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Knee Osteoarthritis
Posted: Dec 1 2020 #(C101643)
B

Knee Osteoarthritis with Tibial Deformity in 49F

HPI

49-year-old female presents with greater than 5 years of right knee pain. She underwent failed previous injection therapy and other conservative measures and presents for knee replacement surgery. She experiences pain with all activities.

PMH

Her past medical history includes a closed tibia fracture treated with a cast.

PE

The patient is 5’4’’ with a BMI of 26. She has a 10 degree flexion contracture and a varus deformity of her right knee. She flexes to 110 degrees and has crepitus throughout her motion arc. Her hip exam and L-Spine exam are normal.

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In addition to the xrays provided above, would you obtain any additional imaging?
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How would you manage this patient at this time?
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If you choose Operative management, what surgery would you perform?
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If you choose Arthroplasty, what type would you perform?
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If you choose Total Knee Arthroplasty (TKA), would you consider enabling technology?
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If you choose Total Knee Arthroplasty (TKA) with Navigation or Robotics, what is the PRIMARY reason you choose to do so?
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If you choose Total Knee Arthroplasty (TKA) with Navigation or Robotics, in what setting would you do it AND what would you post-op plan be?
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If you choose Total Knee Arthroplasty (TKA) and the patient had prior intraarticular steroid injections, how long after the injection would you wait before performing TKA?
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If you choose Total Knee Arthroplasty (TKA), would you use a Continuous Passive Motion (CPM) machine post-operatively?
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If you choose Total Knee Arthroplasty (TKA), would you allow the patient to return to skiing?
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During the Nonoperative management of this patient, what injections would you perform?
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During the Nonoperative management of this patient, would you include radiofrequency ablation (RFA)?
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