Case Study: Knee Arthroscopy: Lateral Meniscectomy
with Chondroplasty in a 35 year-old male

Chondroplasty is performed with the help of arthroscopic shaving equipment. Typically, surgeons remove any loose cartilage flaps or smooth rough transitions between the cartilage and the bone. A combination of arthroscopy biters and shavers is used to achieve a partial meniscectomy.

Chondroplasty is a procedure that involves smoothing degenerative cartilage and reducing unstable cartilage flaps in order to stabilize and treat chondral lesions. Trimming unstable flaps of a torn meniscus to create a stable remnant meniscus is what partial meniscectomy entails.

A 35 year-old male patient visits the office, he is complaining of pain in the left shoulder, left hip, low back and right elbow. It started a couple of months ago when he was a pedestrian hit by a car. He denied loss of consciousness, he went to another hospital where he was evaluated and had x-rays.

No fractures were found. He also was hit in the head and the left knee. His left shoulder got a cortisone injection 2 months ago but had short term relief. He still has pain in left shoulder and knee.

He tried physical therapy and anti-inflammatory drugs as nonoperative treatments, but they were ineffective. A lateral meniscus tear was discovered in the left knee’s discoid meniscus after an MRI was performed.

We spoke about our alternatives for treatment and decided on surgical treatment. We talked about the dangers and rewards, including topics like infection, bleeding, damage to nearby nerves and blood vessels, the necessity for a second operation, the importance of rehabilitation, the inadequacy of symptom relief, the potential need for further cortisone injections, arthritis, and more.

We also talked about systemic consequences, such as blood clots, cardiac, pulmonary, and neurological issues. The client was aware and gave informed consent.

The patient was brought into the operation room and put on a sturdy operating table. Anesthesia was induced throughout. After applying the tourniquet as normal, the left lower extremity was prepared and draped aseptically.

The lower right extremity had thick padding. A break was announced. Ancef, a pre op antibiotic, 2 gm, was administered. Following the exsanguination of the left lower extremity, the tourniquet was inflated.

Through a lateral parapatellar incision, the entry portal was created. The arthrometer was implanted. No arthritis was present when the patellofemoral joint and trochlea were examined.

The entry site for the arthroscope was created using a spinal needle in the medial tibiofemoral compartment. The medial femoral condyle of the patient had grade 1 arthritis, which was cleaned with a razor during examination of the medial tibiofemoral compartment.

Hematology was absent on the medial side of the meniscus. ACL integrity was visible upon examination of the infrapatellar notch. A discoid meniscus with a tear along its body and the anterior horn was visible upon examination of the lateral tibiofemoral compartment.

Shavers and biters were used to accomplish a partial meniscectomy on the lateral meniscus. Margin balances were obtained. The very last photos were captured and stored.

There was a thorough irrigation and drainage of the knee. Nylon #3-0 was used for the closure. Webril, Ace wrap, 4 x 4, and Adaptic were used for dressing. The tourniquet was let go. The patient was transported to recovery in stable condition after being extubated.

After three weeks the patient is seen in the office for his post operative consultation, no x-rays are needed. He denies fever, chills. He missed his first post op appointment. He is working with Manetto hill PT and improving.

We have decided to move through with official physical therapy as well as a home workout regimen for knee rehabilitation after discussing our treatment choices. During the visit, we took the sutures out. We’ll keep applying ice and elevating the knee to reduce discomfort and swelling.

To lower the risk of a deep vein thrombosis, we shall keep using mechanical prophylaxis and early mobilization. As long as there are no contraindications to these medications, we will wean them off of any narcotic medications before switching them to anti-inflammatories and Tylenol.

We also talked about the advantages, disadvantages, and typical adverse effects of using these medicines. In three weeks, the patient will return to assess their development.

With ongoing physical therapy and rehabilitation for the knee, the patient responded well following surgery and is steadily getting better each time he is seen. The patient recovered and healed with continued physical treatment and regular visits.

Disclaimer – Patient’s name, age, sex, dates, events have been changed or modified to protect patient privacy

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.