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Replying to Thread: Gait derangement or Motion Abnormalities?
Created On Monday 13, October, 2008 2:19 AM by constantine

constantine
Junior Member

Posts: 19
Joined: Jun 2008

Monday October 13, 2008 2:19 AM

My patient has right knee impairment. the rom are as follows:

RANGE OF MOTION - KNEES

Flexion Right 85 degrees Left 98 degrees Normal 150 degrees
Extension Right 0 degrees Left 0 degrees Normal 0 degrees

The patient also has antalgic gait and uses a cane for balance.

What method should be appropriate? Gait derangement? or the motion abnormality of the knee impairment? By the way, the patient was status post right knee arthroscopy with partial medial menisectomy. Thanks again...

Edited: Monday October 13, 2008 at 2:20 AM by constantine

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lesliedilbeck
Member

Posts: 71
Joined: Feb 2006

Monday October 13, 2008 8:42 AM

Hello,

The range of motion would yield impairment. However, unless the contralateral uninjured side does not have injury or condition to warrant the 98 degrees your examinee's motion is considered within normal range as it is within the same range as the uninjured side. If you cannot give range of motion impairment you may give 2% lower extremity 1% wpi for the partial medial meniscectomy per Table 17-33.

Gait derangement impairment is not warranted in this case as you have more objective methods.

I hope this helps.

-------------------------
Leslie Dilbeck, W.C.C.P., C.I.R.
Senior Consultant
Brigham & Associates, Inc.

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constantine
Junior Member

Posts: 19
Joined: Jun 2008

Tuesday October 14, 2008 12:37 AM

hi, LD... thanks a lot... you've been a great help... :-)

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denyse
Senior Member

Posts: 740
Joined: Jun 2002

Monday October 20, 2008 12:59 PM

The section says more specific method, not objective. I see many doctors arguing that gait is the more specific for whatever reasons. I disagree, but...

Then it's up to the trier, who is a non medical expert under a court of liberal interpretation. As such, proceed with caution until we get some case law. BTW, most gait disputes are more solid under the lack of x-rays findings. Must have moderate to advance arthritis. If so, look for LC 4663.

The doctor needs to document why he feels gait is more specific. I would not advance to trial with the idea that the judge will toss the opinion because the doctor failed to document - too adverse to the IW. Make him put his opinion in writing, evaluate exposure, get a second opinion from someone above you in the food chain (file doc), and roll the dice. Most docs don't even understand what I am saying, so many will flop. Education.

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