Physician 2nd Quarter 2016 IRR – Joint Surgery Case Study #3
60yoM with prior authorization request for partial knee replacement CPT 27446.
Patient has chronic right knee pain for the last 2 years with associated difficulty performing ADLs.
He has failed conservative management including multiple aspirations and injections, NSAIDS, unloader brace. He underwent arthroscopic medial meniscecotmy and synovectomy in 2014 which showed significant isolated medical compartment erosive changes.
Physical examination reveals 5 degree varus alignment with painful ROM from 0-115 degrees and antalgic gait.
X-rays and MRI confirm “bone on bone” changes of the medical compartment with sparing of the lateral and patella-femoral compartments with regards to arthritis.
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