Operative Note

PROCEDURE:    Meniscus repair.

The patient was brought to the operating room and placed supine on the operating table and given a spinal anesthetic and a tourniquet about the thigh.  The extremity was prepped and draped in the usual manner.  The limb was elevated, exsanguinated, and tourniquet was inflated to 300 mm/Hg for approximately 35 minutes.  The scope was introduced anterolaterally, outflow superolaterally, and operating portal anteromedially.  The findings were that the anterior cruciate ligament was intact, having been reconstructed with hamstring tendon.  There was a displaced medial meniscal tear and this was resected with a portion excised and submitted to pathology.  The remainder was arthroscopically removed with the rotary meniscotome, which was initially a 5 mm resector and then a 3.5 mm resector.  Photos were taken intraoperatively.   
Once the medial meniscus was complete, attention was paid to lateral meniscus where a complex tear, posterolateral meniscus was present, anterior to the popliteal tendon.  This was arthroscopically smoothed out and the tear resected using an up-biter vascular forceps and the 3.5 mm meniscal resector.  The knee was inspected.  The articular surface of the femoral condyle was healthy. There were no loose bodies present in the knee.  The knee was copiously irrigated at the conclusion.  The portal site was closed with interrupted 4-0 nylon and the knee injected with 20 cc 0.25% Marcaine and 0.5% Marcaine plain wrapped with Kerlix and Ace wrap. 

The patient tolerated the procedure well.  No complications were sustained.  He was in good condition at the conclusion of the procedure.
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