DESCRIPTION OF OPERATION: The patient was taken to the operating room, and after scalene block was administered by the anesthesia team, the patient was positioned on the operating room table in a sitting position. Preoperative antibiotics were given. The left shoulder was prescrubbed with Betadine. Next, the left upper extremity, including the left base of the neck and shoulder, were prepped and draped in the usual sterile fashion. After bony palpation, a posterior portal was created with a 15 scalpel blade and this was used for the arthroscope. The arthroscope was placed and a complete inventory of the left shoulder was performed. Under direct visualization, anterior-superior portal was created in a similar fashion and this was used for instrumentation and outflow. The superior labrum including the biceps anchor demonstrated no evidence of tears. There was a tear of the anterior-superior labrum starting at the 11 o'clock position and extending to the 9 o'clock position. There was significant fraying, which was debrided with the radiofrequency device and further demonstration of the personality of the tear demonstrated a complete tear off the glenoid rim. Irregularities of the glenoid rim was identified. It was felt by the operative team that it was of an acute nature, despite a one-year delay for surgery. This also incorporated the anchor of the middle glenohumeral ligament. The anterior-inferior, inferior, and rest of the posterior labrum were within normal limits. There was a negative drive-through sign. The axillary pouch showed no evidence of loose bodies. The articular surface of the glenoid fossa and humeral head were within normal limits. The rotator interval showed no defects. The superior glenohumeral ligament, middle glenohumeral ligament, and anterior band of the inferior glenohumeral ligament were within normal limits. The biceps was medialized, and there was no instability or fraying or neovascularization. The supraspinatus and posterior cuff were visualized, and there was no evidence of tears. Under direct visualization, an anterior-inferior portal was created in a similar fashion just superior to the intra-articular subscapularis and this was used for instrumentation. The rim of the glenoid was debrided with a 4.5 full radius shaver to bleeding bone. This was used to help further reparative process. A 3.0 Bio-FASTak suture anchor was then placed at the 10 o'clock position. Utilizing arthroscopic knot-tying techniques, a suture shuttle was performed and a labral repair was performed with #2 FiberWire in a simple half-hitch fashion. This now recreated the buttress with good labral fixation with probing. The arthroscope was then placed into the anterior-superior portal and visualization demonstrated good buttress with good fixation. It was felt by the operative team that an adequate arthroscopic labral repair had been performed. The instruments were removed, and the portal sites were closed with 4-0 nylon in a simple interrupted fashion. All sponge and instrument counts proved to be correct, and estimated blood loss was less than 5 mL. The wounds were then cleaned and dressed under the sterile field. A Polar Care ice machine and a shoulder immobilizer were placed to the left upper extremity. The patient was then taken to the recovery room in a stable condition.
MT Word Help
Medical Transcription Word Seeker - Google Custom Search for MTs - Searches just Medical Websites
MT Word Help
Medical Transcription Word Seeker - Google Custom Search for MTs - Searches just Medical Websites
