Arthroplasty Case Study

DOI: 1/25/2008. Patient is a 55 year old male floating service technician who sustained injury when he slipped and fell while installing a tub at work. Per OMNI, he underwent left knee arthroscopy ad meniscectomy; 3rd knee surgery for medial compartment arthoplasty on 11/25/13.

Per the panel QME report dated 02/04/13, the IW was deemed P & S for the back and knees as per 02/18/11. The patient requires future medical care provisions for his back and knees. For flare-ups of pain, he should be permitted to see a medical practitioner as required for additional conservative treatment, which could consist of brief courses of physical therapy of up to eight visits per year for the back and/or knees, prescription non-narcotic medications, steroid injections, and knee braces. A left knee arthroplasty is not recommended, either partial or total.

He has pain with sitting, standing, walking, and lying down. He has had physical therapy and chiropractic care with only transient relief. He is taking Motrin, Norco, and Neurontin for pain.
Based on the progress report dated 09/19/16 by Dr. Dhillon, the patient was last seen on 08/15. He continues to complain of low back pain. He has intermittent numbness of the lateral aspect of the left leg to the lateral toes. He does have intermittent weakness of the left leg as well. He continues to take Norco 10/325 5 per day, Motrin 800 mg 3 times a day, and Neurontin 400 mg 2 times a day.
His MRI of the lumbar spine done on 09/14/16 reveals severe L5-S1 discogenic disease with modic changes within the vertebral bodies. There is mild-to-moderate T12-L1, L1-2, L2-3, L3-4, and L4-5 discogenic disease. There is no significant central canal stenosis at any level.
There is a right paracentral L5-S1 disc herniation There is severe bilateral L5·S1 and moderate bilateral L4-5 foraminal stenosis There is diffuse lower lumbar facet joint