Knee injury (acute)

ADULT
  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Suspected septic arthritis
    • Acute extensor mechanism rupture
    • Fracture
    • Evidence of acute inflammation for example:
      • haemarthrosis
      • tense effusion
    • Refer to HealthPathways or local guidelines
    • Ultrasound may be helpful in diagnosing collateral ligament injuries or meniscal tears if patient does not meet MRI eligibility criteria
    • Adequate chronic disease/lifestyle (SNAP) management is a requirement for most surgical procedures
    • QH infection prevention in arthroplasty guideline
    • Pre-operative optimisation for hip and knee arthroplasty
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)

  • Obstructed/locked knee (unable to reach full extension) with confirmed displaced meniscal tear or loose body and no evidence of arthritis on Xray
  • Collateral ligament injury grade 2/3 with or without associated cruciate ligament injury
  • Displaced osteochondral fragment with otherwise normal cartilage
Category 2
(appointment within 90 calendar days)

  • Isolated displaced meniscal tear in patient < 30
  • Displaced meniscal tear + cruciate ligament rupture in patient < 50
Category 3
(appointment within 365 calendar days)

  • Cruciate ligament injuries not meeting criteria for Category 1 or 2
  • Suspected or confirmed meniscal injuries not meeting criteria for Category 1 or 2 that fail to settle after 3 months of non-operative management
  • Patella instability without displaced osteochondral fragment

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Mechanism of injury
  • Current symptoms
  • Examination findings including swelling/effusion, range of motion and ligament exam
  • MRI if patient meets eligibility criteria
    • Inability to extend the knee
    • Suspected anterior cruciate ligament tear
  • Plain Xray if not eligible for MRI

3. Additional referral information Useful for processing the referral

  • Previously injury or surgery
  • Management to date
  • Private MRI images to be pushed into the referral (can be requested by GP to action)

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and available, the referral may be streamed to an associated public allied health and/or nursing service. This may include initial assessment and management by associated public allied health and/or nursing, which may either expedite or negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 13 February 2024

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