[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Clinical Crossroads
Clinician's Corner
February 26, 2003

A 57-Year-Old Man With Osteoarthritis of the Knee

Author Affiliations

Author Affiliation: Dr Lonner is attending orthopedic surgeon, Pennsylvania Hospital, Philadelphia.


Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.

JAMA. 2003;289(8):1016-1025. doi:10.1001/jama.289.8.1016

DR SHIP: Mr V is a 57-year-old man who has had knee pain for at least 30 years. He lives in Boston with his wife, with whom he owns and runs a business. He has managed care insurance and sees his primary care physician, Dr P, at Beth Israel Deaconess Medical Center.

Mr V dates the onset of his left knee problems to a soccer injury at age 26. He was diagnosed with rupture of 2 ligaments and underwent a course of physical therapy. His pain diminished over time, but he was aware that his left knee was never again at "100%." He continued his active athletic life, which included soccer, bicycle racing, and running at least 3 times per week. About 15 years ago, however, pain in his left knee recurred and became severe enough that he stopped running and moved largely to long-distance cycling. Thirteen years ago he underwent an arthroscopic debridement. This improved his level of function and decreased his pain for approximately 2 years, but symptoms subsequently recurred. He has since had several courses of physical therapy but has found the recommended exercises to be so painful that he could not complete them.

First Page Preview View Large
First page PDF preview
First page PDF preview