athletes)

Preparation

• Pre-Procedure Instructions: Patients may be advised to fast for several hours before surgery and adjust any medications as directed by their healthcare provider.
• Diagnostic Tests/Assessments: Imaging tests such as MRI or X-rays to assess the extent of the injury.

Procedure Description

1. Anesthesia: Regional or general anesthesia is administered.
2. Incisions: Small incisions are made around the knee.
3. Arthroscope Insertion: An arthroscope equipped with a camera is inserted to provide a clear view of the inside of the knee.
4. Repair/Augmentation/Reconstruction: Specialized instruments are used to repair or reconstruct the damaged PCL. This may involve suturing the ligament, using a graft (autograft or allograft), or augmenting the ligament.
5. Closure: Incisions are closed with sutures or staples.
6. Post-Surgery: The knee is bandaged, and sometimes a knee brace is applied.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Possibly a physician assistant or surgical technician

Risks and Complications

• Common Risks: Infection, blood clots, knee stiffness
• Rare Risks: Nerve damage, ongoing pain, graft failure
• Management: Risks are managed through proper surgical techniques and post-operative care.

Benefits

• Improved knee stability and function
• Pain relief
• Enhanced ability to perform daily and sporting activities
• Benefits usually realized over several months post-surgery.

Recovery

• Post-Procedure Care: Pain management with medications, icing, and elevation of the knee.
• Instructions: Physical therapy starting a few days to weeks post-surgery.
• Recovery Time: Full recovery can take 6 to 12 months. Restrictions on weight-bearing activities and a gradual return to normal activities.

Alternatives

• Conservative Treatments: Physical therapy, bracing, and anti-inflammatory medications.
• Other Surgical Options: Open PCL repair or reconstruction.
• Pros and Cons: Conservative treatments avoid surgery but may not fully restore knee function. Open surgery is more invasive with a longer recovery time.

Patient Experience

• During Procedure: Patients are under anesthesia and will not feel pain.
• After Procedure: Initial pain and swelling managed with medications, icing, and elevation. Physical therapy is crucial for recovery. Pain typically decreases over the first few weeks, and functional improvements are noted progressively.