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Knee injury (acute)

Emergency department referrals

All urgent cases must be discussed with the on call Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Royal Brisbane and Women's Hospital (07) 3646 8111
  • The Prince Charles Hospital (07) 3139 4000
  • Redcliffe Hospital (07) 3883 7777
  • Caboolture Hospital (07) 5433 8888

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) 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

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • 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 days is desirable

  • Isolated displaced meniscal tear in patient < 30
  • Displaced meniscal tear + cruciate ligament rupture in patient < 50

Category 3

Appointment within 365 days is desirable

  • 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

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • 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

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • 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

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)

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • 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

  • 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

  • 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

  • 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

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

  • 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.)
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