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General Orthopaedics

A State Hospital Soft Tissue Knee Service, Is There A Need?

The South African Orthopaedic Association (SAOA) 57th Annual Congress



Abstract

Introduction:

South Africa has a very sports orientated population and a high blunt trauma prevalence. In August 2008, we re-established the soft tissue knee service at our academic hospital. Our clinic is staffed by a sessional Consultant, a Registrar, and is overseen by a senior honorary Consultant. Here we present a review of our first 2 years experience.

Methods:

The clinic operates on a referral basis. All patients have all their clinical and demographic data and referral data entered into a Soft Tissue Database. The Data for 2009 and 2010 data were collated and analysed.

Results:

A total of 346 patients were assessed and treated, of which 162 received surgery during this period. Patient referrals originated from both the state and independent sectors, and were made by hospital specialists, physiotherapists, and general practitioners. The mean delay from referral to first consultation was 9 days, and the mean wait from first consultation to surgery was 6 weeks. Our 162 procedures comprised of ACL reconstructions (52), PCL reconstructions (5), multiple ligament reconstructions (10), and osteotomies (4), as well as other procedures (91). There were 6 recorded major complications.

Discussion:

A referral based specialist clinic can be successfully operated in a government hospital, and deliver both high quality clinical care, and valuable training opportunities to our trainees. Although currently staffed by part-time staff we believe that we have the capacity for many more patients and believe that we are only treating a small percentage of those in need. We want to increase awareness and referrals.