Orthopaedic Clinic Letter to Patient

24/05/2024

Dear Arthur Pendelton,

This letter recaps the main points from our recent consultation about your right knee joint pain, osteoarthritis of the right knee, and associated symptoms.

Your Concerns

You reported experiencing worsening pain and stiffness in your right knee over the past eight months. The discomfort is mainly on the inner side of the knee and gets worse when walking more than half a mile or climbing stairs. You also noted occasional swelling in the evenings and stated that your sleep is sometimes disturbed by a dull ache in the joint.

Examination Findings

On examining your right knee, there was a mild build-up of fluid inside the joint and tenderness along the inner joint line. You were able to straighten your leg fully, and you could bend it comfortably to 110 degrees, though bending it further caused a grinding sensation and mild discomfort. Your knee ligaments felt stable, and your recent X-rays confirmed moderate wear-and-tear of the cartilage on the inner side of the knee.

Treatment Plan

To manage your symptoms without surgery at this stage, we agreed on the following steps:

• Physiotherapy: I have referred you for a course of targeted exercises to strengthen the muscles around your thigh and knee, which will help take pressure off the joint.
• Activity changes: Switch from high-impact walking on uneven ground to low-impact exercises such as swimming or using a stationary bike.
• Pain relief: You can take paracetamol 1,000 mg PO QID when the pain is troublesome, and apply ibuprofen 5% gel TOP TID directly to the inner side of the knee.

Moving Forward

We will review your progress in the clinic in 12 weeks to see how well the physiotherapy and pain relief are working. If your pain continues to limit your daily activities despite these measures, we can discuss options such as a steroid injection into the knee joint or eventually considering a knee replacement. In the meantime, please seek urgent medical care if your knee suddenly locks up, becomes hot and red, or if you develop a fever.

Additional Information

For helpful tips on managing joint pain at home and staying active safely, please visit the Versus Arthritis website (www.versusarthritis.org). If you have any questions before your next appointment, please contact the orthopaedic secretary on 0161 555 0192 between 09:00 and 17:00, Monday to Friday.

Sincerely,

The Team at Oakwood Orthopaedic Centre