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CAN PHYSIOTHERAPISTS BE USED TO ASSESS ACUTE KNEE INJURIES IN OUTPATIENT CLINICS?



Abstract

Background: In an effort to reduce the waiting times for outpatient appointments and surgery ‘Direct Access Arthroscopy Services’ have been set up in some centres whereby GP’s assess patients with acute knee injuries.

The value of a physiotherapist in the Back Pain clinic is well known, however their effectiveness in an Acute Knee Injury Clinic has not been documented despite the fact that they have already been used in some centres to triage these injuries.

Purpose of study: This study was therefore set up to determine if an experienced physiotherapist can accurately diagnose an acute knee injury and formulate a treatment plan.

Methods: 50 consecutive patients with acute knee injuries were seen in the fracture clinic. They were each assessed and a diagnosis made and treatment plan formulated by the consultant, an orthopaedic SHO and two experienced physiotherapists in random order. Evaluation was by history, examination and X Rays. Final diagnosis was based on arthroscopic findings, further investigations or response to conservative treatment.

Results: We found no statistically significant difference in the clinical diagnosis and treatment plans made by the consultant and the orthopaedic physiotherapist p> 0.05 (Mc Nemar’s Test). In addition the physiotherapist had a higher proportion of correct diagnoses compared to the SHO. Again this difference was not statistically significant.

Conclusion: The results suggest that an experienced physiotherapist can safely and effectively be used to assess patients with an acute knee injury in the outpatient clinic setting.

The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.