Decision Report 201303788

Summary

Mr C's GP referred him to Queen Margaret Hospital's orthopaedic department because he was having pain in his knee despite having received physiotherapy treatment. Mr C was reviewed by an orthopaedic registrar who said that he had a medial meniscal tear (cartilage problems). After Mr C had a scan of his knee, an orthopaedic consultant wrote to him advising that there was no tear and surgery was not required but recommended more physiotherapy. Mr C then attended a private consultation with an orthopaedic doctor who thought that Mr C did have a meniscal tear. Mr C had private surgery a few weeks later and told us that he was able to return to work within four weeks. He complained to us about the treatment he received at Queen Margaret Hospital, saying that he was not offered surgery and that the orthopaedic consultant reached a decision without examining him.

After taking independent advice from one of our medical advisers, we found that the scan did not show that Mr C had a meniscal tear. There was, however, an indication of degenerative changes (osteoarthritis - a common form of arthritis) behind the knee cap, and the board had treated him in accordance with the national guidance for the management of this that was in place at the time. Our adviser also said that there was no assurance that the surgery was the sole cause of Mr C's improvement, as the symptoms of degenerative knee disease may improve on their own. We concluded that the orthopaedic registrar's examination was appropriate, and that it was reasonable for the consultant to not have seen Mr C in person, given that he had reviewed the scan results.