frank100
Forum Guru
Topics: 48
Posts: 586
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A 70 y/o man comes to the physician because of nee pain that has been presented for 10 years. He is unable to comfortably walk further than one block and has difficulty sleeping because of the pain. He has pain on both medial and lateral side of the knee. Range of motion is from 15 to 100 degrees. there is a bowleg deformity whe he stands.
a) anterior cruciate ligament reconstruction
b) Arthroscopic partial menicectomy
c) Quadriceps streghtening excersices
d) Sympathetic blockade
e) total knee replacement
f) Upper tibial osteotomy
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| vnty
Forum Senior
Topics: 24
Posts: 87
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This patient has osteoarthritis,
Osteotomy
Osteotomy is used in active patients younger than 60 years who want to continue with reasonable physical activity. The principle is to shift weight from the damaged cartilage on the medical aspect of the knee to the healthy lateral aspect of the knee. It is most beneficial for significant genu varum or bowleg deformity. (The osteotomy for genu valgum is not a procedure of high predictability as to its effectiveness.) Osteotomy often can save an individual from having a total knee replacement until they are older.
Contraindications for an osteotomy are knee flexion less than 90°, a flexion extension contracture of more than 15°, and a significant amount of varus over 15-20°. Instability due to previous trauma or surgery, severe arterial insufficiency, and bicompartmental involvement are also contraindications.
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| Cedrick
Forum Fanatic
Topics: 322
Posts: 2,041
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E.-Total knee replacement
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| drk1980
Forum Guru
Topics: 147
Posts: 1,038
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yes agree TKR...i was debating about it until i saw its only one of his knees that is affected.
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| radonc
Forum Senior
Topics: 10
Posts: 180
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OA of knee, severe. Needs TKR.
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