Preoperative Diagnosis: Torn medial meniscus, left knee Postoperative Diagnosis: Combination horizontal cleavage tear/flap tear, posterior horn, medial meniscus, left knee. Operation: Arthroscopic subtotal medial meniscectomy, left knee Anesthetic: General endotracheal Description of Procedure: The patient was placed on the operating table in the supine position and general endotracheal anesthesia was administered. After an adequate level of anesthesia was achieved, the patient's left lower extremity was prepped with Betadine scrubbing solution, then draped in a sterile manner. Several sites were then infiltrated with 1% Xylocaine solution with Epinephrine to help control bleeding from stab wounds to be made at these sites. These stab wounds were made anterolaterally at the level of the superior pole of the patella for insertion of an irrigation catheter into the suprapatellar pouch area, anterolaterally at the level of the joint line for insertion of the scope and anteromedially at the level of the joint line for insertion of the various arthroscopic cutting and grasping instruments. The knee was explored, no abnormalities were noted in the suprapatellar pouch area. A very small, un-inflamed, non-thickened medial plica was noted. This did not appear to be of any significant problem to the patient, however. It was elected to leave the area alone. The undersurface of the patella showed some very minimal signs of chondromalacia in the central portions as well as on the medial meniscus. With further probing it was noted that he had both a flap tear of the posterior most portions of the posterior horn of the medial meniscus, along with a horizontal cleavage involving a fair amount of the remainder of the posterior horn of the medial meniscus. The flap tear portion of the medial meniscus tear was removed with the 3.5 mm. basket forceps in combination with the Dyonics intra-articular shaver. The horizontal cleavage tear was probed and it was felt the upper leaf of the horizontal cleavage was the thinner of the two remaining components of the horizontal cleavage tear. The upper leaf of the horizontal cleavage tear was then resected in a piecemeal fashion utilizing combination of the 3 mm. basket forceps and the Dyonics intra-articular shaver. The rim of the meniscus was then smoothed down and balanced and the remaining portions of the meniscus were probed and found to be stable and intact. The intracondylar notch area was visualized and showed some hypertrophic synovitis but the anterior cruciate ligament could be visualized and was noted to be intact. The scope was then shifted to the anteromedial port and the lateral compartment was visualized and found to be free of signs of significant degenerative changes on the joint surfaces and the lateral meniscus when probed showed no signs of injury. CPT code(s): Indexing Path:

Preoperative Diagnosis: Torn medial meniscus, left knee Postoperative Diagnosis: Combination horizontal cleavage tear/flap tear, posterior horn, medial meniscus, left knee. Operation: Arthroscopic subtotal medial meniscectomy, left knee Anesthetic: General endotracheal Description of Procedure: The patient was placed on the operating table in the supine position and general endotracheal anesthesia was administered. After an adequate level of anesthesia was achieved, the patient's left lower extremity was prepped with Betadine scrubbing solution, then draped in a sterile manner. Several sites were then infiltrated with 1% Xylocaine solution with Epinephrine to help control bleeding from stab wounds to be made at these sites. These stab wounds were made anterolaterally at the level of the superior pole of the patella for insertion of an irrigation catheter into the suprapatellar pouch area, anterolaterally at the level of the joint line for insertion of the scope and anteromedially at the level of the joint line for insertion of the various arthroscopic cutting and grasping instruments. The knee was explored, no abnormalities were noted in the suprapatellar pouch area. A very small, un-inflamed, non-thickened medial plica was noted. This did not appear to be of any significant problem to the patient, however. It was elected to leave the area alone. The undersurface of the patella showed some very minimal signs of chondromalacia in the central portions as well as on the medial meniscus. With further probing it was noted that he had both a flap tear of the posterior most portions of the posterior horn of the medial meniscus, along with a horizontal cleavage involving a fair amount of the remainder of the posterior horn of the medial meniscus. The flap tear portion of the medial meniscus tear was removed with the 3.5 mm. basket forceps in combination with the Dyonics intra-articular shaver. The horizontal cleavage tear was probed and it was felt the upper leaf of the horizontal cleavage was the thinner of the two remaining components of the horizontal cleavage tear. The upper leaf of the horizontal cleavage tear was then resected in a piecemeal fashion utilizing combination of the 3 mm. basket forceps and the Dyonics intra-articular shaver. The rim of the meniscus was then smoothed down and balanced and the remaining portions of the meniscus were probed and found to be stable and intact. The intracondylar notch area was visualized and showed some hypertrophic synovitis but the anterior cruciate ligament could be visualized and was noted to be intact. The scope was then shifted to the anteromedial port and the lateral compartment was visualized and found to be free of signs of significant degenerative changes on the joint surfaces and the lateral meniscus when probed showed no signs of injury. CPT code(s): Indexing Path:

An Illustrated Guide To Vet Med Term

4th Edition

ISBN:9781305465763

Author:ROMICH

Publisher:ROMICH

Chapter13: Nerves Of Steel

Section: Chapter Questions

Problem 5SC

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