Knee cartilage injury assessment

Diagnosing a knee cartilage injury requires developing a complete picture of the injury, as well as the patient’s medical history and lifestyle.

There are many diagnostic tools and patient questions that can provide you with the insight that you need. Here are some:

Patient History

  • How old is the patient?
  • How long have they been experiencing pain in their knee?
  • What started the pain?
  • Does their knee hurt, catch, lock, give way, or swell?
  • When does their knee hurt (climbing stairs, on level ground, with weight-bearing activity, at rest)?
  • Where is the pain (proximal, distal, medial, lateral)?
  • What surgeries have been performed?
  • When were they performed?
  • Is there a previous MRI?
  • What rehabilitation program was prescribed, and was it followed?
  • What was the response to the surgery and rehabilitation?

Knee Exam

  • What is the patient’s range of motion (ROM)?
  • Is there evidence of an effusion?
  • Does the patient have an instability?
    • Tibiofemoral
    • Patellofemoral
  • Are there other concomitant pathologies suspected?
    • Meniscal integrity
    • Mechanical alignment:
  • Tibiofemoral
  • Varus/Valgus
  • Patellofemoral Joint

Imaging

  • X-ray
  • MRI
  • CT Scan

Arthroscopic Assessment

  • Where is the defect located?
  • What is the size of the defect?
  • What other co-morbid conditions need to be treated?
  • Is there bony involvement?
  • Is the defect uncontained?

Patient’s Post-surgical Goals

  • Can they take the necessary recuperation time?
  • Are they committed to the full rehabilitation period and program?
  • What level of activity would they like to achieve?
  • Is a return to sports important?

Insurance

  • Who is the insurance carrier?
  • What is the medical policy with respect to ACI?
  • Consider the medical policy when dictating to expedite approval for properly indicated patient
  • What imaging is needed to support insurance claim?
  • Details from imaging may be needed to support insurance claim