Background: In an effort to reduce the waiting times for outpatient appointments and surgery ‘Direct Access Arthroscopy Services’ have been set up in some centres whereby GP’s assess patients with acute knee injuries.

The value of a physiotherapist in the Back Pain clinic is well known, however their effectiveness in an Acute Knee Injury Clinic has not been documented despite the fact that they have already been used in some centres to triage these injuries.

Purpose of study: This study was therefore set up to determine if an experienced physiotherapist can accurately diagnose an acute knee injury and formulate a treatment plan.

Methods: 50 consecutive patients with acute knee injuries were seen in the fracture clinic. They were each assessed and a diagnosis made and treatment plan formulated by the consultant, an orthopaedic SHO and two experienced physiotherapists in random order. Evaluation was by history, examination and X Rays. Final diagnosis was based on arthroscopic findings, further investigations or response to conservative treatment.

Results: We found no statistically significant difference in the clinical diagnosis and treatment plans made by the consultant and the orthopaedic physiotherapist p> 0.05 (Mc Nemar’s Test). In addition the physiotherapist had a higher proportion of correct diagnoses compared to the SHO. Again this difference was not statistically significant.

Conclusion: The results suggest that an experienced physiotherapist can safely and effectively be used to assess patients with an acute knee injury in the outpatient clinic setting.

Background: The decision on how to manage a patient with an acute ACL tear diagnosed at arthroscopy is still very subjective. Since 1995 all such patients in a single surgeon practice were managed either surgically or conservatively based on a modification of criteria described by Daniel. This essentially takes into consideration the presence of associated injuries and the activity level of the patient.

Purpose: This study was conducted to determine if these criteria used were effective in selecting our patients for surgery or conservative treatment.

Methods: We randomly selected 100 patients treated with at least 2 years follow up. The operatively and conservatively treated groups were compared based on the Tegner activity scale, the Lysholm-II1 score before and after treatment and the IKDC score after treatment. These scores were calculated using information from case notes, X Rays, patient questionnaires and outpatient clinic assessments.

Results: There were 42 patients treated conservatively and 58 treated by ACL reconstruction. The average age was 32 years for the operative group and 34 years for the conservative group.

We found no statistically significant difference between the Lysholm-11 scores and the IKDC scores between the two groups.

Conclusion: The criteria used to determine the management of our patients with acute ACL injuries is effective and as such we recommend its use.