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Diagnosis and management of chronic hip and knee pain in a Tasmanian orthopaedic clinic: a study assessing the diagnostic and treatment planning decisions of an advanced scope physiotherapist

Citation

Jovic, D and Mulford, J and Ogden, K and Zalucki, N, Diagnosis and management of chronic hip and knee pain in a Tasmanian orthopaedic clinic: a study assessing the diagnostic and treatment planning decisions of an advanced scope physiotherapist, Australian Journal of Primary Health, 25, (1) pp. 60-65. ISSN 1448-7527 (2019) [Refereed Article]

Copyright Statement

Copyright 2019 La Trobe University

DOI: doi:10.1071/PY18076

Abstract

The aim of this study is to investigate the clinical effectiveness of an advanced practice physiotherapist triaging patients referred from primary care to the orthopaedic clinic with chronic hip and knee pain. An exploratory study design was used to assess 87 consecutive patients referred from general practice in Northern Tasmania. Patients were assessed by both an advanced practice physiotherapist and a consultant orthopaedic surgeon. Diagnostic and treatment decisions were compared, with the orthopaedic consultant decision defined as the gold standard. By using these decisions, over and under referral rates to orthopaedics could be calculated, as well as the surgical conversion rate. Conservative care of patients referred to the orthopaedic clinic with hip and knee pain was limited. The diagnostic agreement between the advanced scope physiotherapist and the orthopaedic surgeon was almost perfect (weighted kappa 0.93 (95% CI 0.87-1.00)), with treatment agreement substantial (weighted kappa 0.75 (95% CI 0.62-0.89)). Under a physiotherapist-led triage service, the surgical conversion rate doubled from 38% to 78%. An advanced physiotherapist assessing and treating patients with chronic hip and knee pain made decisions that match substantially with decisions made by an orthopaedic consultant. A model of care utilising an advanced physiotherapist in this way has the potential to support high-quality orthopaedic care in regional centres.

Item Details

Item Type:Refereed Article
Keywords:joint replacement, assessment, non-operative, orthopaedics, osteoarthritis, physiotherapy, triage
Research Division:Health Sciences
Research Group:Allied health and rehabilitation science
Research Field:Physiotherapy
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Allied health therapies (excl. mental health services)
UTAS Author:Ogden, K (Dr Kathryn Ogden)
ID Code:143826
Year Published:2019
Web of Science® Times Cited:3
Deposited By:Medicine
Deposited On:2021-04-06
Last Modified:2021-05-24
Downloads:0

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