Wednesday, September 10, 2008

#8. TORN LIGAMENT REPAIR - KNEE

PREOPERATIVE DIAGNOSIS: Right knee pain and medial meniscus tear.

POSTOPERATIVE DIAGNOSIS: Right knee pain and medial meniscus tear.

PROCEDURES PERFORMED: (1) Right knee examination under anesthesia with diagnostic arthroscopy. (2) Partial medial meniscectomy, right knee.

DESCRIPTION OF OPERATIVE PROCEDURE: After placement of general anesthesia, the patient's right knee was prepped and draped in the routine fashion for knee arthroscopy. Examination revealed no instability and full range of motion. The knee was arthroscoped through the standard medial and lateral portals. The entire knee joint was evaluated. The suprapatellar region showed fairly normal appearing patella with minimal chondromalacia. There was a medial shelf plica present which was small and appeared to be within normal limits. The medial compartment, however, showed a complex horizontal cleavage tear of the medial meniscus, involving the posterior 40-50% of the undersurface of the meniscus. Fragmented tissue was present in the joint. Photographic record was made.
The anterior cruciate ligament was intact and the lateral compartment showed an intact lateral meniscus. With the motorized debrider and basket forceps, the meniscus was trimmed to a smooth, stable rim. Only the torn tissue was resected.
The knee was then copiously irrigated. All fragmented tissue was removed. The arthroscope was removed. The skin portals were closed with a single 4-0 nylon stitch. The knee was injected with 20 cc of Marcaine and 1 cc of Kenalog 40. The patient was awakened and taken to the recovery room in stable condition. There were no complications. All sponge and instrument counts were correct.

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