Fall & winter care
Innovare TxRegenerative & Wellness
Knee Program · Step 1

What actually happens at your knee evaluation

Forty-five minutes, one provider, and a written plan at the end of it. Here is the visit, in the order it happens, so nothing about it is a surprise.

Book Your Visit (214) 233-3094
In short
A knee evaluation at Innovare Tx is roughly a 45-minute visit with Charles Ortega, PA-C: a structured history, a hands-on examination of the knee and the joints above and below it, in-office ultrasound of the soft tissue where it is useful, and a review of any imaging you bring. You leave with a working diagnosis, a plan for the next six to twelve weeks, and a reassessment date already in the calendar.

The history is not small talk

Most of the diagnostic information in a knee comes from the story, not the scan. Where exactly it hurts, what you were doing when it started, whether it swelled within an hour or over two days, whether it catches or gives way, whether stairs down are worse than stairs up — each of those points somewhere different. A knee that swells within an hour of an injury is a different problem from one that puffs up the next morning.

We will also ask about the boring things that turn out to matter: what your work requires you to do, how far you can walk before it stops you, what you have already tried and for how long, and what you actually want to get back to. The last one shapes the plan more than anything else on the list.

The examination

The knee is examined, but so are the hip and the ankle, because a knee frequently pays for what the joints either side of it are not doing. A typical examination covers:

  • Observation of gait, standing alignment and how you rise from a chair
  • Range of motion, active and passive, compared side to side
  • Palpation of the joint line, tendons, bursae and patella
  • Ligament testing — ACL, PCL, MCL and LCL
  • Meniscal provocation tests and patellofemoral assessment
  • Quadriceps and hip strength, and single-leg control

Where ultrasound fits

We use ultrasound in the room, which changes the visit in two ways. First, it is a live look at the soft tissue — tendon, bursa, effusion, a Baker’s cyst behind the knee — while you move, which a static image cannot do. Second, if an injection or an aspiration is appropriate, the needle can be placed under direct vision rather than by feel.

It has real limits, and we would rather state them than let the technology do the selling. Ultrasound does not see inside the joint the way an MRI does, it does not grade cartilage reliably, and it is not the tool for assessing joint space narrowing — that is a weight-bearing X-ray. If a study you do not yet have would change the plan, we order it. If it would not, we say so.

What we do with imaging you already have

Bring the report. Patients routinely arrive with a phone full of images and no radiologist’s report, and the report is the part that carries the findings. If you have had knee surgery, the operative note is worth more than either — it says what was actually found and what was done about it.

A great deal of what we do at this step is translation. An MRI report on a knee over forty almost always contains findings that sound alarming and are extremely common in people with no pain at all. Knowing which findings on your report are likely relevant to your symptoms, and which are background, is most of the value of the visit. Our knee and orthobiologic glossary covers the terms you will see in writing.

The plan, and the date

You leave with a plan for the next six to twelve weeks and a reassessment already scheduled. That date matters: it is what turns “how does it feel?” into a comparison of the same measurements taken twice. If the plan is working we continue it. If it is not, we change it, and sometimes the change is a referral elsewhere.

Only after that do procedural options belong in the conversation — the autologous orthobiologic procedures we perform here, or a referral for genicular artery embolization or a surgical opinion.

PRP, PPP, BMAC, and A2M are autologous procedures prepared from your own blood or bone marrow. They are considered investigational and are not FDA-approved for the treatment of any specific orthopedic condition, including osteoarthritis. Individual results are not guaranteed. Any decision to pursue an orthobiologic procedure should be made with your provider after a clinical evaluation.

Questions, answered

Evaluation FAQs

Plan on about 45 minutes for a first visit. That covers the history, the hands-on examination, an ultrasound look at the soft tissue when it is useful, a review of any imaging you brought, and the conversation about what happens next. Arriving ten minutes early with your paperwork done keeps the clinical time clinical.
No. If you already have imaging, bring the written report — it is often more useful than the images themselves, and it can save you a repeat study. If you have never had knee imaging, the evaluation decides whether any is worth ordering. Imaging that will not change the plan is not worth your deductible.
Ultrasound is good at soft tissue and fluid: tendons, the quadriceps and patellar tendon, bursae, joint effusion, and Baker's cysts at the back of the knee. It also lets an injection be placed under direct vision instead of by landmark. It does not show the inside of the joint the way an MRI does, it does not grade cartilage reliably, and it does not replace an X-ray for assessing joint space.
Not as a matter of course. The first visit is for working out what is going on. If an aspiration or an injection is clinically appropriate and you want to proceed, that can be discussed, but nothing procedural is presented as a foregone conclusion. Autologous orthobiologic procedures in particular are only discussed after a clinical evaluation of your imaging, your goals and your overall health.
Charles Ortega, PA-C, MPAS, co-founder and lead provider, with 27+ years of medical experience and care in English and Spanish. Dr. Nathan V. Nguyen is the co-founder and supervising physician. If physical therapy becomes part of the plan, Rowena Calleja, PT works in the same building, so the handover is a conversation rather than a referral letter.
A working diagnosis or a short list of what it is most likely to be, an explanation of what your imaging does and does not show, the plan for the next six to twelve weeks, the date of the reassessment, and a plain answer about whether anything in our clinic is likely to help — including when the honest answer is that it is not.

Start with the evaluation

Book at our Addison clinic, or call and we’ll verify your insurance before you come in.

Book Your Visit (214) 233-3094
Call UsRequest a Visit