# Primary Repair Chronic Hip Abductor Tendon Tear



## jenpollock (Oct 21, 2010)

Would appreciate some help with coding this case:  Dr. did a primary repair of chronic hip abductor tendon tear.  Would this be an unlisted procedure?

*OP Note:******************
PREOPERATIVE DIAGNOSIS:
Right hip:       Abductor tendon tear.
Left hip:  Abductor tendinosis.

OPERATION PERFORMED:
Right hip:  Gluteus medius/abductor tendon repair.
Left hip:  Injection, trochanteric bursa.

DESCRIPTION OF PROCEDURE:
Following  induction  of anesthesia, the patient  received  Ancef
parenterally.   She  was  turned  to  a  left  lateral  decubitus
position on a vacuum bag.  Gel pads and pillows were used to  pad
the lower extremities.  The right upper extremity was placed on a
well limb holder.  U-drape was used to isolate the hip area.  The
right  hip  and  lower extremity were prepped and draped  in  the
usual manner including an adherent Iodophor 3M drape.

A lateral incision was utilized.  The iliotibial band was divided
and  retracted.   Gross tearing of the abductor  was  immediately
noted.  This appeared chronic in nature.  This involved at  least
90%  of  the  tendon area.  Following definition of the  anatomy,
progressive  debridement  of  the  abnormal  tendon  tissue   was
performed.   The medial and proximal-most aspect of  the  greater
trochanter  were  cleaned of soft tissue and  curetted.   CurvTek
drill  holes  were  placed.  FiberWire  suture  was  then  placed
through  the  main body of the gluteus medius tendon and  brought
through  the  CurvTek drill holes.  Reduction was performed  with
the  tendon apposed to bone.  The FiberWire suture was tied  over
the  distal bone blocks.  The tendon was repaired at its deep and
superficial   layers  utilizing  Ethibond.   Final   lavage   was
performed.   The  iliotibial band was repaired  with  interrupted
PDS.  The remainder of the wound was closed in layers with Vicryl
with  skin  closed  utilizing Monocryl subcuticular.   Dermabond,
Benzoin and Steri-Strips were applied followed by a dry dressing.
Anesthesia was discontinued.

The  patient  was then returned to a supine position.   The  left
lateral  hip area was prepped.  The left trochanteric  bursa  was
injected with Xylocaine 1 ml and Depo-Medrol 80 mg.

CONDITION AT END OF PROCEDURE:
The  patient  was  then transferred to the PACU  in  satisfactory
condition.

ESTIMATED BLOOD LOSS:
Zero.
***************

Any help would be appreciated!!


----------

