Physician 1st Quarter 2016 Joint Surgery IRR - Case Study #1
66-year-old male with prior authorization for left total knee arthroplasty (CPT 27447).
Patient has been experiencing daily pain over the last two years in the left knee. This is interfering with his ADLs and worse with prolonged activity such as standing or walking.
He has had conservative treatment in the last several months, including injections, NSAIDS, and therapy which only provided temporary relief. He is also had previous arthroscopic surgeries which only provided minimal relief.
His physical examination shows a mild joint fusion with limited range of motion from 0 to 110°. Knee pain is noted during range of motion with crepitation and tenderness of the joint line with an antalgic gait.
X-rays showed evidence of bone on bone arthritis of the left medial compartment as well as lateral tibial subluxation and tricompartmental arthritis with subchondral cysts and sclerosis.
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