As a Personal Injury Attorney, you may focus on the actual loss of function of a particular body part. However, since the body works as a whole and is therefore synergistically greater than the sum of its parts, the loss can have a ripple effect on the body’s functionality and your client’s state of mind.

Let’s look at what may initially be a localized knee injury.

A hypothetical 43-year-old male, previously healthy, with an active lifestyle, is involved in a motor vehicle accident (MVA) whereby he sustains only an injury to the knee, specifically a displaced tibial plateau (knee bone) fracture requiring surgery. The mechanism of action is the transfer of energy driving the victim’s femur (thigh bone) into their tibia (main bone in the lower leg/part of the knee) like a mallet hitting an anvil, and concomitantly driving the knee into the steering column.

What are some of the repercussions or side effects of knee surgery?

Gait changes
Back Pain
Deterioration in sports performance
Chronic pain at the site of injury/surgery
Weight gain from limited activity
Depression from weight gain
Depression from loss of hobbies
Need for future surgery such as Total Knee Replacement (TKR)

How can knee surgery affect my gait?

Did you know that knee surgery can alter a person’s gait enough to cause a person to step incorrectly and have a repetitive injury to the foot? The resultant antalgic gait is characterized by disruption in a person’s walking pattern that’s usually caused by pain or prior surgery. This can in turn cause chronic back pain secondary to favoring the other leg and not walking upright.

What are some secondary effects of a joint fracture?

The movement of a joint relies on the smooth surface of the cartilage to articulate with another smooth surface of the cartilage and the joint fluid between the two (synovial fluid). Joint fractures forever disrupt the virginal surface of these surfaces. The body then will attempt to repair this naturally but a common side effect of this repair is arthritis, an inflammation of the joint. Symptoms of knee arthritis include pain with use, stiffness, swelling, and inability to tolerate exercise, stairs, or running. With a tibial plateau fracture, it is not uncommon to develop severe arthritis requiring a knee replacement.

This example of a tibial plateau fracture from an MVA is one area of bodily insult that can have a domino effect on both functionality and mental mindset even with the surgical repair using all the advances of modern medicine.

This hypothetical 43 y/o man will be unlikely to perform as optimally as he would prior to the accident some are at higher risk for post-traumatic osteoarthritis (1) which will result in chronic pain and future surgery.

Can an Independent Medical Exam negatively affect your client’s claim for damages?

An independent Medical Exam (IME) is usually performed by a specialist who is hired to determine the damages sustained by a personal injury client. Usually, this exam is performed by a physician hired by the defendant.

How can you ensure that this exam is performed fairly and objectively? The optimal way is for you to have a physician representing your client observe the IME.

At Medical Legal Consults, Dr. Louis, a Board Certified Emergency Physician practicing for 20 years, will assess personally your case from a holistic perspective. He will take into account the injury and how it has already affected and will affect, your client personally. Our fees are also significantly lower than a specialist’s fees and we can guide you if and when you might to get a specialist involved. If a specialist is needed, Dr. Louis can also help to facilitate that process.

In summary, when assessing the impact of a knee injury on a client, consider the following:
Does your personal injury case take into account all the factors that are affecting your client?
If your client agrees to settle their case, he/she will get a lump sum. Together with the client, it is wise to consider whether this amount of money will cover your client’s cumulative loss of functionality and potential employment ability for the remainder of their life?
Would a well-composed, clearly written report more clearly communicate the complete physical impact and full value of your case to the opposing counsel?
Do you have physician representation in your clients’ IME to ensure objectivity?

We are here to help you answer these questions. To learn more about Medical Legal Consults, or to speak with Dr. Louis, send us an email at or click here to schedule a free consultation.

FOLLOWING TIBIAL PLATEAU FRACTURE Y. Warschawski y, A. Mor z, A. Elbaz z, G. Segal z, A. Haim x, E. Jacov y, A. Grundshtein y, D. Norman x, E. Steinberg y. y Sourasky Med. Ctr., Tel Aviv, Israel; z Apos Med. and Sports Technologies, Herzliya, Israel; x Technion-Israel Inst. of Technology, Haifa, Israel; k Rambam Med. Ctr., Haifa, Israel

Paul Louis, M.D. is a full-time practicing Emergency Medicine Physician and part-time blogger.