Referrals for degenerative knee complaints

Orthopedics, Primary care

Referrals for degenerative knee complaints

Orthopedics, Primary care
Degenerative knee complaints without any alarming symptoms should be treated by the General Practitioner conservatively without referral to the hospital.

Degenerative knee complaints include knee arthrosis, degenerative meniscal lesions without alarm symptoms where conservative policy is preferred. The conservative treatment consists of lifestyle advice, pain relief, physical therapy and intra-articular injections. These treatments are relatively simple and can be performed by the GP. A referral to the orthopaedic surgeon is rarely necessary. These referrals are expensive and create expectations of surgery in patients. When the patient is treated conservatively directly by the GP, this has a positive effect on the access time to an appointment with the orthopaedic surgeon.

A previous project from To do or not to do? focused on reducing MRIs and arthroscopies in hospitals for knee complaints. This project focuses on reducing referrals from the GP to the hospital.

‘Patients are going to their own GP instead of the hospital and are treated faster.’


The project leaders are planning to provide general practitioners education if the problem analysis confirms the need for it. 10 general practitioners in the Maastricht region and 10 general practitioners in the Nijmegen region receive active education and materials are distributed that the general practitioner can use to better inform the patient. 10 other GPs in Maastricht and 10 in Nijmegen provide passive education with the help of the platform “Prisma”. Finally, a control group of 10 general practitioners in Maastricht and 10 in Nijmegen is followed without an intervention.


Planned duration: 2 years

Learn more:

Contact us at


Tim Boymans, MD, PhD


Paul Koning, MD, PhD

| Prisma

Astrid van Montfoort, MD