610 - When Acute Disability Meets Chronic: An Unexpected Gaitkeeper

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

JW

Justin Wang, MD

PM&R Resident Physician
Nassau University Medical Center
East Meadow, New York, United States

Co-Author(s)

CK

Chi Lam Kwok, DO

PM&R Resident
Nassau University Medical Center
Rego Park, New York, United States
BF

Brent Fogel, DO

PM&R Resident
Nassau University Medical Center
Melville, New York, United States
FB

Forrest Butensky, DO

Resident Physician
Nassau University Medical Center
East Meadow, New York, United States
RC

Ricardo Cruz, MD

Attending Physician
Nassau University Medical Center
East Meadow, New York, United States

Submitter(s)

JW

Justin Wang, MD

PM&R Resident Physician
Nassau University Medical Center
East Meadow, New York, United States

Case Diagnosis: Chronic Meniscal Injury

Case Description: A 56 year old male was admitted to acute inpatient rehabilitation for acute stroke of the right middle cerebral artery causing left sided sensorimotor deficits. While admitted the patient was discovered to have right leg contribution to his gait abnormality. On exam, the patient had a firm, hypermobile, painless mass of the right knee. The patient denied knee pain or instability. He attributed it to playing basketball and feeling a “pop” 6 years prior for which he did not follow up. An MRI of the knee was obtained and showed lateral compartment arthrosis with degenerated and torn lateral meniscus, medial compartment arthrosis with tear of the medial meniscus, and moderate effusion with two large intra-articular loose bodies.

Discussions: Chronic knee meniscus injuries usually arise from degenerative changes, but can be seen in prior acute injuries that failed to heal. When not properly addressed, it can lead to progressive meniscus degeneration, cartilage disruption, development of osteoarthritis, and ultimately loss of functional status. Management starts conservatively with physical therapy, pain control, and activity modification. If this fails then surgical options are considered, especially if the patient is young/active. Development of intra-articular loose bodies can occur when repetitive wear and tear lead to fragmentation of the damaged meniscus and cartilage. Management of loose bodies is similar to that of chronic meniscus injury.

Conclusions: This case highlights the importance of a comprehensive approach during inpatient rehabilitation. While the patient was admitted for left-sided deficits, his pre-existing, undiagnosed orthopedic pathology contributed to his impaired gait mechanics and functional limitations. Addressing chronic musculoskeletal injuries is critical in maximizing rehabilitation outcomes, especially in patients with new-onset disability. Early recognition and multidisciplinary coordination can optimize mobility, prevent further joint degeneration, and improve long-term function.