Osteochondral Fracture

The procedure that took place this morning was the removal of an osteochondral defect of the left lateral femoral condyle; and it was a rather large piece! The patient, 56 male, initially reported a feeling of "locking," and "intense pain" along the medial and lateral joint line, also with stiffness deep from within the knee joint, and some "instability." Upon evaluation of radiographs, the Doctor felt there may be a presence of loose bodies, commonly referred to as 'joint mice,' or technically termed osteochondral defects.

However, while the knee was being scoped, the Doctor noticed a particularly large piece on the monitor. It took some time for him to grab a hold of it, even at one point, losing sight of it and having to reconfigure himself and enter from a different angle. Once he got a decent view of the object, he realized how large of a piece it was. He struggled for next few minutes to finally get a hold of the piece and remove it.

Once removed, he looked around the condyles and any other structures to get an idea where such a large piece may have come from. There was no definitive answer. At this point, they decided to have the knee x-rayed and maybe that could help them discover where it came from, also, if there were any other pieces around they did not get.

There were a few moments that took me by surprise; a "whoa" moment, if you will. There was a point where the surgical table was too high, and he asked for it to be lowered, and apparently the table was being lowered, but the technician didn't know how to stop it, so the patient was being lowered while there were surgical tools still inside him. It may not have been much of a deal, but I was certainly taken away at the time. The other thing that happened, which gave me more insight into the risks with surgery, was the patient was bleeding more than normal, and the doctor requested the tourniquet's pressure be increased. Again, one of the tech's was unsure on how to do this, or maybe just wasn't familiar with the equipment or could not locate the proper tool to, etc., I am not sure, but the Doctor sure was upset. And I am guessing, the last thing you want, as a patient, is to have an angry Doctor performing your surgery.