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TC is a 70-year-old man with a 4-to-5-year history of right knee pain. Initially, the pain was a mild ache that bothered TC after walking his Golden Retriever for 3 miles. More recently, the pain has become sharper. TC perceives the discomfort in the medial side of the knee. The pain limits his ability to climb 2 flights of stairs or walk a half mile. TC is disappointed that he can no longer walk 3 miles with his dog or hike in the woods with his wife and adult daughter. Initially, TC's symptoms were managed by simply resting after long walks and taking acetaminophen if the ache persisted for more than an hour. More recently he has been using ibuprofen 200 mg tablets, 1 or 2 at a time, 2 or 3 times a day.
What would be your recommendations for him? Please include pharmacologic and nonpharmacologic therapies as well as any pertinent education.
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