Progressively increasing knee pain

Chief complaint A 69 year old female presents with knee pain which is progressively increasing over the past 2 months. She is gaining weight lately. His doctor suggested surgery to debride bilateral knees which she denied. Investigations Examination shows swelling in both knees, weak quad, hip extensors & abductors, poor patellar tracking, poor control of subtalar joint neutral with gait, tight gastroc-soleus and anterior hips; weak core; poor balance with single leg stance. Treatment What are your views on the treatment part.

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Yes she needs to be investigated more .But from your description she is likely to develop FFD (fix flexion deformity) at knees and hip,which will be much troublesome..So frequent prone position and some basic exercises will help her a lot..refer for physio ASAP

From history she appears to be a c/o OA with obesity and overweight Hence viewing of xray knee is necessary Gaining weight need to r/o hypothyroidism Weak muscle power needs physiotherapy After presurgical preparations are done than better to subject for TKR

POSSIBLY OSTEOARTHRITIS ADVISABLE ALL. ROUTINE. INVESTIGATION X. RAYS PHYSIOTHERAPY WEIGHT. REDUCTION LIGHT. EXERCISES

OA will be there Rule out inflammatory arthritis Please post knee xrays

Ask to reduce weight, Physiotherapy and Lastly knee replacement

X-Ray of both knee Jt. AP/Lat. TC, DC, ESR, Hb%, ASOT. RAfactor. Uric Acid, BS (F) PP, Urea, Creatinine. Calcium and vitamin D Test essential. Blood pressure? Body Wt? Needs an anti inflammatory drugs Physical exercise or activities.

He needs to be investigated Bmi tft heamogram fbs hba1c ra factor anti ccp xray bothknee standing position Mri also Physiotherapy