News in brief: Joint hypermobility and knee health; Inpatient rehabiliation not needed; Physician chronic care model

Joint hypermobility not a significant determinant of knee health,

Clinicians can assure individuals who have generalised joint hypermobility (GJH) and knee‐specific hypermobility (KSH) that these are not associated with lower knee health and function, Australian research shows.

A Sydney University study involving 732 participants found no correlations between GJH and Knee Injury and Osteoarthritis Outcome Score (KOOS). Males with knee-specific hypermobility showed a weak correlation with lower knee health in the quality of life KOOS domain.

“This suggests that joint hypermobility is not a significant determinant of knee health, the study investigators said in International Journal of Rheumatic Diseases.

“Given this, our recommendation for health professionals is to carefully weigh and address all determinants of knee joint health including, but not limited to, lower limb strength and control, biomechanics/alignment and psychosocial factors, and not to overly attribute joint hypermobility to presenting knee symptoms and dysfunction.”

No need for inpatient rehab after joint replacement

The restrictions brought on by the COVID-19 pandemic have shown that patients undergoing hip and knee replacement can be managed safely and effectively at home rather than undergoing expensive inpatient rehabilitation in private clinics, Victorian researchers say.

A study of 222 patients undergoing joint replacements between period March−June 2020 showed that inpatient rehabilitation reduced by 20% and 55% for knee and hip replacements respectively compared to 268 similar patients managed the same period in 2019. Outcomes were similar but mean acute length-of-stay also declined  by 0.5 days and 1.1 days for knee and hip replacements respectively.

The findings should provide reassurance to private hospitals that a greater proportion of patients can be managed at home following joint replacement, concluded researchers from Monash University in the Internal Medicine Journal.

Physician chronic care model on RACP Budget wish list

The RACP is calling on government to provide more funding for telehealth, digital health record uptake incentives and a physician chronic disease care model in its Pre-Budget Submission for 2021-2022.

In its submission entitled: Reimagining Health Post COVID-19: Reform for preventive, sustainable and equitable health, the RACP makes 48 recommendations that include:

  • Funding a model of care for the management of patients with comorbid chronic health conditions that formalises and supports the integration of consultant physician care (the RACP Model of Chronic Care Management or a variation).
  • Additional funding for videoconferencing technology packages for priority populations to promote equitable access to telehealth.
  • Maintain funding for Specialist Training Program (STP) positions while allowing for some flexibility for medical specialty variations to the recently introduced rural training requirements.
  • Provide a Practice Incentive Payment for consultant physicians to support better digital infrastructure to promote access to telehealth and the delivery of integrated multidisciplinary care.
  • Introduce specialist health items to the MBS to facilitate secondary consultations with GPs and other types of specialists, and allied health providers, with or without the patient present.

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