Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive, localized pain in the right knee, specifically localized to the femoral condyle region. Pain is exacerbated by weight-bearing activities and often presents with nocturnal intensity. No history of acute trauma; symptoms are insidious in onset. Patient reports occasional mechanical symptoms, including catching or locking, and localized swelling.
Clinical Examination Findings
Right knee examination reveals localized tenderness upon palpation of the medial/lateral femoral condyle. Range of motion is restricted by pain, particularly during terminal extension and deep flexion. Joint line tenderness is noted. Effusion is present. Gait analysis demonstrates an antalgic limp favoring the left lower extremity. Neurovascular status is intact distally.
Treatment Protocol
Conservative management initiated: strict non-weight bearing or partial weight bearing with assistive devices (crutches/walker). Pharmacological intervention includes NSAIDs for pain and inflammation control. Referral for advanced imaging (MRI) to stage the osteonecrosis. Discussion regarding potential surgical intervention, including core decompression, osteochondral grafting, or arthroplasty depending on lesion size and stage.