pittiemom2722
Guru
We had a patient who underwent ACL surgery. Two days later only the tightrope button needed to be replaced as it became loose. I'm having difficulty for just that. Any help would be appreciated. Below is a scrubbed Dragon version of the op note.
"We have discussed the potential risks of the procedure completely. The risks we discussed included, but were not limited to bleeding, infection, blood clot formation, pulmonary embolism, fracture, instability, and complex regional pain syndrome. We also discussed there are risks associated with these procedures that we have failed to discuss, but are still possible and the patient understood this and wished for us to proceed with surgery as planned. After identification of the patient he was brought to the operating room postoperative supine position. General anesthesia was induced she was prepped and draped in usual sterile fashion 2 portals from the reconstruction mild medial lateral was used and diagnostic exam was Carried out clot was suctioned and removed and the graft was found to be lax. We were able to backed the graft out enough to grab the button pull the button through the medial portal and just the tip of the graft. By making the medial incision slightly bigger we will see enough graft to remove that tight rope button and reapply a second button. The button was a slightly lengthened and then not pushing the guide through the lateral hole we were able to find the tunnel and placed the normal cannula and tapped into its appropriate depth which is just tapped easily because a hole of previously been made and we passed a fiber stick and pulled the loop out and pulled the button through and out the femoral side. Was then grabbed with a hemostat and pulled back tight against the bone. Tray was taken there was a minimal amount of tissue present but felt this was tight and adequate. Cycled and was tight in flexion extension did not impinge. Copious irrigation was carried out medial portal and lateral incision was closed in 2 layers. Patient was then dressed sterilely. Awakened taken from the operating room recovery room in good condition."
Thank you!!!
"We have discussed the potential risks of the procedure completely. The risks we discussed included, but were not limited to bleeding, infection, blood clot formation, pulmonary embolism, fracture, instability, and complex regional pain syndrome. We also discussed there are risks associated with these procedures that we have failed to discuss, but are still possible and the patient understood this and wished for us to proceed with surgery as planned. After identification of the patient he was brought to the operating room postoperative supine position. General anesthesia was induced she was prepped and draped in usual sterile fashion 2 portals from the reconstruction mild medial lateral was used and diagnostic exam was Carried out clot was suctioned and removed and the graft was found to be lax. We were able to backed the graft out enough to grab the button pull the button through the medial portal and just the tip of the graft. By making the medial incision slightly bigger we will see enough graft to remove that tight rope button and reapply a second button. The button was a slightly lengthened and then not pushing the guide through the lateral hole we were able to find the tunnel and placed the normal cannula and tapped into its appropriate depth which is just tapped easily because a hole of previously been made and we passed a fiber stick and pulled the loop out and pulled the button through and out the femoral side. Was then grabbed with a hemostat and pulled back tight against the bone. Tray was taken there was a minimal amount of tissue present but felt this was tight and adequate. Cycled and was tight in flexion extension did not impinge. Copious irrigation was carried out medial portal and lateral incision was closed in 2 layers. Patient was then dressed sterilely. Awakened taken from the operating room recovery room in good condition."
Thank you!!!
