Professor Walter examines an arthritic knee joint

Video: Clinical examination of knee joint for joint replacement assessment

Professor Walter examines a patient with an arthritic knee prior to knee replacement surgery and 4 weeks after knee replacement surgery (7 minute knee examination video)

In this 7 minute clinical examination video, Professor Walter examines patient with an arthritic knee prior to knee replacement surgery.

A patient history is taken which focuses on:

  • Pain profile – location of pain, radiation of pain and factors which exacerbate and relieve pain.
  • Joint profile – catching, clicking, swelling and tendency for joint to give-way.
  • Activity profile – difficulties with walking, using stairs and rising from chair.

A physical examination of the patient is done to assess for:

  • Quadriceps wasting
  • Bow legged deformation (varus) or knock knee deformity (valgus)
  • Swelling of the knee
  • Flexion contracture (Difficulty straightening knee /leg)
  • Wasting of hamstring and calf muscles
  • Bilateral varus thrust
  • Crepitus
  • Sensory changes (loss of sensation)
  • Effusion (test with effusion wipe test)
  • Extensor lag
  • Knee flexion
  • Knee pain location through palpation of the joint
  • Impact of valgus and varus loading

X-rays are examined for:

  • Loss of joint space
  • Osteophytes
  • Cystic changes in bone
  • Sub-chondral sclerosis
  • Tibial subluxation relative to femur
  • Widening of lateral/colateral ligament
  • Patello femoral ligament articulation changes
  • Joint space narrowing