dstruve
Networker
sorry this is lengthy, but i have no idea where to go with this. doc wanted 27416, i was leaning more toward 27511 or 27540. and then what about the arthroscopy part???
L knee arthroscopy with mini open arthrotomy and osteochondral ORIF
Scope was introduced into the intercondylar notch and swept to the suprapatellar pouch. Large amount of lipohemarthrosis was noted. This was evacuated with suction. Two large osteochondral lesions were noted. the scope was then flipped down to the medial gutter and medial compartment. the meniscus was found to be intact. ACL was found to be intact. There was a large donor site for the two osteochondral lesions. it was deemed that an open arthrotomy was needed. scope was removed. lateral incision was then made from approximately the mid pole of the patella to the tibial tubercle. sharp dissection was carried out through the skin and the subcutaneous tissue. the peritenon was then split. the capsule was then incised. a small amount of the fat pad was removed. the two osteochondral lesions were then removed. they were taken to the back table and placed in normal saline. they did have nice bony backing to them. the cartilage edges were trimmed. the donor site was then cleaned. the most inferior weight bearing area of the condyle was cleared. the largest of the two fragments were found. a guide pin was placed into the center over the top of this. a drill was placed for a bioabsorbable screw. a tap was then used and a bioabsorbable screw was placed. three bioabsorbable darts were then placed in the surrounding quadrants. these were placed beneath the subchondral area. moving up to the most superior lesion two osteochondral dars were placed. cartilage was then trimmed.
L knee arthroscopy with mini open arthrotomy and osteochondral ORIF
Scope was introduced into the intercondylar notch and swept to the suprapatellar pouch. Large amount of lipohemarthrosis was noted. This was evacuated with suction. Two large osteochondral lesions were noted. the scope was then flipped down to the medial gutter and medial compartment. the meniscus was found to be intact. ACL was found to be intact. There was a large donor site for the two osteochondral lesions. it was deemed that an open arthrotomy was needed. scope was removed. lateral incision was then made from approximately the mid pole of the patella to the tibial tubercle. sharp dissection was carried out through the skin and the subcutaneous tissue. the peritenon was then split. the capsule was then incised. a small amount of the fat pad was removed. the two osteochondral lesions were then removed. they were taken to the back table and placed in normal saline. they did have nice bony backing to them. the cartilage edges were trimmed. the donor site was then cleaned. the most inferior weight bearing area of the condyle was cleared. the largest of the two fragments were found. a guide pin was placed into the center over the top of this. a drill was placed for a bioabsorbable screw. a tap was then used and a bioabsorbable screw was placed. three bioabsorbable darts were then placed in the surrounding quadrants. these were placed beneath the subchondral area. moving up to the most superior lesion two osteochondral dars were placed. cartilage was then trimmed.