W. Va. Code R. § 85-20-44

Current through Register Vol. XLI, No. 24, June 14, 2024

Section 85-20-44 - Treatment Guidelines: Meniscal Injuries

44.1. The mechanism of injury is similar to that for knee sprains but symptoms of pain and swelling fail to resolve in the anticipated period of time and the symptoms frequently include a sensation of "catching or giving away" of the joint and a history of locking of the joint may be elicited.

Clinical findings may include joint space tenderness, a mild effusion and restricted range-of-motion and positive McMurray's sign.

44.2. The appropriate diagnostic tests are as follows:

a. Plain x-rays;

b. Arthrocentesis;

c. MRI;

d. Arthrogram; and

e. Diagnostic arthroscopy.

44.3. The appropriate treatment is as follows:

a. Outpatient/nonoperative treatment.

1. Short-term use of nonsteroidal anti-inflammatory drugs in conjunction with an arthrocentesis and short-term immobilization with a period of limited weight bearing;

2. Physical modalities and/or rehabilitative procedures.

b. Outpatient/operative treatment.

1. Options include arthroscopic meniscectomy and/or arthroscopic meniscal repair; and

2. Physical therapy/rehabilitation.

c. Inpatient/nonoperative treatment not indicated.

d. Inpatient operative treatment - The reasons for admission for surgical treatment may include the presence of associated medical conditions, a concomitant knee injury such as a fracture of the tibial plateau or a major ligamentous disruption, or the presence of other injuries which require inpatient treatment.

44.4. The duration of treatment may vary up to three (3) months. The injured worker's age and pre-existence of arthritic changes within the joint will influence the duration of treatment.

44.5. The anticipated outcome is as follows:

a. Improved knee function with minimal residual symptoms; and

b. Possible predisposition to the development of traumatic arthrosis of the knee.

W. Va. Code R. § 85-20-44