DOI: 12/13/2012. This is a case of a 63-year-old male security officer who sustained a work-related injury to the right knee when he missed a step and fell down the stairs. As per Omni, the patient had a right knee meniscus tear. The patient had right knee replacement on 11/19/14.
Per progress report dated 10/23/14 medicatiosn include Atenolol, Norco and cyclobenzaprine.
Based on progress report dated 07/06/15, the patient presents with chronic right knee pain, described as dull and achy. Pain is worsened by sittlng,standing, and walking, and relieved by walking/exercise.
He has been weaning norco and flexeril. He has also recently received part of a series of synvisc injections, which have helped somewhat.
He reports increased pain since last
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His use of medications has decreased substantially. He uses one Norco 7.5/325 every 2-3 days. This is down from 1 tablet 4 times a day. Norco provided 50% reduction in pain. There are no adverse effects or aberrant behaviors. CURES report was reviewed. Last urine drug screen on 12/04/14 was appropriate.
On examination, there is tenderness upon palpation over right medial knee joint line. Mild atrophy of right medial quadriceps muscle is noted. Strength is 4/5 with knee extension on the right compared to the left.
Patient is able to raise from a seated position with mild difficulty. Gait is antalgic.
Current medications include Atenolol, Norco 10-325 mg 1 tablet every 6 hours as needed and Cyclobenzaprine 10 mg 1 tablet 3 times daily.
IW was diagnosed with knee pain.
He was advised to decrease Norco 7.5/325 mg from 4 times daily to twice daily as needed #60 (should last 45 days) and Cyclobenzaprine 10 mg 1 tablet twice a day as needed #90 for 6 weeks.
Per Review # 197682, the IW was certified with a 30-day supply of Flexeril 10mg for weaning to discontinue.
Current request is for 45 Tablets of Norco 7.5/325 mg; and 90 Tablets of Cyclobenzaprine 10 mg between 7/14/2015 and