Osteoarthritis Hip and Knee Service

The Osteoarthritis Hip and Knee Service (OAHKS) coordinates the management and treatment of people with hip or knee osteoarthritis and helps manage waiting lists for specialist clinics and elective surgery.

The service incorporates a multidisciplinary musculoskeletal clinic staffed by a musuloskeletal coordinator/physiotherapist and other staff, such as a rheumatologist, nurse practitioner or orthopaedic surgeon. The OA Hip and Knee Service aims to coordinate optimal communication between referring GPs, allied health services, waiting list managers and surgeons.

Through system and workforce change, it has achieved the following benefits:

• better use of limited specialist orthopaedic services, including deferral of people who do not need surgery to conservative management
• early comprehensive assessment resulting in fast-tracking surgical assessment as appropriate and/or early referral for conservative management
• active management of the elective surgery waiting list, including prioritisation to match patient need
• improved patient satisfaction.

How the service helps people with osteoarthritis

OAHKS helps people manage their osteoarthritis by developing and coordinating a management plan that suits their needs.

The service provides information and guidance on the best way to manage osteoarthritis. It can assist in detecting deterioration to ensure people can access to surgery when they need it.

How the service helps general practitioners

OAHKS works collaboratively with patients and their general practitioners to achieve best possible outcomes in the management of osteoarthritis.

The findings of any assessment and proposed treatment plan will be forwarded to general practitioners for information or feedback.

The service will advise of any significant variation from the proposed treatment plan.

The hip and knee questionnaire

The Hip and knee questionnaire is a validated tool consisting of eleven questions and takes five to ten minutes to complete. It collects information about:

• severity of pain
• enjoyment of life
• ability to self care and care for others
• ability to undertake paid employment
• variations in the severity of disease overtime.

A score is calculated based on the answers given in the questionnaire.

That score is then used in conjunction with clinical assessment to prioritise access to specialist clinics and surgical waiting lists.

Patients can request help to complete the questionnaire.

The questionnaire can be reused at regular intervals to identify clinically and socially relevant changes in disease burden and to reprioritise access to services.

The questionnaire is available in 12 community languages.

Locations

The Osteoarthritis Hip and Knee Service is available at a number of public hospitals in Victoria.

• Alfred Health
• Austin Health
• Ballarat Health Services
• Barwon Health
• Bendigo Healthcare Group
• Eastern Health
• Goulburn Valley Health
• The Royal Melbourne Hospital
• Northeast Health Wangaratta
• Northern Health
• Peninsula Health
• Monash Health
• St Vincent's Hospital
• Western Health

Waiting times for surgery

Timely access to specialist clinic appointments can prevent further worsening of a person’s condition, including overall physical and psychosocial wellbeing.

Levels of clinical urgency

All patients on an orthopaedic elective surgery waiting list have been assessed by an orthopaedic surgeon and categorised according to the urgency of their condition.

In Victorian public hospitals, there are three levels of clinical urgency that currently guide scheduling of patients for elective surgery.

Category 1

Urgent - admission within 30 days is desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency.

Category 2

Semi-urgent - admission within 90 days is desirable due to the person’s clinical condition.

Category 3

Non-urgent - admission within 365 days is desirable due to the person’s clinical condition.

Current waiting times

The Victorian health services performance website publishes current statistics for waiting times for elective surgery.

This website also documents the time taken for patients to have similar surgery over a 12-month period.