Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • suspected acute bone or joint infection: do not commence antibiotics until reviewed by specialist medical officer, contact the on-call registrar to discuss clinical concerns
  • suspected fracture or dislocation
  • tense effusion/hemarthrosis
  • ruptured or severed tendons
  • multiple ligament knee injury

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 — appointment clinically indicated within 30 days

  • suspected malignancy
  • acute loss of full extension of the knee
  • single acute knee ligament injury

Category 2 — appointment clinically indicated within 90 days

  • new onset pain in previous arthroplasty joint
  • chronic functional instability of knee
  • patella instability
  • effusion of unknown origin

Category 3 — appointment clinically indicated within 365 days

  • osteoarthritis of the knee
  • meniscal injuries
  • functional impairment with or without pain unresponsive to maximal medical management

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • complete past medical history
  • current medication list
  • body mass index (BMI)
  • previous surgery
  • private health cover/compensable status e.g. WorkCover claims
  • employment status (category 2 and 3 patients)
  • neurovascular assessment (emergency presentations only)
  • management history including:
    • injury/trauma if relevant
    • onset and duration
    • pain
    • associated features, e.g. swelling, instability
    • functional impairment
    • use of immobiliser/splint/cast
  • functional range of motion (ROM)
  • bilateral plain knee X-ray weight bearing anterior posterior, lateral and skyline views include radiological details/accession number

Additional information to assist triage categorisation

  • complete blood examination (CBE)
  • electrolytes, urea, creatinine (EUC)
  • liver function tests (LFTs)
  • estimated glomerular filtration rate (eGFR)
  • erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • glycated haemoglobin test (HbA1c)
  • smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation
  • alcohol and other drugs history including type, amount and frequency

Clinical management advice

Consideration of risks versus benefits of surgical intervention may include:

  • age
  • frailty
  • additional comorbidities
  • patient expectations of outcome
  • patient suitable for surgery, engagement in self-management
  • body mass index (BMI) and weight loss
  • smoking/vaping status - if active, strongly consider referral for smoking/vaping cessation.

Optimisation of chronic medical conditions should occur as part of initial assessment and conservative management as this may impact on suitability for surgical intervention.

Patients with BMI ≥ 35 should be referred for weight loss management with or without bariatric opinion. Patients with BMI ≤ 40 may be considered for review with documented evidence of participation in attempts to lose weight.

Clinical resources