Authors (including presenting author) :
Lui AKH(1), Wong HY(1)*, Hui PS(1), CHOI TL(2), LEE CP(3), LEE S(3), CHOW TL(3), CHIU WH(3), LAI ML(3), TANG SP(4), LAW FM(4), LAM PH(3), CHAN YL(4), KOO SC(2), Cheung CT(1), LEUNG KW(3), LAW SW(2)
Affiliation :
(1) Department of Physiotherapy (PT), AHNH (2) Department of Orthopaedic and Traumatology (O&T), AHNH (3) Department of Family Medicine (FM), NTEC (4) Specialist Out Patient Department (SOPD), AHNH
Introduction :
In October 2023, with joint collaboration of Department of O&T, FM, SOPD & Allied Health, FMOR – Focus on Osteoarthritis (OA) knee service model was implemented in AHNH aiming at relieve of the pressure of long waiting list of stable OA knee new cases in SOPD of AHNH.
Objectives :
(1) To enhance the management of stable OA knee cases waiting for ORT SOPD by providing earlier FM specialist consultation. (2) To provide early physiotherapy intervention to OA knee patient and prevent chronicity of the condition (3) To improve the self-efficacy of patients in the management of OA knee symptoms.
Methodology :
Under the FMOR service, new OA knee referral to O&T SOPD were triaged to FM for specialist consultation. Suitable patients were referred to physiotherapy with fast-track appointment. Course of physiotherapy including exercise therapy, hydrotherapy, TELE-health and pain modalities were delivered. The Numeric Pain Rating Scale (NPRS), Knee Injury and Osteoarthritis Outcome Score (KOOS), 30 second chair-sit-to-stand test (30 CST) and walking tolerance were used as outcome measure. Paired t-test was used to analyze the improvement in NPRS, walking tolerance, 30 CTS and KOOS.
Result & Outcome :
From October 2023 to March 2025, 267 patients have completed physiotherapy treatment. After the intervention, significant reduction in NPRS from 5.7 to 3.87 (p < 0.001) was shown. The walking tolerance was increased from 35.97 minutes to 48.25 minutes (p < 0.001). The 30 CTS significantly improved from 6.96 to 8.97 (p < 0.001). All three KOOS sub-scale showed significant improvement (p < 0.005). As a result, 74% of the patients were able to manage their condition with Physiotherapy and FMOR clinic, whereas 26% of the patients were referred to ORT SOPD. The FMOR service model effectively triaged suitable cases to primary health care setting and Physiotherapy. Also, patients could receive fast-tracked physiotherapy service and start earlier intervention, which showed significant improvements in their pain, function, and self-efficacy.
