My stitches are out, phew. They were really grossing me out already. My appointment went well, actually, this is probably the best appointment I have ever had. There was no talk, mention or suggestion of a future surgery! I think I turned a new page! Dr. Kelly was happy with my ROM so far, and even secretly pleased that I had been in bed for so long since it seemed to help the hip a lot. He showed me all of the scope pics, there were tons, I think more than my other 2 surgeries combined. Also the before and after x-rays. He had tons of pictures of my psoas, it looked beautiful! He said he was really nervous going in that the psoas was really going to be an issue and he had promised me he wouldn't cut it. "You were right" he said, and repeated it!! I explained that I hadn't meant to give him a hard time about it, but I truly believed from the bottom of my heart that the psoas was fine. I explained that it had always been tight and tender but hadn't changed in the whole interim of pre and post surgery and rehab. He even had a final shot of the psoas as he was coming out, just to make everyone happy!
He said there was a lot of scar tissue that he removed. The cartilage on the femoral head looked great, it was not perfect on the acetabulum but not too bad. It had been damaged slightly from the cam impingement. Now for the cam.....it was there. Duh, haven't I been having impingement for a while now! The CT-scan should have picked it up, they measured the alpha angle, I have to look up the report, I believe that an alpha angle under 50 is normal and mine was 34 (don't quote me on that). Well, it turns out that I had 'special cam impingement'. It was not typical, which is why it was initially missed, it was very subtle, but not mild, meaning, it sure as hell was there but difficult to see. Just my luck! So he shaved it down and gave me a normal looking femoral head which no longer impinges ! YAY!!
I explained about the nausea and he regretted not being able to get my beloved Dr.Jules for anesthesia, but at least being in bed and doing nothing has helped with the pain. He wants me to take it easy with rehab, go slow, especially in the beginning and not to overload the other leg. Right now, it is good, and has not lost anything!
So now it all falls in the hands of rehab! I think we can handle this!!! :-)
Oh, I forgot to ask for my op-report, I will call first thing Monday morning!
Showing posts with label operative report. Show all posts
Showing posts with label operative report. Show all posts
Wednesday, November 21, 2007
Wednesday, July 18, 2007
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.
*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.
Operative Report 3/5/07
First 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 was administered. She was placed in supine position on the traction table and approximately 10mm of traction was achieved across the femeroacetabular joint.
The right hip was then prepped and draped in the standard, sterile fashion. A lateral portal was established under fluroscopic guidance using the Seldinger technique, distal lateral accessory portal was then established.
Arthroscopic examination demonstrated some cartilaginous loose bodies within the joint and demonstrated a large anterior superior labral tear with an acetabular rim lesion and associated synovitis.
The tissue of the labral tear was of nonviable quality. At this point, a labral debridement was performed . Labrum was recontoured to a normal anterior inferior and posterior superior labrum. Acetabular rim lesion was clearly identified and then, using a 5.5mm high speed bur, the acetabular rim lesion was shaved down to remove the rim osteophyte.
At the completion of the acetabuloplasty and labral debridement, a wide synovectomy was performed using the TAC-S radiofrequency probe. All cartilagenous loose bodies were then removed from the joint. Remaining cartilage surfaces on the femoral head and acetabulum were in good condition. the ligamentum teres demonstrated no significant fraying.
At this point, traction was released. Suction was re-established. No further pathology was identified. The arthroscopy portals were closed with 3-0 nylon sutures and the wounds were cleaned, dried.
The bottom of the page says continued, but I do not have more!
*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 was administered. She was placed in supine position on the traction table and approximately 10mm of traction was achieved across the femeroacetabular joint.
The right hip was then prepped and draped in the standard, sterile fashion. A lateral portal was established under fluroscopic guidance using the Seldinger technique, distal lateral accessory portal was then established.
Arthroscopic examination demonstrated some cartilaginous loose bodies within the joint and demonstrated a large anterior superior labral tear with an acetabular rim lesion and associated synovitis.
The tissue of the labral tear was of nonviable quality. At this point, a labral debridement was performed . Labrum was recontoured to a normal anterior inferior and posterior superior labrum. Acetabular rim lesion was clearly identified and then, using a 5.5mm high speed bur, the acetabular rim lesion was shaved down to remove the rim osteophyte.
At the completion of the acetabuloplasty and labral debridement, a wide synovectomy was performed using the TAC-S radiofrequency probe. All cartilagenous loose bodies were then removed from the joint. Remaining cartilage surfaces on the femoral head and acetabulum were in good condition. the ligamentum teres demonstrated no significant fraying.
At this point, traction was released. Suction was re-established. No further pathology was identified. The arthroscopy portals were closed with 3-0 nylon sutures and the wounds were cleaned, dried.
The bottom of the page says continued, but I do not have more!
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