Abstract
This study reports on the follow-up of Total Knee Arthroplasty patients in secondary care, by a physiotherapist working in an extended scope practitioner role, as a member of the orthopaedic team, and who had undertaken a negotiated work based learning module (NWBL) to develop practice skills in image interpretation at the School of Health Sciences, University of Liverpool.
Following successful completion of the NWBL by the physiotherapist an audit was undertaken of the patients seen in a total knee arthroplasty review clinic during a twelve month period. The patients were reviewed at one, three, five or seven years post-operatively on the behalf of two orthopaedic consultants specialising in total knee joint replacement (TKR). A total of 508 TKR’s were reviewed in 438 patients. Of these 37 (7%) were booked for further review by the consultants; 24 (4.7%) regarding management of their TKR, 7 (1.5%) regarding management of their contra-lateral knee and 9 (2%) regarding management of another joint. Radiographs of a further 34(6.7%) patients were discussed with the consultants (usually within a week) but did not require a review appointment by them.
The number of cases who had radiographs discussed with the consultants, but who did not require a further review appointment, suggests that the practitioner erred on the side of caution in image interpretation.
The results suggest a physiotherapist working in an extended scope practitioner role can carry out yearly follow-up of TKR patients, provided the appropriate practice skills have been developed, thereby reducing the congestion in busy follow-up clinics and allowing the surgeons to concentrate on more complex cases.
Practitioners working in such roles should be members of the orthopaedic team with regular communication with the orthopaedic surgeons.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
