CPT® Code 27381

The procedure described by CPT® Code 27381 pertains to the suture of the infrapatellar tendon, which is more accurately classified as a ligament connecting the tibia (shinbone) and the patella (kneecap). This tendon, often referred to as the patellar tendon, plays a crucial role in knee stability and movement. The surgical intervention involves a secondary reconstruction, which indicates that this procedure is performed after an initial repair has failed or is inadequate. The operation begins with a midline incision that extends from the top of the patella down to the medial aspect of the tibial tubercle, allowing for adequate access to the affected area. During the procedure, medial and lateral flaps are created to facilitate exploration of the surrounding structures, specifically the medial and lateral retinacula, which are connective tissues that support the knee. The torn infrapatellar tendon is then identified and mobilized, followed by debridement, which involves the removal of damaged tissue. Depending on the location of the tear, additional debridement may be performed on the tibial tubercle and/or the inferior pole of the patella to prepare the site for reconstruction. Sutures are placed in the torn tendon to secure it, and the bony surfaces of the tibial tubercle and/or inferior pole of the patella are prepared for the attachment of the tendon. This preparation may involve drilling tunnels or placing suture anchors to facilitate the secure anchoring of the tendon. The sutures from the tendon are then passed through these tunnels or anchors, effectively securing the infrapatellar tendon to the bone. In some cases, a second drill hole may be created in the tibial tubercle, allowing for a suture to be passed through the quadriceps tendon at the upper pole of the patella, which is essential for maintaining proper patellar height. Once the correct patellar height is achieved, the sutures of the infrapatellar tendon are tied off to secure the reconstruction. The procedure concludes with irrigation of the wound and closure of the incision. Additionally, if necessary, a fascial or tendon graft may be utilized to reinforce the repair, ensuring a robust reconstruction of the infrapatellar tendon.