Abstract
A pilot study of a physiotherapy led shoulder clinic was initiated in January 1999 as a direct response to increasing orthopaedic consultant out-patient clinic waiting times.
The orthopaedic consultant reviews letters from GP’s to the orthopaedic clinic. Patients with benign musculoskeletal shoulder problems are referred to Shoulder Assessment Clinic (SHAC). The physiotherapist completes a subjective and objective assessment and a shoulder score is recorded using Constant and Murley Shoulder (Constant and Murley 1985). The scoring system has a maximum of 100 points indicating perfect, pain-free movement and function. The Constant and Murley Shoulder score remains most widely used and validated scoring system in Europe for the shoulder.
A total of 130 patients were referred to SHAC between January 1999 and December 1999. Sixty-six patients were treated and discharged by physiotherapy alone with an average increase in shoulder score of 40 points. Twenty-seven had surgery, 19 had steroid injection. Overall waiting time to be seen in SHAC was 58 days. Since this initial pilot, 320 patients have been assessed and treated in the SHAC.
Our experience of physio-led shoulder clinic shows patients can be assessed and treated with a far shortened waiting time, and the improved shoulder scores suggest effective treatment. This allows more patients of an appropriate type to be seen in the outpatient orthopaedic clinic.
The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN
