LOCATION: Outpatient, Hospital PATIENT: Kyle Swank SURGEON: Mohomad Almaz, MD PREOPERATIVE DIAGNOSIS: Retained metal, left knee. POSTOPERATIVE DIAGNOSIS: Same plus tear anterior horn of medial meniscus. PROCEDURES PERFORMED: Arthroscopic examination of the left knee with metal (screws) removal, medial meniscectomy. ANESTHESIA: Spinal. ESTIMATED BLOOD LOSS: Minimal. This 39-year-old male suffered with discomfort in his left knee due to retained hardware from a previous ORIF of a medial femoral condyle fracture. PROCEDURE: After an appropriate level of anesthesia was achieved, the left leg was prepped and draped in orthopedic manner. We made initially two portals, one medial and the other lateral to the patellar tendon. Sharp dissection was carried through the skin and blunt dissection carried into the joint space. On examination of the knee, we appreciated that the lateral compartment was in good condition. There was an anterior horn tear of the medial meniscus that was debrided back to stable tissue. The patient had grade 2 chondromalacia in a diffuse manner involving the medial compartment. The anterior cruciate ligament was probed and felt to be essentially intact. The PCL was noted to be present also. We used our shavers to identify the screws medially on the medial femoral condyle. We got back to the posterior medial corner. We had to make three stab wounds for each of the screws. We did this first with a needle, then sharp dissection through the skin and blunt dissection carried into the joint space. We then backed the screws out. We then appreciated on x-ray that the patient had a rather large spur involving the medial condyle. Upon probing and looking at the medial condyle, this was very posterior, did not appear to be particularly medial. No attempt was made to debride it. We then irrigated the wound, closed the wound with interrupted nylon sutures, and placed the patient in a knee immobilizer. The patient appeared to tolerate the procedure well and left the operating room in good condition. Pathology Report Later Indicated: Necrotic tissue.