Managing non-traumatic Adolescent knee Pain: feasibility of using the MAP-Knee Tool in secondary care

BACKGROUND: A clinical decision-support tool (MAP-Knee Tool) was recently developed to support the consultation process between clinicians and adolescents with non-traumatic knee pain and enhance shared decision-making while reducing diagnostic uncertainty.

OBJECTIVES: We aimed to assess the feasibility of using the MAP-Knee Tool in an orthopaedic department for adolescents consulting with non-traumatic knee pain.

DESIGN: Feasibility study.

METHOD: We combined interviews, a questionnaire, and observations of two orthopaedic surgeons. Feasibility was evaluated based on Acceptability (dichotomised to 'acceptable' (categories 6-7) or 'unacceptable' (categories 1-5) from a 7-point rank scale ranging from 'very acceptable' to 'very unacceptable'), Appropriateness (time consumption), Fidelity (whether the tool was used as intended and the referral pattern), and Sustainability (whether surgeons would continue to use the tool). Consultations with adolescents aged 10-19 years with non-traumatic knee pain were eligible for inclusion.

RESULTS: We included 16 consultations. The duration of each consultation ranged between 8 and 20 min, which fit within the time frame of the surgeons' usual consultations. Both surgeons rated the tool as "very acceptable". They referred nine adolescents for treatment, four for diagnostic imaging, and three did not receive further treatment or referrals, and the surgeons expressed that the tool did not affect their referral. The surgeons stated that the tool was applicable to practice within their context and that they would especially recommend it to younger doctors.

CONCLUSIONS: The MAP-Knee Tool is feasible to use in secondary care based on the experiences of orthopaedic surgeons using the tool during consultations with adolescents.