The impact of an Acute Knee Clinic.
BACKGROUND
The aim of this audit was to analyse the impact of an open access clinic for the treatment of soft tissue knee injuries with regard to delay to treatment.


METHODS
Data from 100 consecutive patients seen in our sports clinic in 2000 were collected. Following this audit, an Acute Knee Clinic was introduced and took place once per week. In 2006, the audit loop was closed and data from 100 consecutive patients seen in the Acute Knee Clinic were collected.


RESULTS
The time from injury to the first review by a specialist is referred to as the time to diagnosis. The introduction of the Acute Knee Clinic led to an 89% reduction in the time to diagnosis for accident and emergency referrals and a 32% reduction for general practitioner referrals. The average number of visits of any sort made by the patient prior to review by a specialist in 2000 was five as opposed to one in 2006.


CONCLUSIONS
An Acute Knee Clinic with open access is a simple method of dramatically reducing the delay to diagnosis. This decreases the total delay to treatment which is of particular importance in patients requiring anterior cruciate ligament (ACL) reconstruction due to the risk of secondary meniscal and chondral injuries. Decreasing the delay to diagnosis and appropriate treatment reduces the recovery time. This not only reduces the socio-economic cost of soft tissue knee injuries but may also decrease the psychosocial consequences for the patient. By reducing the number of times a patient is seen by medical practitioners prior to review by a specialist has the potential to decrease the total cost of treatment. The socio-economic impact and potential actual cost savings of treatment are particularly important with the current economic climate.
Ball
Simon
S
Department of Orthopaedics, University College Hospital, London, UK. si_ball@hotmail.com
Haddad
Fares S
FS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070598:Anterior Cruciate Ligament Injuries; D042241:Early Diagnosis; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis*; D008131:London; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration; D017695:Soft Tissue Injuries / Q000175:diagnosis*; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D055815:Young Adult