Right Knee Case Studies

Based on the progress report dated 03/28/16 by Dr. Bakhos, the patient presents for follow-up of his right knee

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: 01/14/2011. Patient is a 35-year old male Spanish, regular employee who sustained a work-related injury while bending over to pick up air hose off floor. Per OMNI, patient was diagnosed with Right Knee Strain. MRI of the right knee dated 02/03/2011 revealed menisci, cruciate ligaments, and collateral ligaments, small acute impaction injury with full-thickness cartilage defect in medial femoral condyle, small displaced osteochondral lesion of the inferior medial trochlea, mild diffuse patellar tendinosis, and moderate joint effusion without loose intra-articular chondral or osteochondral body. As per office notes dated 3/24/16, the patient is an obese patient who suffers from ongoing knee and lower back pain which indicates her for aquatic

Health History: A 25-year-old male injured his left knee in a recent skiing accident. The patient stated that he lost his balance because the inner edge of his right ski got caught while skiing. This resulted in the right leg being externally rotated followed by and audible “pop” as he lost footing. By evening, the right knee joint had become swollen, causing intense pain. The primary care physician referred the case to an orthopedist.

The patient underwent repeat MRI of his right knee on 1/28/16. As per office notes dated 7/25/16, review of system revealed that the patient has a history of weakness, shortness of breath, joint pain, muscular weakness, stiffness and muscular pain, headache and dizziness, as well as nervousness. The patient presents today stating that he would like to have his rod removed. He says that his right knee continues to give out on him and he wants to go on longer than 2 mile hikes without having knee pain and feeling instability. Examination of the right lower extremity revealed that the patient’s incisions are clean, dry, intact, and well-healed. The patient’s knee demonstrates discomfort with patellar grind-the symptoms are consistent with his last several exams, and are relatively unchanged. Knee is stable to varus and valgus stress, however, valgus stress does cause some discomfort on the lateral side. Distal neurovascular status is intact. Impression includes right displaced comminuted fracture of shaft of right femur, initial encounter for closed fracture; right chondromalacia patellae, right knee, and right sprain of other specified parts of right knee, initial

The knee is a complex joint. There are many different injuries that can occur during sports. The most predominant type of injuries to the knee is those done to the Meniscus and the ligaments. There are two areas of ligaments that are commonly affected; the cruciate ligaments and the Collateral ligaments. Within the Cruciate ligaments there are posterior and anterior injuries, and within the Collateral ligaments there are medial and lateral injuries. It is very important that these injuries be taken seriously in athletics due to the seriousness of their affects to the knee.

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.

The purpose of this study was to demonstrate the diagnostic value of MRI in diagnosing the presence or absence of the most common injuries of the knee; the meniscus tears, the cruciate ligament

examined the notch area and probed the anterior cruciate ligament. It was intact. We then examined the lateral compartment and probed the lateral meniscus. It was intact. We examined the medial compartment once again finally, looking for any remaining loose fragments. We then drained the knee and removed the hardware. The skin incisions were left open, and sterile dressings were applied under a

Per PA Alford, your MRI of left knee shows a chondral defect, osteoarthritis at the patellofemoral compartment with a focal near full-thickness chondral defect at the trochlea. Osteochondral injury at the medial femoral condyle, with a 1 cm area of partial-thickness chondral defect and subchondral bone marrow edema. No meniscus or ligament tear.

The patient has difficulties ambulating stairs. Her pain is waking her up at night. She failed to improve with the plethora of conservative treatment entailing physical and acupuncture therapies, activity modifications, home-type exercise, injections, medications. On physical examination, the patient is utterly uncomfortable. She ambulates with antalgic gait. Well healed incisions are noted on the left knee. Patellar crepitus noted on the flexion and extension of the right knee with medial and lateral joint line tenderness more so in the medial side. McMurray's test is positive medially. Patellar crepitus is noted together with pain in patellar compression. Patient’s Voltaren gel was refilled. Patient was recommended to undergo right knee arthroscopy with partial meniscectomy and lateral patellar release surgery. She failed to improve with above mentioned conservative treatment. Any further conservative treatment will be of no benefit. Patient was also recommended 12 PT sessions for the right knee

Introduction: In severe knee deformities, traumatic or congenital, malalignment of the mechanical axis of the femur and tibia causes excessive joint loading, which may increase articular cartilage degeneration. Osteotomy is a recognised treatment technique in such cases, as it redistributes the weight-bearing force on the knee. It can be performed in the distal femur or proximal tibia. Varus deformity causes excessive pressure in the medial compartment, therefore proximal tibial osteotomy, medial opening or lateral closing, is an option. In valgus deformity, distal femoral lateral opening wedge procedure is the most consensual choice of treatment, but proximal tibial wedge osteotomy, medial closing or lateral opening, can also be done.

01/26/16 Progress Report documented a follow-up visit for left knee pain. The patient has attended 13 visits of PT and his knee is more painful now. He is currently having daily medial sided knee pain. He cannot run, walks with a limp, and has swelling and limited range of motion. The Worker’s compensation denied his MRI. He has been having pain in his knee since 09/03/15. The patient has a PMH significant for LKS with ACL reconstruction by FAB, 1.5 years ago. He reported swelling, catching,

DOI: 12/2/2011. The patient is a 48-year old male service/installer technician who sustained a work-related injury to his bilateral knees, left shoulder, upper/lower back and neck. Per OMNI, patient underwent a left hip arthroscopy with a major synovectomy, debridement of the anterosuperior labrum, chondroplasty of the femoral head on the anterosuperior aspect, as well as a femoroplasty on 11/4/2014.

The patient stated that he began experiencing painful swelling in his right knee over a decade ago. A large mass grew around the knee and he underwent a total knee arthroplasty. Not long after the arthroplasty of his right knee, he began experiencing similar symptoms in his left knee and right elbow.