Removal of a small foreign body a drainage of an old hematoma

Added: 2026-06-04

[00:00:05]So this patient's coming in. It's kind of an unusual situation. He was sort of getting things ready around Christmas time. Was on his knees and something went into his knee and it's created some real swelling and discomfort since then.

[00:00:16]Ultrasound showed potentially a hematoma beneath. You can see how it's swollen all the way around here versus whether this is all cystic change, which could be, but I doubt it. And then there's a foreign body in through here. So we're going to do an elliptical incision. Just dissect that down a bit. We might just be cleaning out um this area and then having a hematoma that's there that we just drain out a little bit.

[00:00:34]>> So again, no pain when I do that.

[00:00:36]>> No.

[00:00:41]>> So as opposed to just doing a basic incision and seeing if this will drain for us, which we do with sort of more basic hematomas, the reason for the incision in this case is just because we have identified an actual foreign body.

[00:01:00]I'm going to call that form body a xenomorph an alien.

[00:01:13]So around the knee langanger's lines can lie in both directions predominantly in this direction. You squeeze this you can see it sort of runs in both directions.

[00:01:32]to get some irrigation.

[00:01:51]guys do great things. You know, you help out people so much. Like I could never do I'm wasn't auto worker cranking nuts and bolts of crers, but what you guys do is fantastic.

[00:02:02]>> Everybody has a role. It's all different.

[00:02:04]>> Yeah.

[00:02:06]But it's so good for people.

[00:02:18]I was wondering with dentists how they handle little young screaming kids. How do you how do you feel in a little kids mouth?

[00:02:28]>> Yeah, I would tell you that it's always the anesthetic part that's the >> making sure everybody's comfortable.

[00:02:43]In case you're wondering, normally the one doctor goes, "What's wrong below your knees?" I goes, "No, that's just my dad's like that. He's got the kind of big bump below the knee there." So >> you can get what we call Ashka Slatter's disease, which sometimes, >> okay, >> will be a swelling or micro fracturing of the tibial tuberosity. So you have a prominence that's here.

[00:03:20]this, as you can see, some scar tissue that's here.

[00:03:40]That's not hurting.

[00:03:41]>> No, no.

[00:03:58]So much clot that's there. There's some old blood, which is why that was so darkish when it sort of drained. Looks not bad, though.

[00:04:09]Looks pretty clean.

[00:04:18]Two months ago, I got out of the shower, went to put my cans on.

[00:04:21]>> Yeah.

[00:04:22]>> Blood starts. Well, I guess some of that yellow running pee looking stuff mixed with it, but zero sanguage component like said like a straw color.

[00:04:31]>> Yeah.

[00:04:33]>> Yeah. Straw. Exactly. Right. Just going to irrigate this out. Just make sure it's So see how that color is more pinkish red. That's more of the of a new blood.

[00:04:51]Find anything in there yet?

[00:04:53]>> Well, we taken a section that's out so that it's such a small piece. Yeah, exactly. Okay.

[00:04:59]The rest of this looks pretty clean. You had a whole bunch of old blood that came out. So, I think it's more it's certainly not a cyst, which is what I thought. It doesn't didn't feel like it.

[00:05:06]Um, I think it was just inflammation of the bersa and then a hematoma around it.

[00:05:10]>> Okay. Just clean that out and then I'll stick that close for you.

[00:05:14]>> And you don't know if the bersa was punctured or or anything like that, do you?

[00:05:19]>> Uh, it could have been. So, this might be could be why it's so inflamed. Sorry.

[00:05:23]>> Um, >> but that should have a chance to heal.

[00:05:26]Mhm. Looks fine from this perspective to be honest.

[00:05:36]>> So that looks quite clean actually there.

[00:05:39]>> So I'm just going to grab some 3.

[00:05:44]Now you be um prescribing anything for like infection or just keep up the the remaining four antibiotics. I got >> I'm going to extend that. So normally if we take out a for body we don't have to but we're always careful whenever we're right on top of a joint you just don't want that to get secondarily infected.

[00:06:02]>> So we'll have some say okay. Yeah.

[00:06:05]>> And that's sort of a little bit of me wimping out too because there's an argument to be had that we could get away without it. We just don't want to take that chance.

[00:06:13]>> Yeah. You don't want to give big complication. Yeah.

[00:06:17]>> One more quick question. So, if I'm taking antibiotics, um, I'm thinking I should be eating a bunch of Greek yogurt. Would that be smart or No.

[00:06:26]>> Uh, it's not not here or there for that perspective. You can certainly talk about taking a probiotic after you finish the antibiotic. There's something be thought about that in terms of reestablishing your flora. Yeah, that would be worthwhile >> because I had a sinus infection and clinic lady gave me by accident.

[00:06:43]>> Yep.

[00:06:44]>> Oh, it killed everything. I had a pylori for like six months.

[00:06:47]>> Yeah. Yeah. Yeah, by accident is a strong one. It's a macroy class.

[00:06:49]>> Nasty.

[00:06:51]>> Hard on your stomach, too. It's a good antibiotic. I mean, it's good at what it does, but to make sure it's appropriate when you're using it.

[00:06:59]>> Well, I told one doctor about the H.

[00:07:02]pylori. He goes, "You didn't take any antibiotics." I go, "Yeah, the way you put me in by accident for science infection." Oh, that was your sinus infection.

[00:07:10]>> Goes, "Well, it wasn't too bad." He goes, "She shouldn't give you that."

[00:07:14]>> Yeah. There's an argument to be had that. So there's criteria we have for which sinus irritations we treat or not.

[00:07:19]>> Um if you're following that kind of stuff.

[00:07:22]>> Yeah.

[00:07:28]>> Sadly we tend to overprescribe antibiotics globally.

[00:07:33]Scissors aren't very sharp.

[00:07:50]Now, should I just leave those stitches area alone, keep it clean, or should I uh I like putting on polyorn 3, but should I just not bother?

[00:08:01]>> No, I wouldn't do anything topically as long as you just keep it dry for the most part.

[00:08:04]>> Okay.

[00:08:04]>> This should heal nicely for you.

[00:08:06]>> Oh, put a bag on and shower then. Yeah, just when you shower because you don't want anything that's like humidity and moisture tend to >> Oh, it beams up.

[00:08:15]>> Well, that's No, that's the process by which we tend to get infected if we have it >> too enclosed and warm. So, >> okay, definitely keep it dry and let it heal up.

[00:08:43]So what we come back for take the stitches out and see how it is.

[00:08:46]>> Yeah. So the stitch and then we see that it should be healing properly. So we'll send this sample off to the lab. So they'll analyze to make sure there's the foreign body that's there and make sure everything else is fine.

[00:08:55]>> Okay.

[00:09:00]>> And then we'll see you back to make sure that this is healed properly. There's no issues. Looks pretty clean to be quite honest.

[00:09:06]>> Should be all right.

[00:09:12]>> So, how long you been doing this, doctor?

[00:09:14]>> Uh, me about uh coming up on 30 years.

[00:09:18]>> Oh, wow.

[00:09:24]>> Goes by fast.

[00:09:26]>> You know what? You think retirement will go slow?

[00:09:29]>> It's incredible. You think you're doing that works of Tik Tok? I swear I've been retired for three years now from praises and well I keep busy and it's like what do you mean it's already like past supper and and but I stay I stay up to 3 4 in the morning sometimes so I don't get up till noon watching TV.

[00:09:51]So this looks pretty clean. So certainly incision is nicely opposed. Stitches look nice and clean. So we'll just put a dressing on that and see him back in about 10 days. grace that