CPT® Code 27558

Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair, with augmentation/reconstruction

The CPT® Code 27558 refers to the open treatment of a knee dislocation, which includes internal fixation when performed, along with primary ligamentous repair that may involve augmentation or reconstruction. Knee dislocations can occur in various forms, including anterior, posterior, lateral, medial, and rotary dislocations, each affecting different ligaments within the knee joint. The knee is stabilized by four primary ligaments: the medial collateral ligament (MCL) and lateral collateral ligament (LCL), which are located on the inner and outer aspects of the knee, respectively, and the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which are situated within the joint capsule. The treatment approach for a knee dislocation is contingent upon the specific ligaments that are injured and the severity of the dislocation. The procedure typically begins with an incision over the knee, followed by an incision of the joint capsule to expose the injury site. This area is then cleared of any debris, such as loose osteochondral fragments, to facilitate the reduction of the dislocation, which is subsequently verified through radiographic imaging. In cases where ligaments are torn, they are repaired using sutures or staples. If there are avulsed ligaments accompanied by significant bone fragments, internal fixation methods, such as screws, may be employed to secure the ligaments and restore knee stability. The procedure may also involve augmentation, where a tendon graft is used to reinforce the repaired ligament, or reconstruction, which is necessary when a ligament is too severely damaged to be repaired and must be replaced with a new graft. This comprehensive approach ensures that the knee joint is stabilized and functional post-treatment.