# Attention knee experts: arthroscopic lateral release and ORIF patella



## Alta (May 10, 2009)

ARTHROSCOPIC LATERAL RELEASE, ORIF PATELLA, QUADRICEPS REALIGNMENT.

Arthroscopically: There was a small osteochondral sliver off the medial aspect of the patella and extensive soft tissue damage in the VMO area. The superior medial portal was established and through the inferolateral portal a lateral release was performed using a tissue ablation cutter in standard fashion. The knee was then thoroughly irrigated. Instrumentation was removed.

Open: The incision was made over the patella proximally in the midline about three inches and the subcutaneous tissue was elevated in the quadriceps. The VMO was exposed. There was significant attenuation and damage to the VMO and this was debrided and taken down. There was an osteochondral fragment of the patella which had a large bony rim that extended about 1 cm into the articular cartilage of the patella and it was felt open reduction internal fixation was a better solution than removal and a 3.5 mm cannulated screw was placed after fixation of the fragment with K wire. Fixation was obtained. The VMO was then advanced following tacking of the VMO in the advanced position and checking the tracking. Using imbricating mattress type sutures with #1 Ethibond, the quad was repaired with frequent adjustments to make sure the patella was tracking normally. 

So for the arthroscopic part I have 29873.

The patellar fracture/dislocation I had 27524. He did not do a patellectomy he did an internal fixation.

For vastus medialis oblique I am lost. I have 27430.

What do you think?  Any takers?


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## rajalakshmir (May 10, 2009)

*knee*

s ur are absolutely correct .i too agree


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## nikkisgranny (May 11, 2009)

Look at 27422. I don't know if this will help.


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## mbort (May 11, 2009)

I agree with nikkisgranny, look at 27422.  I dont think the 27340 fits.
(it may bundle, check your CCI edits, I think the 29873 bundles too)


Mary, CPC, COSC


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## Alta (May 11, 2009)

*Thank you!*

I totally missed that one.  I will check the edits tomorrow.  Thanks!


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