chapter 3: History and Physical Examination

History of Prior Surgeries

If a patient has had previous surgery, did the symptoms change postoperatively? If preoperative complaints were related only to pain, and postoperative complaints include instability, one should suspect that postoperative instability is the result of unnecessary or excessive realignment surgery. Conversely, if preoperative complaints were primarily instability, and constant pain occurs postoperatively, postoperative neuroma, RSD, or inappropriate shifting of articular load onto an articular lesion should be concerns.

Operative notes and, if available, arthroscopic photos or videotapes provide important information. Particular attention should be paid to the condition of the articular surfaces and the extent of any soft‑tissue release or realignment. Patient understanding and recall of information from prior surgeries is sometimes incomplete and it is the responsibility of the examiner to obtain the most accurate records available. Review of such records can be quite enlightening and is always worth the time invested.






Inside Chapter 3: