# Open Medial plication



## mbort (Aug 27, 2008)

I've bounced all over the book and spent way to much time on it so here it is.....Its the "open" medial plication that has me.



PREOPERATIVE DIAGNOSIS:	Patellar instability with torn medial retinaculum, right knee.

POSTOPERATIVE DIAGNOSIS:	Patellar instability with torn medial retinaculum, right knee.

PROCEDURES PERFORMED:
	3.	Open medial plication .


...........  This allowed much better approximation of the patella within the trochlear groove, but it did not want to stay in the same region.

 The midline skin incision was then utilized for visualization of the distal medial quadriceps insertion as well as the medial retinaculum and imbrication type sutures were then carried out to soft tissue balance of the knee and get the patella to be into its normal position.  Then, #2 FiberWire was used for maintaining the tissue in its reapproximated position.  Once the medial plication was completed, the knee was placed through full range of motion.  There was no undue tension on our repair and the patella was tracking in a normal anatomic fashion without any successful lateral patellar tilt or lateral malalignment.  At the completion of the procedure, deep irrigation fluid was aspirated from the knee.  The deep wound was copiously irrigated using antibiotic irrigation.  The deep dermis was then closed using 2-0 Vicryl.  The superficial subcutaneous tissues were closed using first the 3-0 undyed Vicryl and then a running 4-0 Monocryl suture.  At the completion of the procedure, the patient was transferred to the recovery room with distal sensory and motor examinations intact.


Thanks
Mary


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## coderguy1939 (Sep 2, 2008)

I'm attempting to code a very similar operation.  I have notes from an ortho coding seminar that indicates that there is no code for medial reefing/plication.  I think we're looking at an unlisted code here.


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## PatriciaCPC (Sep 23, 2008)

Hey... How did either of you fair with these surgeries? Here's my best guess: 27422... Please let me know if you have used another code successfully. Thanks!!


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