1. Module #1 James E. Carpenter, MD Peter M. Murray, MD Sterile Technique & Ortho. Surgery Room Setup Developed by the Surgical Skills Task Force of the American Board of Orthopaedic Surgery (ABOS) in collaboration with the American Academy of Orthopaedic Surgeons (AAOS), and the American Orthopaedic Association (AOA)/Council of Orthopaedic Residency Directors (CORD) Presentation #2: Preparing a Patient’s Knee for Surgery

2. Preparing a patient for knee surgery ABOS/AAOS Surgical Skills Task Force 2013

3. Before entering the O.R. Identify patient, mark site per AAOS guidelines: – “X” on site with initials – Level written for spine cases – Mark must be visible after prepping and draping Patient communication: – Explain process – Last questions – Identify family/friend contact

4. Pre-op Safety Checklist (AAOS)

5. Positioning considerations Move patient to end of table – Allows better access Consider a bump under hip so patella is straight up Tourniquet high on thigh, snug but not tight – Avoid venous tourniquet effect Protect other leg – SCD – Heels, peroneal nerves free of compression

6. Knee Positioning Drape off tourniquet with steridrape or equivalent Consider a bump for foot to hold knee flexed at 70- 90 degrees For arthroscopy, place lateral post at mid-thigh

7. Knee Prepping Suspend leg using curved leg holder and a stirrup Prep from knee outward to thigh and ankle

8. Knee Draping Hold leg with towel, circulator releases foot and removes support Sterile, impervious stockinette is rolled down calf, then wrapped with ace

9. Knee Draping Two layers of drapes are used “U” drape from foot to just below tourniquet

10. Extremity drape passed over foot and pushed up thigh Ioban used to seal off stockinette, and over incision site (if desired) Knee Draping

11. Positioning, prepping, draping complete! Ready for Surgical TIME OUT Preparing a patient for knee surgery