Upy, Fight Rhee 2. Partial medial meniscectomy, right knee ANESTHESIA: Spinal
OPERATIVE INDICATIONS: This patient is a 67-year-old with right knee pain. He received minimal relief of his pain with
corticosteroid injection. He is now brought for arthroscopic evaluation.
OPERATIVE FINDINGS: The patient has a degenerative tear involving the posterior horn of the medial meniscus. There was
an area of grade IV chondral changes involving the medial tibial plateau adjacent to the meniscal tear. There were also
extensive areas of grade IV chondromalacia involving the medial femoral condyle. The ACL was intact. The lateral
compartment was actually without significant abnormality. There was grade II chondromalacia involving the trochlea.
OPERATIVE PROCEDURE: After adequate induction of spinal anesthetic, the right knee was prepped and draped in a standa
fashion. A pre-gauge tourniquet was placed about the right thigh but was not inflated. Initially, a superior medial stab wour
was made and the arthroscopic in-flow cannula was introduced into the knee. This was followed by standard medial and
lateral parapatellar stab wounds, and the arthroscope and probe were inserted into the knee. The suprapatellar pouch,
patello femoral joint, lateral gutter, medial gutter, medial compartment, inter condylar notch, and lateral compartment wer
all systematically identified with the findings as above. Attention was directed to the medial compartment. Using a basket
forceps and a meniscal shaver, the degenerative tear of the medial meniscus was debrided down to a stable rim. No
significant debridement was undertaken on the chondral surfaces because they were down to bare bone in places. The
trochlear surface was debrided of unstable chondral elements, but there was no bare bone exposed. After this was done, the
knee was copiously irrigated until the egress was clear. The knee was then drained. The portals were closed using 4-0 nylon
in simple fashion. The knee was then instilled with a solution of 26 cc Marcaine with Epinephrine and 2 mg Duramorph. A
dressing of Xeroform, plain gauze, Webril, and an ACE wrap was applied. The patient tolerated the procedure well and was
returned to the recovery room in stable condition.
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