Bilateral knee osteoarthritis

The patient is here for follow-up appointment for her pain in her bilateral knees and osteoarthritis bilateral knees. She is status post left knee intraarticular PRP injection. She is almost five weeks after the PRP injection with no significant pain relief. She is doing physical therapy with some improvement. The patient has also started noticing pain in the right knee, especially in the back of the knee. She saw a rheumatologist a month ago who sent her to ER to rule out a clot, which she had an ultrasound done and apparently the clot was negative. She also had an MRI of the right knee, which showed tricompartmental arthritis changes and loose body within the suprapatellar bursa. Otherwise, she has no new complaints since her last office visit. There are no other changes in her past medical history, past surgical history, or medication allergies.

DIAGNOSIS:
Bilateral knee osteoarthritis.

RECOMMENDATIONS:
I will start the patient with physical therapy for the right knee two to three times a week for four weeks. I also discussed option if the patient does not want to go for knee replacement, a Zeel injection in the left knee. The patient wants to think about it and is interested in trying it.

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