FIRST. Is it the correct side? Your initials should be visible on the correct knee. It is important to document the instability by the examination under anesthesia.
I also look for the associated laxities, such as, postero-lateral and posterior cruciate.
I then measure the AP laxity on both knees with the KT -1000. This is entered on the computer data form. I compare the manual maximum on the normal side with the manual maximum obtained at the end of the case with the KT-S.
Over the past year we have changed our pain management to be pre-emptive. There has been a lot of studies to show that there is less post-op pain if the patient receives the blocks before the incision is made. The best pre-emptive block is the spinal.
Our routine now is to inject 20cc of Marcaine 0.25% with epinephrine and Morphine 2 mgm into the joint before the prep. A femoral nerve block is done by the anesthetist with a nerve stimulator using 20 cc of Marcaine 0.25% with epinephrine. The anesthetist gives i.v.; 30 mgm Torodol and 1 gm Ancef.
We Now are Ready to Prep and Drape
- I put the tourniquet on and use it only to do the graft harvest.
- I use a Linvatec pump. This works in coordination with the Apex driver system for the shaver and burrs.
- I use 1 amp of adrenaline in 3 litre bags of normal saline. In a routine case we use 4 to 5 bags of saline. ( 12-15 litres).
- I use a low profile leg holder placed around the tourniquet. The leg is flexed over the side of the bed.
| E.U.A. Kt-1000 Measurements, Joint Injection, Femoral Nerve Block | Back to Top |