Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive left knee pain following a remote history of significant trauma (e.g., ligamentous injury/fracture). Pain is exacerbated by weight-bearing activities, prolonged standing, and stair climbing. Reports morning stiffness lasting <30 minutes, occasional mechanical symptoms including catching or locking, and intermittent joint effusion. Previous conservative management has provided limited relief.
Clinical Examination Findings
Left knee examination reveals mild to moderate joint line tenderness, crepitus on range of motion, and palpable osteophytes. Range of motion is restricted in terminal flexion/extension. Mild effusion present without signs of acute inflammation. Ligamentous stability (ACL/PCL/MCL/LCL) is intact, though joint space narrowing is clinically suspected. Gait demonstrates an antalgic component favoring the right lower extremity.
Treatment Protocol
Initiate multimodal conservative therapy: weight management, physical therapy focusing on quadriceps strengthening and range of motion, and activity modification. Prescribe NSAIDs as needed for pain control. Consider intra-articular injections (corticosteroids or viscosupplementation) for symptomatic relief. If refractory, discuss surgical consultation for arthroscopic debridement or total knee arthroplasty (TKA).