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Knee pain (chronic)

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
  • Knee extensor mechanism rupture
  • Suspected fracture
  • Evidence of acute inflammation for example
    • haemarthrosis
    • tense effusion
  • Suspected infection or sudden pain in arthroplasty
  • if joint infection is suspected refer immediately to emergency or contact the orthopaedic registrar on call.  Do not commence antibiotics unless delay to specialist review is likely

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

  • Suspected malignancy
  • New pain in previously well-functioning arthroplasty

Category 2

Appointment within 90 days is desirable

  • Symptoms rapidly deteriorating and causing sever disability

Category 3

Appointment within 365 days is desirable

  • Some functional impairment and/ or pain persists despite maximal management

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 for assessment and management information if available
  • Consider pre-operative optimization of patient with diagnosed and undiagnosed diabetes, prior to referral
  • Better health self-management program
  • Obesity is associated with an increase in complications associated with surgery – consider dietitian & weight reduction monitoring if BMI >35.  Mandatory for BMI >40.
  • Chronic disease requires to be optimized prior to referral or the patients may not proceed to surgery
  • ACSQHC – OA of the Knee decision support tool
  • Consider pre-operative optimisation of anaemia, as defined by a haemoglobin of < 13.0g/dL in men and 12.0g/dL in women, prior to referral
  • Smoking is a contraindication to hip and knee arthroplasty surgery

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • General referral information
  • History of symptoms: pain, true locking, instability, swelling, recurring infections
  • Injury details (if any): date, mechanism, severity, recurrence and evolution of injury
  • Previous joint surgery
  • HbA1C (diabetic patient referral only)
  • True locking (vs intermittent stiffness)
  • Results of clinical ligament and meniscus tests if completed
  • Height, weight and BMI
  • XR results – knee, weight bearing AP, lateral and skyline of both knees
  • Smoking status
  • FBC, ESR, CRP, Iron studies results (if indicated by medical history)

Additional referral information (useful for processing the referral)

  • Management to date
  • Has non-operative management been completed?
  • Hip and knee questionnaire (patient to complete)
  • Investigations for inflammatory arthropathy

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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