The patient is a 41-year-old male who presents with severe left medial-sided knee pain which has been present for many years and has progressively worsened. The pain is activity-related and associated with mechanical symptoms to include catching and locking, with no feelings of instability. He denies any inciting trauma.
He is active duty military and has been on restricted activities for over 3 years, avoiding running or heavy lifting. Feels improvement with medial off-loader brace. He has had multiple rounds of directed physical therapy and two prior corticosteroid injections. He additionally has had multiple arthroscopic debridements of his medial meniscus over the course of his military career. He is hopeful to get back to activities like horseback riding.
No significant past medical history.
Focused physical examination demonstrates clinical varus deformity, mildly antalgic gait with no varus thrust, moderate tenderness isolated over the medial joint line and otherwise full range of motion. Strength is 5/5 for knee flexion and extension. The knee is ligamentously stable, with genus varum that does not correct to neutral on manual stress, and the limb is neurovascularly intact. Positive McMurray and Thessaly localizing to the medial joint line. Rotational profile symmetric and within normal limits.
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