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Author Topic: Have operative report can someone translate?  (Read 1121 times)

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Offline AmandaB

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Have operative report can someone translate?
« on: October 26, 2004, 11:27:09 PM »
Hi All,

I posted before asking about my hubby's knee and now have the post operative report but am having trouble understanding exactly what they did so I am hoping maybe you all could help me with the translation.
Here goes:
"There was anterior synovial tissue which was hypertrophic, especially the fat pad.  These areas were generously debrided.
The patellar cartilage was soft and somewhat abraded. We debrided this using a full radius resector. The trochlear groove was soft but in generally good condition.
The scope entered the medial compartment. There was no plica identified along the way nor were there any loose bodies identified in either the medial or lateral gutter or in the suprapatellar pouch. The cartilage in the medial compartment was basically normal as was the meniscus. It was thoroughly probed and found to be stable and intact. The ACL was similarly intact to direct probing and clinical evaluation.
A figure four position was utilized to enter the lateral compartment. Again, the cartilage surfaces were normal and the meniscus was generously probed and found to be stable and intact.  Again, more synovial tissue was resected in this area to facilitate visualization and hopefully provide therapeutic benefit.  We injected the knee with Marcaine."
Ok so there it is. It has been 5+ months since this surgery and he is still in alot of pain, there is still swelling, locking, grinding, popping and his ROM is limited.  He has been in PT since 5 days post op and there is little to no improvment.  The OS says hubby has PFS but everything I read doesn't match up to what he is experiencing (pain at the bottom of the knee and inner side as well as what was listed above).  On top of that I have read that PFS is not really a diagnosis but a sign that something is wrong.  There is a visable difference between his left (bad) quads and his right but no about of PT seems to be helping.
Any ideas in light of what the above report says?
I am so confused and to top it off we have the insurance companies breathing down our necks.
I was able to convice our family doctor to order a CT but there is a 4+ week wait for that.
I think I have gone on long enough and help/ info/ advice you have would be greatly appreciated.
Thanks.

Offline dm

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Re: Have operative report can someone translate?
« Reply #1 on: October 27, 2004, 04:42:31 AM »
Here's my go at it, hope it helps:

"There was anterior synovial tissue which was hypertrophic, especially the fat pad.  These areas were generously debrided.
The patellar cartilage was soft and somewhat abraded. We debrided this using a full radius resector. The trochlear groove was soft but in generally good condition" to me this means taht they removed synovial tissue in the front part of the knee that was thickened. The groove that the kneecap rides in was softened but not in bad shape. the back of the kneecap itself has some damage to it.

Note here: the softened articular cartilage on the back of the kneecap and the trochlear groove is called chondromalacia. I do not know if anything can be done for it.

" Again, more synovial tissue was resected in this area to facilitate visualization and hopefully provide therapeutic benefit.  they removed more of the synovial lining in the outside of the knee, hoping that wil help the complaints.

"The cartilage in the medial compartment was basically normal as was the meniscus. It was thoroughly probed and found to be stable and intact. The ACL was similarly intact to direct probing and clinical evaluation.
A figure four position was utilized to enter the lateral compartment. Again, the cartilage surfaces were normal and the meniscus was generously probed and found to be stable and intact.  " this meant that the acl and both meniscus were fine, with no sign of damage to the rubbery stuff covering the bone ends (articular cartilage).

As for the quad deficits, and that PT doesn't seem to be helping, I'd have to ask if he's had estim or TENS used to make the quads fire. I've had pt sessions where they used the tens and had me doing short arc work - the routine with the knee bent over a bolster and then you straighten the knee. I had to tighten the muscles through the tens triggering them, kind of "doubling up" the work the muscle was having to do, and it was easier if I did it right, than if I did it wrong. Me tightening the quads made the "pins and needles" feeling of the tens unit less, so it was a kind of training method to get me to work the muscle right, I think.

As I understand it, weak quads can make pfs pain worse. I've got patellar tendon tendonitis, and I've been told to do a lot of what amounts to quad work.

hope I've helped a little. I use this medical dictionary online to help understand unfamiliar terminology.....http://www.nlm.nih.gov/medlineplus/mplusdictionary.html
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Offline chris-oregon

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Re: Have operative report can someone translate?
« Reply #2 on: October 27, 2004, 07:50:39 PM »
AmandaB,

I am definately not an expert, but all the symptoms that you have described for your husband sounds to me like your husband may be having scar tissue problems. Please, take a look at the soft tissue section and write a bulletin there. ROM, pain, and quad issues, from what I know, are major indications of scar tissue problems. What is your husband's ROM. Does his knee cap move both latterally and vertically?

Take a look...my posts are there also under Soft tissue.
There are a lot of wonderful people in the soft tissue that may be able to help you!!

Please let me know what happens!
Good Luck
Chris  ;D
April 2004 ACL Reconstruction
August 2004 MUA and LOA
Arthrofibrosis