What is a great monthly maintenance routine for optimal performance? Looking to optimize my MacBook Pro 2010 for audio and visual creation.

There is one very simple thing you should do, and that is leave it alone. Macs don't need 'defragging' or 'cleaning up' or 'optimizing' - there are programs which offer this sort of thing and they mostly do more harm than good (and some of them are close to being malware). Macs have built-in procedures for looking after themselves and you've already done the few things you can do yourself. Incidentally, don't be tempted to delete any program which is part of the system, such as iTunes or Quicktime - doing so can lead to unexpected problems.

None you need to do. There is no need to "optimize" the computer. Just use it sensibly. Don't run more concurrent applications than is supported by the installed RAM. Maintain at least 20 GBs of free space on the disk drive. Avoid third-party add-ons you really don't need. Don't install software you don't know how to uninstall. Don't install anything unless you know exactly what it does. Don't delete files unless you know the consequences of doing so - stay away from system files.