DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSES:
1. Degenerative arthritis of the right knee.
2. Left heel retrocalcaneal bursitis with Haglund’s deformity.
POSTOPERATIVE DIAGNOSES:
1. Degenerative arthritis of the right knee.
2. Left heel retrocalcaneal bursitis with Haglund’s deformity.
OPERATIONS PERFORMED:
1. Injection of right knee with lidocaine and Depo-Medrol.
2. Excision and resection of a left heel exostosis and Haglund’s deformity.
3. Bursectomy of left retrocalcaneal bursa.
SURGEON: John Doe, MD
ANESTHESIA: Spinal.
DESCRIPTION OF OPERATION: The patient was brought to the operating room. After induction of spinal anesthetic, the right knee was prepped and draped. Five mL of Depo-Medrol 80 mg and 0.5% Marcaine were used to inject into the joint. Band-Aid was applied. The patient was then turned to a straight lateral position with the left heel up. Prepping and draping was then done. Care was taken to the patient’s previous left knee replacement. Proximal thigh tourniquet was used. Elevation, exsanguination, and inflation of the tourniquet to 350 mmHg was then made.
A posterolateral incision along the tendoachilles was then made and carried through the skin and the subcutaneous tissue. Thickened bursa was first excised in the retrocalcaneal space and then exposed by subperiosteal dissection the bump or the exostosis of the calcaneal tuberosity. Dissection to release some of the fibers of the tendoachilles of its superior corner was then done. Sharp retractors were placed around the bump. An osteotome was used to resect the Haglund’s deformity, decreasing its irritation on the tendoachilles. There was some partial degeneration of the tendon. Most of the tendon, however, was left intact on the inferior and plantar aspect of the tuberosity.
Following this, an image intensifier was brought in to verify a satisfactory resection of the bone and that no osteophytes or prominences were left behind. Further trimming and smoothing down to the bone was then done. Irrigation was then carried out. The edges of the tendoachilles were then reattached using 0 Ethibond sutures, 2-0 Vicryl for the subcu and mattress 4-0 nylon sutures for the skin. A fluffy compression dressing and Ace wrap were applied. The patient was brought to the recovery room in stable condition following removal of the exostosis and the bursal excision.
