Arthroscopy Note: RIGHT Knee &
Patient name :
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Age / DOB :
Surgeon :
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Findings / EUA

ACL - & Pivot Shift
MCL - LCL - PCL -
RANGE OF MOVEMENT -
Portals (Circle)

Intra articular injections:


Wound closure:
Dressings:
PFJ
Lateral compartment
Medial compartment
Cruciates

Post op �

neurovascular obs.
Home today . Heavy dressing reduced in 2 days.
Keep wounds clean dry and covered for 2/52
Wound review in
Orthopaedic clinic follow up in .
(Optional) Suggestions for long term treatment: