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HPI
A 76-year-old male presents with severe left knee pain. Has had numerous cortisone injections over the past year, which failed to provide relief beyond 3 weeks. Tylenol and NSAID have also failed to provide relief. Pain wakes him up at night, and severely compromises his life. He is very active and wants to remain so.
PMH
CAD - 2006 - diagnoses - 1/2022 - CAD s/p stent - asymptomatic w/o nitro since Jan 2022 - able to climb a flight of stairs without any symptoms A-FIB - Symptoms consist of palpitations - Rate controlled with metoprolol - On Xarelto for DVT prophylaxis DM Type 2 - HgA1c 7.4 MODERATE AORTIC STENOSIS - diagnosed with TTE in January 2022 - LV Dysfunction w/ EF 45% PROSTATE CANCER - diagnosed on routine screening in 2014 - Treated with radiation in 2014 - On leuprolide for 3-4 years
PE
On physical exam, he has pain in medial and lateral joint lines with palpation. There is varus limb alignment, partially passively correctable with valgus stress. He has a 5-degree flexion contracture with flexion to 110 degrees with pain at extremes. There is crepitus with motion. He has no pain with hip ROM. Left lower extremity neurovascularly intact.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support your clinical decision.
Total Knee Arthroplasty at ASC
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