DOI: 12/23/2013. Patient is a 51-year-old female registered nurse who sustained a work related injury due to repetitive work. Per OMNI, she is initially diagnosed with strain to the knee patella.
MRI of the right knee dated 10/9/15 revealed globular increased signal intensity is seen throughout the medial meniscus most consistent with intrasubstance degeneration; tricompartmental osteoarthritic changes; joint effusion; pre-patellar soft tissue edema, query contusion; and chrondromalacia patellae.
Per the panel QME Supplemental report dated 12/31/15, the patient is not yet at maximum medical improvement (MMI). Patient was diagnosed with right knee sprain with chondromalacia/osteoarthritis.
As per medical report dated 8/24/16, patient complains constant bilateral knee pain, right greater than left, rated 8/10, …show more content…
It was also noted that since the pain has not improved with rest, medication, therapy, and arthroscopy in addition to the x-rays, the next step is total knee resurfacing. It was also noted that the patient will require medical clearance prior to surgery and due to the complexity, the provider notes that he needs an assistant surgeon. The patient will need to be hospitalized for 3 to 5 days, be provided with a Continuous Passive Motion Unit, and a cold unit for 3 weeks, front wheel walker for ambulatory assistance, a 3-in-1 commode, and outpatient postoperative physical therapy twice a week for 6 weeks.
Based on the amended medical report dated 10/06/16 by Dr. Schiffman, the patient is a candidate for a right total knee replacement. The patient has severe degenerative joint disease of the right knee and has had extensive treatment. She weighed 216 pounds and her height is 5 feet and 4 inches, giving her a body mass index of 37.1. Patient has a history of hypertension and thyroid disease however these conditions are well controlled by medications provided by her primary care
MRI of the right knee dated 10/9/15 revealed globular increased signal intensity is seen throughout the medial meniscus most consistent with intrasubstance degeneration; tricompartmental osteoarthritic changes; joint effusion; pre-patellar soft tissue edema, query contusion; and chrondromalacia patellae.
Per the panel QME Supplemental report dated 12/31/15, the patient is not yet at maximum medical improvement (MMI). Patient was diagnosed with right knee sprain with chondromalacia/osteoarthritis.
As per medical report dated 8/24/16, patient complains constant bilateral knee pain, right greater than left, rated 8/10, …show more content…
It was also noted that since the pain has not improved with rest, medication, therapy, and arthroscopy in addition to the x-rays, the next step is total knee resurfacing. It was also noted that the patient will require medical clearance prior to surgery and due to the complexity, the provider notes that he needs an assistant surgeon. The patient will need to be hospitalized for 3 to 5 days, be provided with a Continuous Passive Motion Unit, and a cold unit for 3 weeks, front wheel walker for ambulatory assistance, a 3-in-1 commode, and outpatient postoperative physical therapy twice a week for 6 weeks.
Based on the amended medical report dated 10/06/16 by Dr. Schiffman, the patient is a candidate for a right total knee replacement. The patient has severe degenerative joint disease of the right knee and has had extensive treatment. She weighed 216 pounds and her height is 5 feet and 4 inches, giving her a body mass index of 37.1. Patient has a history of hypertension and thyroid disease however these conditions are well controlled by medications provided by her primary care