Other knee conditions

Non-osteoarthritic knee pathology including ligament, meniscal and patellar conditions.

Eligibility

At least one must be met for the patient to be eligible for referral.

Knee pathology with appropriate imaging (weight-bearing AP and lateral) and clinical examination including ligament/meniscus tests

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Acutely septic prosthetic joint — refer to ED

Joint dislocation — refer to ED

Knee extensor mechanism rupture — refer to ED

Locked knee where the joint cannot be moved at all — refer to ED

Open injury with possible tendon or joint involvement — refer to ED

Acutely painful, hot, swollen joint, especially if febrile — refer to ED

Suspected acute bone infection — refer to ED

Suspected fracture, or fracture requiring manipulation or operation — refer to ED

Routine referral criteria

Determine Category 2 or 3 urgency.

Existing total knee replacement with new pain, loosening or other concern

Suspected malignancy of the knee, leg or calf

Anterior knee pain

Chronic anterior cruciate ligament (ACL) tear

Knee ligamentous injury or instability

Loose body, unstable osteochondral fragment or osteochondritis dissecans (OCD)

Meniscal injury with intermittent mechanical symptoms (locking, clicking, catching)

Recurrent patellar dislocation

Spontaneous osteonecrosis of the knee

Usually managed in primary care

Recurrent patellar dislocation where non-surgical management has not been trialled
Ultrasound imaging is not indicated for these conditions