Supporting GPs in the management of lower-limb conditions
Adelaide OrthoCare provides assessment and management of patients with hip, knee, trauma and other lower-limb conditions.
The aim is to provide patients with a clear diagnosis, an understanding of their treatment options and an appropriate management plan, while keeping the referring doctor informed throughout their care.
Referral may be appropriate for patients with:
- Hip or knee pain affecting mobility or quality of life
- Osteoarthritis or other degenerative joint conditions
- Persistent symptoms despite appropriate non-operative treatment
- Suspected or established joint replacement requirements
- Complex or revision hip and knee arthroplasty
- Ongoing or new pain or instability following joint replacement
- Acute or chronic lower-limb trauma
- Fracture complications, including malunion or non-union
- Irritation from metalwork
- Lower-limb deformity
- Limb-length discrepancies
- Problems following previous orthopaedic surgery
- Uncertainty regarding diagnosis or appropriate management
- Patients seeking an orthopaedic opinion regarding treatment options
Referral does not necessarily mean that surgery will be recommended. Non-operative management and ongoing care in the community may be appropriate.
To assist with an efficient assessment, please include where available:
- Presenting symptoms and duration
- Relevant medical history and comorbidities
- Previous orthopaedic procedures or surgery
- Previous treatment and response
- Current medications
- Relevant examination findings
- Relevant imaging and reports
- Relevant pathology or investigation results
- Smoking status where relevant
- Functional limitations and impact on daily activities
- The specific clinical question or reason for referral
For patients being considered for joint replacement, information regarding previous injections, physiotherapy and other non-operative treatment can also be helpful.
Please include relevant existing imaging with the referral where available. For many lower-limb conditions, standing or weight-bearing X-rays can provide important information about alignment and joint space. The appropriate imaging depends on the clinical problem.
Please do not delay referral simply to obtain additional imaging if you are uncertain what investigation is required. Imaging can be arranged or reviewed as part of the orthopaedic assessment when appropriate.
At the initial consultation, the patient’s history, symptoms, examination and available investigations will be reviewed.
Treatment options will be discussed according to the individual patient’s circumstances. These may include:
- Education and reassurance
- Activity modification
- Physiotherapy and rehabilitation
- Medication
- Injections where appropriate
- Further investigation
- Surgical treatment where indicated
Where surgery is being considered, the benefits, risks, alternatives and expected recovery will be discussed with the patient before a decision is made.
Patients with symptomatic hip or knee arthritis may be assessed for:
- Total hip replacement
- Hip resurfacing
- Unicompartmental knee replacements
- Total knee replacement
- Partial knee replacement
- Primary joint replacement
- Complex revision hip and knee replacement
The decision to proceed with joint replacement is based on the patient’s symptoms, functional limitations, clinical findings, imaging, general health and individual circumstances.
Similarly, the approach (anterior, posterior for hips and midline or curved lateral for knees), use or robotic or Patient Specific Cutting guides will be discussed explaining the benefits and limitations of each.
Patients with more complex presentations can also be referred for assessment, including:
- Failed or complicated joint replacement
- Periprosthetic fractures
- Malunion and non-union
- Lower-limb deformity
- Limb-length discrepancy
- Complex trauma
- Complications following previous surgery
Where appropriate, management may involve collaboration with other medical, surgical, rehabilitation or allied health services.
For acute injuries or conditions requiring immediate assessment, please contact the appropriate emergency or hospital service. I am on the emergency on call roster and Ashford Hospital and the Royal Adelaide Hospital.
For non-emergency patients who require an earlier orthopaedic assessment, please indicate the clinical urgency clearly on the referral and contact the rooms if required. I am able to see urgent referrals at short notice if the referral highlights the urgency.
Communication with the referring doctor is an important part of the patient’s care. A consultation letter will be provided following assessment, outlining the clinical findings, relevant investigations and management plan.
Where surgery is undertaken, relevant post-operative information and follow-up correspondence will also be provided. If there is a specific question you would like addressed in the consultation, please include it in the referral.
Referring a Patient
Referrals can be sent to Adelaide OrthoCare using the button below or by one of the following pathways:
- Email: [email protected]
- Healthlink: adelorth
- Fax: 1300 800 571
Please ensure the referral includes the patient’s current contact details and relevant clinical information.
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