Decision Report 201902618

Summary

C complained about the care their partner (A) received at an orthopaedic clinic in Inverclyde Royal Hospital. A was assessed for knee pain by an advanced physiotherapy practitioner (APP). C complained that the APP incorrectly diagnosed A as having a degenerative lateral meniscal tear (torn cartilage between the thigh bone and shin bone) and mild osteoarthritis (chronic breakdown of cartilage in the joints leading to pain, stiffness and swelling) and unreasonably decided to manage the condition by avoiding invasive measures as opposed to surgically. An orthopaedic review and scan the following year found no evidence of a tear. A ultimately required partial knee replacement surgery. C complained that the initial misdiagnosis and management plan contributed to the subsequent deterioration.

In responding to the complaint, the board said that the APP gave appropriate advice and treatment in keeping with the clinical picture at the time. They noted there was a subsequent deterioration of A’s knee over the following year.

We took advice from a consultant physiotherapist (a person qualified to treat disease, injury, or deformity by physical methods such as massage, heat treatment, and exercise), who considered that the APP carried out an appropriate examination and reached a reasonable conclusion as to the cause of A’s knee pain. There could have been a tear that did not show up on the MRI scan. We also noted the x-ray evidence showed that A had some arthritic change in their knee. There wasn’t sufficient evidence to say what the primary cause of A’s knee pain was, however, the treatment plan would have been the same regardless. We found that the decision to recommend conservative management was reasonable and in keeping with relevant guidelines. We did not uphold this complaint.