Enterior Cruciate Trauma Case Study

Physical therapy saw the patient, and the result of the examination are as follows; 6/10 left knee pain at rest and during activity (0 no pain, 10 worst pain), manual muscle testing for both upper and lower extremities were 4/5 except left knee flexion/extension 3+/5 due to pain, sensation on both UE/LE were intact to light touch, Stephen requires a moderate assistance of one person for both functional mobility and gait activity. He uses a front wheeled walker up to 35 feet due to decreased balance and antalgic gait from the left knee

DOI: 10/3/2013. Patient is a 51-year-old male bottling machine operator who sustained injury to his left knee when he hit it on an L-bracket after he stepped over a conveyor belt, missed a stool, and fell over. The patient underwent a left knee arthroscopy on 3/31/14.

As stated earlier, the patient admitting challenge was right total knee replacement related to history of osteoarthritis as evidenced by unrelieved pain. Osteoarthritis (OA) is a disease that “results from cartilage damage that triggers a metabolic response at the level of the chondrocytes” (Lewis, Dirksen, Heitkemper, Barry, Goldsworthy & Goodridge, 2011, p. 1881). As it progress, it causes the cartilage to become “dull, yellow, and granular” instead of being “smooth, white, translucent” (Lewis et al., 2011; Gulanick & Myers, 2014, p. 1881).As a result, it eventually becomes softer, less elastic, and less capable to resist wear during heavy use. Moreover, as the “central cartilage becomes thinner, cartilage and bony growth increases at the joint margins … that results to uneven distribution of stress across the joint” that contributes to a decrease in motion. (Lewis et al., 2011; Gulanick & Myers, 2014, p. 1882). According to this patient, OA has been giving her pain for about two years that lead her to the decision of having the knee replacement.

The medical evidence shows the claimant had twisting injury to left knee with lateral meniscus tear on 7/1/13. He was also noted to have preexisting osteoarthritis of the left knee. The claimant underwent arthrosopic partial meniscectomy on the left knee on 2/27/14 with some symptomatic relief. An orthopedic report on 1/13/14 noted ongoing left knee pain. The physical exam showed tenderness; pain with flexion and extension; positive McMuray's test and negative Drawer's test. X-rays of left knee on 1/13/15 showed mild left knee osteoarthritis.

DOI: 6/28/2007. Patient is a 66 year old male ship-packer who developed pain from unloading stack of bread from trailer. Per OMNI, he underwent knee surgery on 5/28/2008, partial knee replacement on 4/12/2010, and elbow surgery on 5/08/2013.

Based on the progress report dated 07/20/16, the patient complains of low back pain, on the right side. Oral pain medications allow 50-60%imporvement.

related injury to his right shoulder when a bathroom stall door struck him. As per OMNI entry, he is status post right shoulder repair on 09/23/2011 and repeat shoulder surgery on 03/23/2012. The patient was subsequently diagnosed with shoulder impingement syndrome, right. AME dated 1/12/16, future medical provisions states that the left knee will be treated conservatively including anti-inflammatories and perhaps periodic intra-articular cortisone injections. Viscoelestic supplementation is not recommended. It is also stated that it is reasonable to obtain a spinal consultation with someone such as Dr. Jones, Dr. Herron, or Dr. Hutchinson. The prior lumbar MRI scan (6/27/14) demonstrates instability and stenosis, so it is recommended for an

DOI: 11/20/2015. Patient is a 26-year-old male laborer who sustained injury while he was moving a 12 x 12 timber with a co-worker when the weight shifted to his end, causing him to fall backwards and the timber struck him. Per OMNI, he was initially diagnosed with right knee contusion.

DOI: 2/10/2011. Patient is a 56-year-old male controller who sustained a knee injury when he hit his knee when he turned while sitting on a chair. Per operative reports, the patient is status post right knee diagnostic arthroscopy with chondroplasty and removal of scar tissue on 12/14/2012, right knee arthroscopy and trochlear microfracture, partial medial meniscectomy and plica excision on 02/28/2012, and right total knee arthroplasty on 11/30/15.

As per medical report dated 4/21/16, the patient reported that medications help and reduce pain. The pain is 4/10 with medications and 7/10 without medications. Per the prescription script on the same date, tramadol 50 mg is to be taken 1 tablet every 6-8 hours #60, Flexeril 10 mg 1 tablet three times daily #90 and Naproxen 500 mg 1 tablet twice daily #60.

HISTORY OF PRESENT ILLNESS: Mr. Kays returns today after being seen two days ago with a complaint of acute exacerbation of chronic pain in the left knee. He was referred for MRI evaluation and presents today for review of the MRI and recommendations. His pain is slightly better, but essentially unchanged, as he has had no therapy since last being seen. He continues to use crutches and be limited in his range of motion.

He is status post left total knee arthroplasty on 04/12/2016. Physical examination of the left knee revealed tenderness to palpation along the medial joint line and subpatellar area. There is tenderness on the distal tibial condyle as well. The patient is subsequently diagnosed with recurrent rotator cuff tear with reverse total shoulder replacement, bicipital tendinitis of left shoulder, left shoulder pain, chronic left knee pain, status post Oxford unicompartmental replacement for arthrosis. As per office notes dated 5/23/16, the patient complains for left knee, shoulder and back pain. Pain level of his knee is 5 to 8; pain scale of 8 before taking medication, then goes down to 5 after the medication. The patient is using ice, rest, crutches but still has swelling. Some areas are noted to be warm and tender. The patient is also depressed due to his back pain and right knee pain. It was mentioned that the urine drug screen has been consistent. Currently, the patient describes the pain as aching, annoying, constant, and sore pain at the left knee, shoulder and back. Physical examination notes that the patient is in mild

the patient complains of pain, periodic swelling, and locking in her left knee. The pt also reports a history hypertension, sedentary lifestyle, and a skiing accident that injured her left knee 30 years ago. Further questions to assist with the proper diagnosis of the patient includes: when did the pain started? What is the severity of the pain? When does it occur? When did the swelling begin? What aggravate and alleviate the symptoms? Does activity makes stiffness worst or better? Is there pain with limp? What are your usual activities? History of previous injury? What medications she is taking? Any allergies?

DOI: 10/4/2007. Patient is a 42-year-old male upholsterer who sustained a work-related injury to his left knee due to being struck on table. Patient is status post left partial medial meniscectomy on 10/9/15. He was declared P & S by Ortho AME Dr. Berman on 04/02/09.

Range of motion (ROM) was tested on both legs so that a comparison could be made between the injured and non-injured side.