Clinical quiz: chronic knee pain worse with walking

 

A 67-year-old active male presents with chronic right knee pain that has been worsening over two years. He localises the pain specifically to the medial aspect of the knee. It is worse with walking and going up or down hills.

There is no pain at rest or at night, and no history of locking or instability. He still plays golf and cycles short distances but is unhappy with the ongoing unresolved pain despite maximal non-operative management.

On examination:...

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