Shaping better health
REMEDY : BNSSG referral pathways

Acute knee & shoulder clinics

Checked: 03-01-2019 by vicky.ryan Next Review: 03-01-2020

Acute knee clinic - NBT

An urgent, Acute Knee clinic is available on e-referrals, at NBT.

Conditions treated - Refer patients with acute injury to the knee suspicious of traumatic cartilage, ligament or  meniscal pathology

Procedures Performed - Assessment, Investigation, Diagnostic/ Therapeutic Injection, Arthroscopic/ Open Surgery including repair and reconstruction for cartilage, ligament and meniscal knee injuries

Suggested investigations - X rays of the knee to rule out acute fracture if this is suspected clinically should be performed prior to and included with any referrals

MRI scans are not required prior to referral but if performed should be included with any referrals

Service Note: This is an assessment clinic for non-fracture, knee trauma patients 16 years and over

Exclusions - Chronic Knee Problems, Follow up of previous elective knee patients, Degenerative knee pathology, Insidious onset knee problems. These patients should be referred via the standard elective knee outpatient clinic services at NBT

MATS previously have advised that due to the acute nature of these clinics that referrals to these acute clinics do not need to be submitted via MATS/CATS/MIS.

Practices should submit these direct through e-Referral to ‘Urgent, Orthopaedics, Knee’.

Acute shoulder clinic - NBT

An urgent, Acute Shoulder clinic is available on e-referrals, at NBT. This clinic deals with soft tissue injuries. Fractures are dealt with at the specific fracture clinic.

Conditions treated - Refer patients with suspected Acute rotator cuff injury

Criteria for referral: 

  • Suspected traumatic acute rotator cuff injury.
  • Age 30-60 (including those in this age range who have suffered a traumatic anterior GHJ dislocation).
  • Recent trauma, functioning arm to non-functioning arm

Procedures Performed - Clinical assessment/further investigation and treatment as appropriate

Suggested investigations - Must refer with Shoulder 3 view x-ray (AP, Lat. and axilla) - NO FRACTURE.   MRI if appropriate

Service Note: assessment clinic for acute rotator injuries 16 years and over

Exclusions - Recurrent Dislocators, GHJ OA or rotator cuff tear arthropathy, Frozen shoulder. These patients should be referred via the elective orthopaedic pathway

MATS previously have advised that due to the acute nature of these clinics that referrals to these acute clinics do not need to be submitted via MATS/CATS/MIS.

Practices should submit these direct through e-Referral to ‘Urgent, Orthopaedics, Shoulder/elbow’

Fracture Clinics

See the Fracture Clinic section for details on referring to the individual fracture clinics at NBT, UHB and WAHT.