ankle surgery - Dr did an open cartilage transplantation

emkahu

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Dr did an open cartilage transplantation with medial malleolar osteotomy and repair of peroneus tendon. Diagnosis is osteochondritis desiccans lesion LT ankle as well as peroneus brevis tendon tear.
Op report reads, medial malleolar osteotomy was then carried out through an open medial incision. Pre-drilling was accomplished with 2.5 drill bit, and then a sagittal saw being cooled by irrigation was then used to perform an oblique medial malleolar osteotomy. Excellent visualization of the medial talar dome was accomplished and the osteochondral lesion was removed, leaving a deep crater, the bottom of which was significantly sclerotic in nature. The surrounding cartilage was debrided back to stable tissue, as was the bottom of the OCD defect where it was back to healthy, slighty punctate bleeding tissue. The area was then irrigated out, extensively dried and de Novo juvenile cartilage was transplanted into the base of the defect for a total of 1 package of the graft. It was then held in place with fibrin glue which was allowed to dry sufficiently and obtained an excellent surface that was just below flush with the native cartilage as desired. the medial malleolar osteotomy was then reassembled with cancellous screws, both 50 mm in lingth; 1 partially threaded, 1 fully threaded. After compression of the medial malleolar osteotomy.
Attention was then turned to the lateral ankle where an incision was made posterior to the distal fibula and the peroneal tendon sheath was opened. The peroneus brevis tendon was noted to be significantly degenerated and split. This was debrided back to stable healthy tissue and the split was repaired with 3-0 Vicryl sutures. Excellent reapproximation of the tendon was accomplished and the retinaculum was repaired.

I was thinking 27659 for the repair of the tendon but I do not know about the cartilage transplatation. Maybe 27705 for the osteotomy???

Any help will be greatly appreciated!

Thanks
Lisa
 
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