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Warwickshire Knee Referral Pathways

Osteoarthritis – OA. Inflammatory (non-traumatic joint swelling and pain). Anterior Knee Pain (no dislocation). Recent Injury (plus mechanical symptoms Eg locking, swelling, giving way, no OA). Injury MRI if suspected Meniscus/ACL chondral injury after 6/52 therapy.

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Warwickshire Knee Referral Pathways

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  1. Osteoarthritis – OA Inflammatory (non-traumatic joint swelling and pain) Anterior Knee Pain (no dislocation) Recent Injury (plus mechanical symptoms Eg locking, swelling, giving way, no OA) Injury MRI if suspected Meniscus/ACL chondral injury after 6/52 therapy Patient Presents to GP, Patient Willing to be Referred, Offered Informed Choice & Entering Pathway, OA knees must have X rays prior to referral Warwickshire Knee Referral Pathways OA Severe Injury Mild No giving way No locking Injury No locking But JLT effusion Inflammatory Single Joint Inflammatory Multiple Joints or Non-articular features & positive bloods Injury Meniscal tear ACL Ligament History of: Twist + POP + unstable knee or locking Anterior Knee Pain Multiple Dislocator OA Moderate Anterior Knee Pain syndrome Anterior Knee Pain Patellar Mal alignment OA Mild Negative Bloods Positive Bloods X-rays bone on bone Functionally restricted Weight loss Encourage exercise Analgesia Consider NSAIDs Secondary Care For inflammatory conditions consider Rheumatology MUSCAT Orthotics + injection for Moderate OA Physiotherapy Failed Failed Surgery Failed Physiotherapy Rehabilitation Agreed Orthopaedics 2008 (Revised and consolidated May 2010/May 2012) Agreed –June 2012)

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