Emerg Med J 20:37-39 doi:10.1136/emj.20.1.37
  • Original Article

Management of soft tissue knee injuries in an accident and emergency department: the effect of the introduction of a physiotherapy practitioner

  1. O O Jibuike1,
  2. G Paul-Taylor1,
  3. S Maulvi1,
  4. P Richmond1,
  5. J Fairclough2
  1. 1O O Jibuike, G Paul-Taylor, S Maulvi, P Richmond ,Emergency Unit, University Hospital of Wales, Cardiff, UK
  2. 2J Fairclough, Orthopaedic Department, University Hospital of Wales
  1. Correspondence to:
 Mr O O Jibuike, Department of Accident and Emergency Medicine, Morriston Hospital, Morriston, Swansea SA6 6NL, UK;
  • Accepted 14 June 2002


Objective: To assess the effect of the introduction of a physiotherapist with an extended scope of practice in the management of acute soft tissue knee injuries in an accident and emergency (A&E) department.

Methods: The A&E department established an Acute Knee Screening Service (AKSS) in 1998. An experienced physiotherapist was appointed to run the AKSS after additional training. Local guidelines and protocols were developed in conjunction with trauma knee surgeons, radiologists, physiotherapists, and A&E doctors. This study describes 100 consecutive patients managed by the AKSS over a three month period and comparisons are made over a similar period before the introduction of the AKSS.

Results: The initial diagnosis of patients with acute knee injuries referred to the service showed meniscal injuries (38%), cruciate ligament injuries (18%), fractures (2%), patellofemoral joint injuries (10%), and others (32%). Ninety five per cent of patients referred to AKSS were seen within one week. Medical time was saved in both A&E and trauma clinic. Fifty nine per cent of patients were treated and discharged from the service without further medical review. Thirty nine per cent (39) were referred to trauma clinic and of these 44% (17) had MRI scans performed as requested by the physiotherapist. Eighty eight per cent (15) of these scans showed significant abnormality: (nine, anterior cruciate ligament tears, one, posterior cruciate ligament tears, and nine meniscal tears).

Conclusions: A physiotherapy practitioner working with an extended role is a valuable addition to an A&E department. The AKSS improves the quality of care of acute knee injuries, saves medical time, and fosters cooperation across services within the NHS.


  • Funding: none.

  • Conflicts of interest: none.

Responses to this article

Free sample
This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of EMJ.
View free sample issue >>

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.


Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

Navigate This Article