title: Impact of a surgical screening clinic for patients with knee osteoarthritis:  a descriptive study.
abstract: OBJECTIVE
  To evaluate a surgical screening clinic for patients with knee osteoarthritis (OA) referred for total knee arthroplasty (TKA) and explore management before referral.
  
  
  METHODS
  Descriptive study using retrospective chart review.
  
  
  METHODS
  Large Canadian teaching hospital.
  
  
  METHODS
  Patients with knee OA referred for TKA over a 1-year period.
  
  
  METHODS
  Patients underwent standardized assessment by physicians who practice sport medicine to determine eligibility for surgical consultation.
  
  
  METHODS
  Proportion of patients deemed eligible for surgical consultation and undergoing TKA, and conservative management options tried before clinic referral.
  
  
  RESULTS
  Of the 327 patients, 172 (52.6%) were referred to the surgeon, of whom 76% underwent TKA. Options used before referral were medications (92.0%), injections (41.3%), and physiotherapy (34.9%). Patients referred to the surgeon, compared with those who were not, were more likely to have met all referral criteria (86.5% vs 33.3%, P < 0.001), tried 3 or more options (70.9% vs 49.7%, P < 0.01), used injections (58.7% vs 32.3%, P < 0.001), scored higher on the Hip-Knee Priority Tool (45 vs 24, P < 0.001), and had been referred by a physician who practices sport medicine (88.2% vs 46.2%, P < 0.001).
  
  
  CONCLUSIONS
  Orthopedic surgical screening by trained physicians using standardized tools halved the number of surgical consultations. Few conservative management options were tried before referral, indicating the need to enhance presurgical care for patients with knee OA.
authors.affiliation: Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Klett
authors.forename: Renata
authors.initials: R
authors.lastname: Frankovich
authors.forename: Geoffrey F
authors.initials: GF
authors.lastname: Dervin
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D002170:Canada; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013531:Surgicenters; D016896:Treatment Outcome