KNEE AND SURGERY
English version of the website of Dr. J.E.Perraudin, french orthopaedic surgeon in Paris : www.docteurperraudin.com : the content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Last updated 6 Sept 2012
Consultation
The examination of the patient begins with the "history", whereby the doctor spends time listening to his patient about his symptoms.
  • Was the pain brought on by an injury ?
    • how did the injury occur?
    • When did it occur? How has it been managed?
  • The pain
    • Is it dull and unremitting? intermittent? during activity or afterwards?
    • Is the pain specifically located?
    • Is it continuous, day and night?
    • What aggravates and quiets pain?
  • Swelling : does the knee become visibly swollen?
  • Limited range of motion ?
  • Locking : the knee excursion gets blocked at a particular angle, and the patient is unable to achieve a full excursion.
  • Pseudo-locking : similar except that the patient, after a short time, can overcome the block and get the knee moving again.
  • Catching : is a sensation during normal movement, when a sudden pain is experienced and the knee does not go through its full excursion, being halted reflexly.

After taking a history, the orthopaedic surgeon will perform a physical examination.

  • In the standing position first :
    • Varus (bow leg) or valgus (knock knee deformity)
    • Back knee'd position
    • Are the patellae pointing straight ahead or pointing inwards ("squinting patella")?
  • He will focus on your walk, the range of motion of your limbs, and joint swelling and tenderness.
  • He will perform manual tests on the knee to determine the amount of instability that exists. The lachman test, anterior drawer test and pivot shift test are exams he may use to see how much the tibia moves in relation to the femur.

X-rays can reveal signs of bone fractures, chips or osteoarthritis.MRI (magnetic resonnance imaging) is a non-operative procedure that allows the physician to determine may be ordered to assess damage to soft tissues such as ligaments and menisci cartilage.

 

Docteur Jean Etienne Perraudin, last updated 1 september 2012.

 

 

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