prolotherapy-knee

As Seen On...

Knee


Front
knee

MCL LCL PesAnserine LateralTibialPlateau MedialTibialPlateau InferiorPoleofthePatella SuperiorPoleofthePatella
Appearance


Palpation
1. MCL R L
2. LCL R L
3. Pes Anserine R L
4. Lateral Tibial Plateau R L
5. Medial Tibial Plateau R L
6. Inferior Pole of the Patella R L
7. Superior Pole of the Patella R L
8. Other
Observed Abnormality? Yes No

Sensation Intact? Yes No

Moves Extremities w/o Deficit? Yes No


Range of Motion

Valgus Stress
FullLimited    LevelPainExplain
Varus Stress
FullLimited    LevelPainExplain
Anterior Drawer
FullLimited    LevelPainExplain
Posterior Drawer
FullLimited    LevelPainExplain
Other
FullLimited    LevelPainExplain


Procedure Note
Consent
Skin Cleaned with Chlohexadine
Other

Tender Points Injected with:Dextrose PRP
Joint Injection:Dextrose PRP Stem Cell


Resolution of Symptoms? Yes No

Tolerated Well? Yes No
Procedural Sedation:
Dose

Dose

Dose