ORTHO
BULLETS
Free CME
Join now
Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Knee Osteoarthritis
Posted: Feb 23 2023 #(C102144) 2023 California Orthopaedic Association Annual Meeting
A

Knee Osteoarthritis in 76M with Comorbidities. Appropriate for ASC?

}

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.

Poll
1 of 13
In addition to plain film radiographs of the knee, would you obtain further imaging to guide management?
Other
Submit
P: 163459
How would you manage the patient at this time?
Other
Submit
P: 163460
During the Nonoperative management of this patient, what injections would you perform?
Other
Submit
P: 163628
If you choose Arthroplasty, what procedure would you perform?
Other
Submit
P: 163462
If you choose Total Knee Arthroplasty (TKA), what would you do with the PCL?
Other
Submit
P: 163470
If you choose TKA AND Sacrificed the PCL, what type of bearing design would you use?
Other
Submit
P: 163472
If you choose TKA, what fixation strategy would you utilize?
Other
Submit
P: 163467
If you choose TKA, would you plan on using technology?
Other
Submit
P: 163464
If you choose Total Knee Arthroplasty (TKA) with Navigation or Robotic Assisted, in what setting would you do it AND what would you post-op plan be?
Other
Submit
P: 163616
If you choose TKA, and were considering same-day outpatient surgery in this patient, who would evaluate and qualify the patient for same-day surgery?
Other
Submit
P: 163649
If you choose same-day outpatient TKA at the ASC, what safety net would you implement in case the patient was not safe to go home?
Other
Submit
P: 163652
If you performed an outpatient TKA at the ASC and sent the patient home, what would be your pain management strategy for the first 48 hours?
Other
Submit
P: 163769
If you performed an outpatient TKA at the ASC and sent the patient home, would you give the patient your personal cell phone number?
Other
Submit
P: 163772
icon
OUTCOMES
Post-procedure P1
All Videos (4) Podcasts (0)
Sort by
EF
L1\L2 Evidence
Date
Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options