I struggle with this case scenario too. My ortho did medial patellofemoral ligament reconstruction utilizing quadriceps tendon turndown and VMO advancement.
He lists 27422 and 27427. These bundle but 27428 does not bundle with 27422 and I'm wondering if his work is more intraarticular and 27428 may be more specific.
The surgeon states he first harvests the central third quadriceps, drills into the medial femoral condyle, then "released the VMO for imbrication reinforcement." "...placed the graft, tensioned it appropriately, and placed a .... screw to hold this within the tunnel." "We then reinforced this with our hamstring semitendinous graft and advanced the VMO to the lateral third of the patella."
I am wondering if 27422 and 27428 with 718.86 and 717.89 is appropriate?
Please any help will be greatly appreciated. And I'm sure that "freemac" will appreciate any feedback too.
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