DOI: 11/28/2015. Patient is a 48-year-old male carpenter who sustained injury while working on a ladder, he felt pain in his right knee. Per OMNI entry, he was initially diagnosed with right knee meniscal tear. Patient is status post right knee partial medial and lateral meniscectomy, chondroplasty, microfracture technique, removal of loose bodies; plicectomy, and three compartment synovectomy on 02/25/16.
Based on the medical report dated 07/06/16 by Dr. Keinman, the patient complains of right knee pain which has almost completely resolved, since undergoing his arthroscopy. He reports that his pre-operative symptoms have almost completely resolved and he only has mild residual pain on long periods of ambulation on certain movements, which …show more content…
Patient reports Improvement in tolerance to walking but still has difficulty in stair climbing and partial squats particularly picking up object from the ground. Pain is rated as 4-6/10. Symptoms are increased with prolonged standing and partial squatting. Pain is described as sharp and stiff. Patient has limitations with prolonged walking, stairs, running and bending.
On examination of the right knee, recurrent swelling is noted. There is infrapatellar tenderness during deep palpation. Tightness of the hamstring muscle is noted.
Range of motion (ROM) shows flexion of 140 degrees and extension of 0 degrees. Stress testing shows 4-/5 with flexion and extension.
Assessment is medial meniscus tear.
Patient’s problems include the following: decreased participation in recreational activities; limitations in functional activities; decreased range of motion (ROM); joint swelling; decreased strength; gait impairment; positive special testing for medial meniscal pathology; and decreased ability to negotiate stairs.
Recommendation was made for PT, 3 times a week for 6
Based on the medical report dated 07/06/16 by Dr. Keinman, the patient complains of right knee pain which has almost completely resolved, since undergoing his arthroscopy. He reports that his pre-operative symptoms have almost completely resolved and he only has mild residual pain on long periods of ambulation on certain movements, which …show more content…
Patient reports Improvement in tolerance to walking but still has difficulty in stair climbing and partial squats particularly picking up object from the ground. Pain is rated as 4-6/10. Symptoms are increased with prolonged standing and partial squatting. Pain is described as sharp and stiff. Patient has limitations with prolonged walking, stairs, running and bending.
On examination of the right knee, recurrent swelling is noted. There is infrapatellar tenderness during deep palpation. Tightness of the hamstring muscle is noted.
Range of motion (ROM) shows flexion of 140 degrees and extension of 0 degrees. Stress testing shows 4-/5 with flexion and extension.
Assessment is medial meniscus tear.
Patient’s problems include the following: decreased participation in recreational activities; limitations in functional activities; decreased range of motion (ROM); joint swelling; decreased strength; gait impairment; positive special testing for medial meniscal pathology; and decreased ability to negotiate stairs.
Recommendation was made for PT, 3 times a week for 6