DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Anterior cruciate ligament tear, right knee.
POSTOPERATIVE DIAGNOSES:
1. Anterior cruciate ligament tear, right knee.
2. Medial femoral condylar defect, osteochondral fracture.
OPERATIONS PERFORMED:
1. Diagnostic arthroscopy of the right knee.
2. Arthroscopically assisted anterior cruciate ligament reconstruction.
3. Removal of loose body and debridement of medial femoral condyle.
SURGEON: John Doe, MD
ANESTHESIA: General.
COMPLICATIONS: None.
DESCRIPTION OF OPERATION: The patient was brought to the operating room and administered a general anesthetic by the department of anesthesia. Once the anesthetic had a chance to take effect, a pneumatic tourniquet was applied to the right upper thigh. The right knee was prepped and draped in the usual manner. A superior portal was then created and was distended with saline.
Anteromedial and anterolateral portals were then created. The lateral compartment was visualized. The lateral femoral condyle and tibial plateau were visualized and noted to be intact. The lateral meniscus was also unremarkable. The parapatellar region was very much unremarkable. One could view a loose body within the joint. This was removed. There was a defect related to medial femoral condylar region, which was trimmed utilizing the ArthroCare unit. The patient has a situation in which autologous chondrocyte implantation is going to be necessary based upon this defect. The anterior cruciate ligament was very much torn. This was debrided. The remaining portion of the anterior cruciate ligament was removed.
Notchplasty was performed. The cadaver ACL was prepared on the back table. We then made our tunnels with the drill at the appropriate position. A 10 mm chamfer drill hole was then created. We found the over-the-top position as related to the femoral tunnel. This was noted at approximately 11 o’clock. The 30 mm graft was put in place. It was secured in place with interference screw, 8 x 25, as related to the femoral tunnel. The knee was placed in a flexed position and we then inserted another interference screw, 8 x 25. The wound was copiously irrigated at this time. Excellent stability was noted.
The wounds were then closed with 2-0 Vicryl and a running 2-0 nylon suture. The wounds were then cleansed and dried. A dressing was applied consisting of Steri-Strips, Xeroform, 4 x 4, ABDs, Kerlix, cast padding, and a knee immobilizer with an Ace bandage. The patient was then taken to the recovery room in satisfactory condition, having tolerated the procedure quite well.
