ortho1991
Guru
Hi All,
I need help with this. Here is part of the op-note.
Any suggestion will be appreciated
A medial arthrotomy, eversion of the patella, showed a loss of the
central distal pole representing about 60 or 70% of the distal half of the
patella. However, there did not appear to be a major bone defect and,
therefore, we examined the fragment. It was quite softened and mostly
cartilaginous, but perhaps a small millimeter of bone in the most inferior
aspect. WE attempted to see if this would fit back and if we could pin this one
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area, however, this was abandoned in favor of a micro fracture. The knee was
ranged and noted to be stable and the patellar defect did not seem to come into
play from 0 to 75 degrees of flexion. We then passed a #2 Orthocord, two
sutures, along the medial retinaculum. We denuded the medial aspect of the
patella down to bare bone with a slight grooving of this bone, drilled three
holes through this area and with a suture passer passed the four limbs of
Orthocord, thus restoring stability medially and repairing the medial
patellofemoral ligament that had appeared to come off the patella in this
region. We then repaired the arthrotomy with #1 Vicryl, #2-0 Vicryl for
subcutaneous tissues and closure of the skin with running Monocryl.
It should be noted that in this patient also, since we were unable to repair the
fracture, we did an abrasion chondroplasty and a microfracture of the defect.
She will be treated for this microfracture with CPM 0-60 degrees.
I need help with this. Here is part of the op-note.
Any suggestion will be appreciated
A medial arthrotomy, eversion of the patella, showed a loss of the
central distal pole representing about 60 or 70% of the distal half of the
patella. However, there did not appear to be a major bone defect and,
therefore, we examined the fragment. It was quite softened and mostly
cartilaginous, but perhaps a small millimeter of bone in the most inferior
aspect. WE attempted to see if this would fit back and if we could pin this one
------------------------------------------------------------------------------
area, however, this was abandoned in favor of a micro fracture. The knee was
ranged and noted to be stable and the patellar defect did not seem to come into
play from 0 to 75 degrees of flexion. We then passed a #2 Orthocord, two
sutures, along the medial retinaculum. We denuded the medial aspect of the
patella down to bare bone with a slight grooving of this bone, drilled three
holes through this area and with a suture passer passed the four limbs of
Orthocord, thus restoring stability medially and repairing the medial
patellofemoral ligament that had appeared to come off the patella in this
region. We then repaired the arthrotomy with #1 Vicryl, #2-0 Vicryl for
subcutaneous tissues and closure of the skin with running Monocryl.
It should be noted that in this patient also, since we were unable to repair the
fracture, we did an abrasion chondroplasty and a microfracture of the defect.
She will be treated for this microfracture with CPM 0-60 degrees.