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Firstly, I would establish what are the symptoms the patient is suffering from. I would focus on pain, loss of function and severity of symptoms. I would like to know the exact location of the pain, alleviating and relieving factors, and where the pain is radiating to. How the pain is affecting activities of daily living such as cutting toenails, putting shoes and socks on, how easy it is to go up and down stairs are all questions I would ask. Treatment to date is also important; has the patient had any physiotherapy/rehabilitation, trialled any analgesics? Previous surgical procedures need to be established. Assessment of the effect of osteoarthritis on the patient’s function, quality of life, occupation, mood, relationships and leisure activities is also important. Clinical examination findings such as assessment of the soft tissue envelope is also important. Severity of the deformity in the coronal plane will need to be established. A fixed flexion deformity should also be noted. The competency of the knee collateral ligaments and degree of deformity correction should be assessed in order to plan the type of implants.
Develop an aptitude for defining key topics, features and processes, vital for your FRCS (Tr&Orth) Viva exam success, with this newly updated and detailed guide. This new edition expertly delivers invaluable insights into tactics and planning, for candidates to sharpen exam skills, and gain confidence. Thoroughly updated to include an expanded basic science section, to answer all of your viva questions, this guide also supplies candidates with new illustrations and exam-specific diagrams; adapting to meet the expectations of a constantly changing syllabus. Vital for orthopaedic surgeons in training, this forward-looking text includes a drawing chapter, for candidates to practise creating succinct, exam-style illustrations, before the exam itself. Proactive in its approach, this book addresses the balance between trauma, general orthopaedics and basic science; by editors with extensive national and international experience of preparing candidates for the FRCS(Tr & Orth).