Secondary Care - Examination
Commissioning guide 2013 Painful osteoarthritis of the knee
Difference in the medial joint line height between weightbearing (right) and non-weightbearing (left) X-ray.
In secondary care patients will be assessed whether they fulfil the criteria for a surgical intervention.
In the history we will focus on:
Examination we will be looking for:
Almost every patient suspecting knee osteoarthritis really requires standing radiograph of a knee in two views.
If extent of damage of the cartilage will not be clear, MRI Scan will be requested.
CT scan will only be requested for a patient with existing deformities for pre-op planning.
Profound engagement of the patient in the process will be expected and requested.
If patient will not fulfil the criteria for operative management they will be offered continuous support with all non-operative measures including advice, exercise, the Weight loss, manual therapy, Oral medication, injection therapy and braces.
If patient is undecided a follow-up appointment can be offered usually in 6 to 12 months.
In our opinion decision to have the surgery is dynamic process and can always be postponed, delayed or reinstatement.
In the history we will focus on:
- how long the symptoms are present,
- distribution of the symptoms between day and night,
- impact of the symptoms and pain on activity and rresting,
- need for a walking aid and
- the regular use of painkillers.
Examination we will be looking for:
- deformity,
- swelling,
- tenderness,
- reduction in range of movement and
- fluid in the joint.
Almost every patient suspecting knee osteoarthritis really requires standing radiograph of a knee in two views.
If extent of damage of the cartilage will not be clear, MRI Scan will be requested.
CT scan will only be requested for a patient with existing deformities for pre-op planning.
Profound engagement of the patient in the process will be expected and requested.
If patient will not fulfil the criteria for operative management they will be offered continuous support with all non-operative measures including advice, exercise, the Weight loss, manual therapy, Oral medication, injection therapy and braces.
If patient is undecided a follow-up appointment can be offered usually in 6 to 12 months.
In our opinion decision to have the surgery is dynamic process and can always be postponed, delayed or reinstatement.
