Orthopaedics: Knee procedures

1) Endoscopic repair of anterior cruciate ligament, wrong position of ligament graft

The patient suffered a twisting injury in the accident, and more detailed examinations indicated that the anterior cruciate ligament was torn. An endoscopy of the knee was performed on the patient, and the anterior cruciate ligament was repaired in it using a tendon graft.

The knee continued to be sore and unstable during the follow-up period. A new endoscopy was performed on the patient's knee, finding that the anterior cruciate ligament graft was too anterior on the femoral side. The position of the ligament graft was repaired, after which the pain began to alleviate.

The endoscopy of the knee and ligament repair were medically indicated to treat the anterior cruciate ligament injury. However, the level of professional competence of an experienced physician specialising in endoscopic examinations of the knee was not achieved in the operation, when the canal required for fixing the ligament graft was insufficiently positioned.

The patient was compensated for personal injury caused by the prolonged pain in the knee and the resurgery.

2) Rupture of the anterior and posterior cruciate ligament and collateral ligament, stiff knee after surgical treatment

A patient's knee joint was dislocated in an accident. Ruptures were found in the anterior and posterior cruciate ligament and the medial collateral ligament. The joint capsule was repaired in surgery, medial collateral ligament and cruciate ligaments were fixed to the femur. After the operation, the knee was stable but its motion range was more limited than before. Scar tissue was removed in minimally invasive surgery.

The knee surgery was medically indicated to treat the severe multiple traumas caused in the accident. The technical implementation of the operation was appropriate based on the report available. The trauma was a severe ligament trauma of the knee, which almost always leaves functional impediment in spite of appropriate treatment. Moreover, the formation of scar tissue in the knee could not be avoided in this situation.

The case did not meet the criteria for an injury compensable under the Patient Injuries Act.