Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • acute, multiple ligament knee injury (Grade 3 – complete) with uncontrolled pain and compromised mobility
  • acute, post-surgical complications (for example bleeding, infection, wound breakdown)
  • acute onset painful atraumatic knee effusion or haemarthrosis
  • ruptured or severed tendons
  • suspected acute bone or joint infection
    Note: do not commence antibiotics until reviewed by specialist medical officer. Contact on-call registrar to discuss clinical concerns.
  • suspected fracture or dislocation.

When public outpatient services are not routinely provided

  • Mild knee osteoarthritis or soreness.
  • Uncomplicated degenerate meniscal tears.
  • Uncomplicated inflammatory arthropathy (including crystal arthropathies).
    Note: consider referral to rheumatology.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Acute obstructed or locked knee (i.e. unable to reach full extension).
  • Acute, single ligament knee injury (Grade 2 or 3 – partial or complete) with functional knee instability.
  • Acute, multiple ligament knee injury (any grade) with functional knee instability.
  • Acute loss of full knee extension.
  • Post-primary patella dislocation.

Note: Consider assessment and treatment by physiotherapist prior to referral

Category 2
Recommended to be seen within 90 calendar days.

  • Knee pain identified due to post-traumatic injury and/or effusion.
  • Recurrent functional knee instability associated with suspected knee ligament injury.
  • Patella instability.
  • New onset knee pain in previous arthroplasty joint.

Note: Patients are strongly encouraged to have undertaken a trial of non-operative management (including exercise and physiotherapy, optimisation of health co-morbidities) prior to referral.

Category 3
Recommended to be seen within 365 calendar days.

  • Meniscal injuries in the absence of locked knee.
  • Functional impairment without knee instability and/or with knee pain persists despite maximal management.

Note: Patients are expected to have undertaken a trial of non-operative management (for example exercise and physiotherapy, optimisation of health co-morbidities) prior to referral.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition, including symptoms and their duration, severity, location of pain and impact on function.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • management history including injury or trauma (if relevant), onset and duration, pain, associated features (for example swelling, instability), functional impairment and use of immobilisation, splint or cast
    • x-ray: bilateral knees – anterior to posterior (AP), lateral and skyline views (weight bearing).

If available

  • MRI result: knee (if suspected locked knee, significant internal or ligamentous derangement).
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ or among a vulnerable, disadvantaged or priority population.
  • If the patient is willing to have surgery (where clinically relevant).
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.
  • If the patient requires an interpreter (if so, list preferred language).

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

Contact us

If you would like to provide feedback about the contents of this page, please submit an enquiry to the SRC project team at NSW Health.

Submit an enquiry

Current as at: Monday 17 June 2024
Contact page owner: System Purchasing