Bilateral knee pain

The patient is a 63-year-old very poor historian. He presents today for evaluation of his knees to see if he will be a candidate for our knee protocol. He states he has been told that he needs bilateral knee replacements. He states he has had prior x-rays, but does not have them with him today.

IMPRESSION:
1. Suspected bilateral knee osteoarthritis.
2. Extremely poor historian.
3. History of two strokes; currently on aspirin 650 mg a day, but denies any other anticoagulant use.

PLAN:
We discussed his case and I told him that I would like to get copies of his x-rays. Due to the severity of his pain, I feel he should be fitted for bilateral unloader knee braces. I am fine with fitting him up for viscosupplementation protocol and we will get him started with that as well physical therapy. I told him to find his x-rays and bring them and we will order new x-rays as well. I have recommended that he come off his aspirin for five days prior to injection and he voices understanding. We will set him up for viscosupplementation protocol at this discretion.

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