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HPI
The patient is a 45-year-old male who presents with severe right medial-sided knee pain which has been present for a number of years and progressively worsening. He notes pain is activity-related and associated with mechanical symptoms to include catching and locking, with no feelings of instability. He denies any inciting trauma. He is active duty military and has been on restricted activities for over 3 years, avoiding running or heavy lifting. Feels improvement with medial off-loader brace. He has also had multiple rounds of directed physical therapy and two prior corticosteroid injections prior to being referred to my office.
PMH
He is otherwise healthy with no past medical history.
PE
Focused physical examination demonstrates a profound clinical varus deformity, mildly antalgic gait with no varus thrust, moderate tenderness isolated over the medial joint line and otherwise full range of motion. Strength is 5/5 for knee flexion and extension. The knee is ligamentously stable, with genus varum that does not correct to neutral on manual stress, and the limb is neurovascularly intact. Positive McMurray and Thessaly localizing to the medial joint line. Rotational profile symmetric and within normal limits. Radiographic parameters: Anatomic lateral distal femoral angle: 84 degrees Mechanical lateral distal femoral angle: 90 degrees Anatomic/mechanical medial proximal tibial angle: 81 degrees Posterior tibial slope: 3 degrees
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
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Right knee diagnostic arthroscopy, medial meniscal debridement, medial opening-wedge high-tibial osteotomy