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A 48-year-old woman with right knee pain

A 48-year-old woman with a history of hypertension, rheumatoid arthritis treated with chronic prednisone, and a two-pack-per- week cigarette use, presented to clinic with 8 years of right knee pain. She had an intra-articular steroid injection with some relief 6 years ago. She denied any hip pain and uses a cane for ambulation. On physical examination she appears to be a healthy 5’2’’, 160-pound woman who walks with an antalgic gait. She has a 20° flexion contracture, with flexion limited to 90°, and a mild valgus deformity of her knee. The extremity was neurovascularly intact and she had full, painless hip range of motion.

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