Non-operative management usually includes a detailed history of the condition, details of the current symptoms and disability, current and previous medications and past medical history. Clinical examination is undertaken by Mr. Johnson and subsequently radiographs or MRI scans can be arranged if necessary. An opinion is usually then available and discussed with the patient. Mr. Johnson will outline options for further treatment, and patients will then be encouraged to participate in the decisions about which treatment options are most appropriate. Initial management for some conditions may include physiotherapy, use of anti-inflammatory medication (Ibruprofen, diclofenac, vioxx etc), and bandages and supports. Joint injections either with hyaluronic acid (Synvisc) or methyprednisiolone may occasionally be considered. If non-operative management proves unsatisfactory with an inability of the patient to return to their desired activity or further instability occurs then the surgical option can always be revisited.
Alternately if the symptoms are significant or non-acute or non-operative treatment has been undertaken for a time, the prospect of early surgical intervention and arthroscopy may be appropriate and this will be discussed with patients.