The patient was placed supine on the operating room table after satisfactory spinal anesthesia had been induced. A tourniquet cuff was placed around the patient's left upper thigh. The patient's left lower extremity was then prepped and draped in a routine sterile fashion. An Esmarch was used to extravasate the blood from the left lower extremity, the knee flexed to 90 degrees, the tourniquet was inflated to a pressure of 375 mm Hg. A 1.5 cm incision was made over the left anterior medial joint line. Soft tissues were divided and bleeding sites were cauterized. Dissection was carried down to the joint capsule and this was opened. Approximately 30 ccs. of synovial fluid was drained from the knee.
Inspection of the joint revealed a complete interstitial tear of the anterior cruciate ligament. This was not repairable and was cleanly excised. The undersurface of the patella was palpated and no evidence of chondromalacia was noted. No evidence of synovial plaque were noted. The left medial meniscus was examined with a probe and a peripheral bucket handle tear was noted extending to the far reaches of the posterior horn. Using the meniscotome and sharp dissection the partial medial meniscectomy was carried out without difficulty.
The joint was then irrigated with antibiotic solution. Bleeding sites were then cauterized. The joint capsule and synovium was closed using interrupted 0 chromic suture. The skin was closed using a running 3-0 nylon subcuticular stitch. TENS nerve stimulator strips were placed along both sides fo the patient's incision. A bulky dressing was applied to the patient's incision and the leg was wrapped in Ace bandages. The tourniquet was released, tourniquet time was 25 minutes. Blood loss was minimal. There were no complications. The patient returned to the recovery room in stable condition.