Acute and Chronic Knee Injuries - Osteoarthritis " Amir is a 51-year-old construction worker "

Case study ( 6116 views as of April 14, 2024 )

Amir is a 51-year-old construction worker who has had increased pain and swelling in his right knee for over a year. However, in the last 2 months, it has gotten much worse, and he has had to modify some of his duties at work. He got so swollen and red last week that he wasn’t able to go to work, which broke an 8-year streak of perfect work attendance.

Amir went to see a doctor at a walk-in clinic, as he doesn’t have a family doctor. He was sent for x-rays and on a follow-up visit, was told he has arthritis, probably from “a bunch of old injuries”. He was given a prescription for pain medication and told he would have to live with it. He may need surgery in the future.

Amir might benefit from getting a referral to a Rheumatologist, Sports Medicine Specialist and Physiotherapist. Upon evaluation these specialists may then opt to refer Amir to a Bracing Specialist, Pain Management Specialist and/or an Orthopedic Surgeon. Amir may also receive applicable information by consulting with an Athletic/Personal Trainer, Pharmacist and an Acupuncturist. Tools to aid in his rehabilitation can be found at a Medical Supply Store.

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Conversation based on: Acute and Chronic Knee Injuries - Osteoarthritis " Amir is a 51-year-old construction worker "

Acute and Chronic Knee Injuries - Osteoarthritis " Amir is a 51-year-old construction worker "

  • During patellar subluxation, the patella moves partially out of its normal position within the patellofemoral groove, which is located at the front of the femur. This can occur due to various reasons, including: Muscle imbalances: Weakness or imbalance in the muscles surrounding the knee, particularly the quadriceps and hamstrings, can contribute to patellar subluxation. Trauma: A direct blow or forceful twisting of the knee can cause the patella to move out of place. Structural abnormalities: Some individuals may have inherent anatomical abnormalities that predispose them to patellar instability, such as a shallow patellofemoral groove or a malalignment of the lower extremity. Ligament laxity: Loose or stretched ligaments around the knee joint can lead to increased mobility of the patella, making it more prone to subluxation. The symptoms of patellar subluxation may include pain, swelling, a feeling of the kneecap sliding out of place, and difficulty straightening or bending the knee. Treatment options depend on the severity of the condition and may include physical therapy to strengthen the muscles around the knee, bracing or taping to provide stability, and in some cases, surgery to correct underlying structural issues or repair damaged ligaments. It's important to consult with a healthcare professional, such as an orthopedic specialist or a sports medicine physician, for an accurate diagnosis and appropriate treatment plan for patellar subluxation.
  • People who have recurrent ankle sprains often require surgery in order to repair damaged cartilage and the ligaments on the side of the ankle to help stabilize the ankle and prevent it from rolling again
    • People who have had recurrent ankle sprains often have damage or holes in the cartilage which can benefit from arthroscopic surgery in order to clean it up and reduce discomfort.
  • Amir should definitely seek additional medical advice about this injury. If his occupation is contributing to it he might be eligible for assistance from WSIB. They can assist him in navigating the healthcare system as well as provide him with possible retraining if necessary.
  • I find that often people in the "trades" are less likely to seek the medical attention they require for an injury because they don't get paid if they don't work. This ultimately puts more stress on the health care system as these injuries become more serious. Making things like physiotherapy easier to access would benefit a lot of people
  • A sports medicine physician would be a great resource, as more imaging may be needed to fully assess the extent of this man's knee pain. An MRI may give more insight into what treatment plan is most appropriate. In terms of his pain management, if he has exhausted more front line treatment options, a specialist may recommend injections to help control the pain.
    • That's a good suggestion. Many sports medicine physician's seem more open to further treatment when family doctor's have exhausted all options
  • I find the advice "you'll just have to live with it" very frustrating. If this gentleman had seen the doctor sooner he might have had more options
  • Acupuncture treatments have greatly improved the arthritis in my hip and I believe he could benefit from some acupuncture
    • Acupuncture has greatly helped my husband's chronic knee issues
    • @starvers82, did you have you acupuncture done as part of physiotherapy treatment or by another professional certified in acupuncture techniques?
  • It's concerning that the patient was experiencing both redness and swelling. Redness isn't as common of a side effect of arthritis
    • That sounds like you have a lot of injury below the skin and the swelling and redness is an indication that it was a lot more serious than the laceration.
    • I once had a fall and bruised my shin bone. While the laceration from the fall was quite small the wound itself caused a lot of swelling and redness in my leg.
    • That's an interesting observation. Could the redness be a sign it is an acute injury rather than chronic pain?
  • Do you have different treatment approaches for aging individuals with acute or chronic knee injuries?
    • I think you have to take a person's complete medical history and current issues into consideration before treating knee injuries. Certainly with the gentleman in this case study, he is still young and is working, so returning to his normal daily activities is essential to his livelihood. With an elderly man, for example, the treatment may focus more on pain management and activity modification.
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