Operative Report 7/2/07

Second Surgery
*these reports are dictated, therefore, some words are missing and or incorrect

After the patient was correctly identified in the holding area, she was brought to the operating room. Spinal anesthesia with combined epidural was administered. The left hip was prepped and draped in the usual sterile fashion.

The lateral portal was established under fluroscopic guidance and then a distal lateral accessory portal was established.

Arthroscopic examination demonstrated a large anterior superior labral tear with associated___________ lesion also evidence of a Cam delamination effect and associated synovitis.

At this point, a labral tear debridement was performed at the level of the affected tissue. A smooth contour was achieved to the anterior, inferior, and posterior superior labrum.

Then, the acetabular rim lesion was clearly identified and a rim decompression was performed to reestablish the normal contour of the femoral head and neck junction. At the completion of the rim decompression, a wide synovectomy was then performed using the Tac-S radiofrequency probe.

The cartilage on the femoral head and acetabulum within the joint were in good condition. the ligamentum teres was in good condition, as well. At this point, the scope was brought into the peripheral compartment and a Cam bump identified with clear synovial herniation and pitting.

The junction between the normal articular cartilage and the area where the impingement was occurring was clearly demarcated and a Cam decompression was performed using a 5.5 mm high speed bur. Re-contouring of the affected region was established with good reestablishment of the normal articular cartilage. At the completion of the Cam decompression, all bony debris was evacuated from the joint. No further pathology was identified.

The instruments were removed from the hip and the arthroscopy portals were closed with 3-0 nylon sutures. A "morphine" (should say marcaine) cocktail was placed into the joint. The wounds were cleaned and dried. Sterile dressings were applied. The patient was awakened from anesthesia and brought to the PACU having tolerated the procedures well.