Knee Osteoarthritis Pathway Posted: 1/10/2022 ID: (C101934)

Knee Pain in 67F

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PRESENTATION
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POLLS
8,582
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OUTCOMES
4
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VIDEOS
2
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EVIDENCE
11
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Comments
8
CASE DESCRIPTION
AGE 67 / Female
CC Left knee pain
HPI A 67-year-old female presents with long-standing left knee pain and valgus deformity. She reports pain that interferes with her life daily. Previously, she enjoyed taking long walks with her husband, which she can no longer do due to knee pain. She has failed conservative measures including a corticosteroid injection 4 months ago and several months of PT. She previously underwent a right TKA with a separate surgeon and she is very happy with the results of that prior operation.
PMH PMH: HTN PSH: right TKA
PE Obese female with a BMI of 31. Focused exam of the left lower extremity reveals minor valgus malalignment of the left knee with a small effusion. She is tender to palpation about the medial and lateral joint lines. Lacks 5 degrees of full extension, flexes back to 120 degrees. There is obvious crepitance with ROM. Knee stable to varus and valgus stress. She is neurovascularly intact.
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/101934/a90ccf90-16a2-411a-b86a-290ea4696578_preop_knee_oa_ap.jpg https://upload.orthobullets.com/cases/101934/374a4bc4-c4ce-4cef-a426-7035d5453755_preop_knee_oa_lat.jpg https://upload.orthobullets.com/cases/101934/eab59354-fe7f-45b6-8b2f-5cd9af8b4dca_preop_knee_oa_scanogram.jpg https://upload.orthobullets.com/cases/101934/7a4a0a14-a47b-4f9a-92b9-603b72f26b0f_template_ap.jpg https://upload.orthobullets.com/cases/101934/ea474013-8e12-401e-a589-c9dde379e9e3_template_lat.jpg
POLLS
OB Community
1) In addition to plain film radiographs of the knee, would you obtain further imaging to guide management?
Other
2) How would you manage the patient at this time?
Other
3) If you choose Operative management, what surgery would you perform?
Other
4) If you choose Arthroplasty, what procedure would you perform?
Other
5) If you choose TKA, what prosthesis design would you plan to utilize?
Other
6) If you choose TKA, would you plan on using technology?
Other
7) If you choose TKA, would you utilize a tourniquet?
Other
8) If you choose TKA, what type of bearing design would you use?
Other
9) If you choose TKA, what fixation strategy would you utilize?
Other
10) If you choose TKA, would you plan on resurfacing the patella?
Other
11) If you choose TKA, what chemical anticoagulation would you use postoperatively?
Other
CASE OUTCOMES
PROCEDURE 1: Left cemented, standard instrumentation (non-robotic) posterior-stabilized total knee arthroplasty
Post-procedure P1
https://upload.orthobullets.com/cases/101934/2e57c7e8-5897-472b-a2c7-839fccbafc24_postop_immediate_ap.jpg https://upload.orthobullets.com/cases/101934/de74239d-eec3-419a-9789-32b51fbeb7fb_postop_immediate_lat.jpg https://upload.orthobullets.com/cases/101934/49b34249-b702-44cf-8727-b0850fa2d45c_6_wk_scanogram.jpg https://upload.orthobullets.com/cases/101934/fab8f2ad-41bd-493e-b187-bb41a09bb151_6_wk_wb_axis.jpg
VIDEOS & PODCASTS (2)
EVIDENCE (11)
EXPERT COMMENTS