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Abstract
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PURPOSE: To elucidate referrals from sports medicine clinic (SMC) to orthopaedics, consensus rates among physicians and surgeons on surgical need in these patients, and reasoning of the patients who refused to have surgery despite the recommendations by both groups in non-emergency sports injury patients.
METHODS: We conducted a retrospective cohort analysis by using the administrative and referral records of a sports medicine clinic for the 15 months between October 2017 and January 2019. Gender, age, diagnosis and type of sport were compared between two groups (patients referred to orthopaedics vs patients treated in SMC). Agreement between orthopaedics and SMC on surgical need in those patients who were referred to orthopaedics was evaluated. We additionally screened the hospital archive for surgery reports of patients recommended surgery, and, if a patient did not have a surgery record, we investigated the reasons by telephone interview and categorized these reasons.
RESULTS: Surgical evaluation needed for 4.7% (n=155) of the patients. Patients referred to orthopaedics were younger (median: 22.0 years), mostly male (n=119, 76.8%) and involved in contact sports (n=108, 69.7%) (p<0.001 for all) compared to patients treated conservatively. Majority of the consultations were made owing to certain diagnoses such as cruciate/collateral ligament sprain (n=70, 45.2%), meniscal tear (n=21, 13.5%), and cartilage injuries (n=15, 9.7%). Most of the patients diagnosed with Achilles tendon rupture (n=2, 100%) and patellar instability (n=13, 81.3%) were referred to surgery. Orthopaedics agreed with the sports medicine physicians' opinions in most cases (n=110, 71.0%). Thirty-four patients (30.9%) recommended surgery by the surgeon postponed/refused the treatment for various reasons or had surgery in another hospital.
CONCLUSION: Most non-emergency sports injuries can be treated conservatively. Young and male patients participating in contact sports are more likely to need surgical treatment. Non-surgeon musculoskeletal health care providers may consider referring patients to orthopaedics considering the data demonstrated in this study. Nevertheless, patient's motivation to undergo an operation should be considered before referring to orthopaedics.
Language: en |