Orthopaedic Service Research Articles

A Geospatial Analysis of Hand Trauma Care: A Statewide Cross-Sectional Study.

Traumatic hand injuries often present with high acuity, but little is known about the influence of geospatial and socioeconomic factors on the timely delivery of care. This cross-sectional study used the Michigan Trauma Quality Improvement Program database, a state-wide registry with 35 level I or II trauma centers. Adult patients sustained hand trauma requiring urgent operative treatment between 2016 and 2021. Zip codes of injury location were linked with the corresponding percentile score on the Area Deprivation Index (ADI), a comprehensive measure of neighborhood disadvantage. Multiple regression analyses were used to determine associations of patient, injury and geospatial characteristics with the odds of sustaining acute hand trauma and time to operative treatment. Among 1,826 patients, the odds of sustaining acute hand trauma based on the ADI followed a bimodal distribution. Female sex, smoking, obesity, work-related injury and residence in a minor city were associated with increased odds, while younger age, comorbidities, and rural residence were associated with decreased odds. For 388 patients who underwent surgery within 48 hours, time to treatment was significantly increased in the highest ADI quintile, for patients who underwent fracture fixation, and for those with severe global injury severity. Multi-system injuries, moderate global injury severity and direct admission to an orthopaedic service were associated with shorter times to treatment. Patients in areas with greater neighborhood disadvantage may experience delayed operative care after acute hand trauma. This study highlights the importance of considering underserved populations and geospatial factors when determining the allocation of hand surgery resources. Prognostic Level III.

Implementing a Hospitalist Comanagement Service in Orthopaedic Surgery.

➤ Hospitalist comanagement of patients undergoing orthopaedic surgery is a growing trend across the United States, yet its implementation in an academic tertiary care hospital can be complex and even contentious.➤ Hospitalist comanagement services lead to better identification of at-risk patients, optimization of patient care to prevent adverse events, and streamlining of the admission process, thereby enhancing the overall service efficiency.➤ A successful hospitalist comanagement service includes the identification of service stakeholders and leaders; frequent consensus meetings; a well-defined standardized framework, with goals, program metrics, and unified commands; and an occasional satisfaction assessment to update and improve the program.➤ In this article, we establish a step-by-step protocol for the implementation of a comanagement structure between orthopaedic and hospitalist services at a tertiary care center, outlining specific protocols and workflows for patient care and transfer procedures among various departments, particularly in emergency and postoperative situations.

Site of Service Disparities Exist for Total Joint Arthroplasty.

The rate of outpatient total joint arthroplasty procedures, including those performed at ambulatory surgical centers (ASCs) and hospital outpatient departments, is increasing. The purpose of this study was to analyze if type of insurance is associated with site of service (in-patient vs outpatient) for total joint arthroplasty and adverse outcomes. We identified patients undergoing unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), or total hip arthroplasty (THA) using Current Procedural Terminology codes in a national administrative claims database. Eligible patients were stratified by type of insurance (Medicaid, Medicare, private). The primary outcome was site of service. Secondary outcomes included general complications, procedural complications, and revision procedures. We evaluated the associations using adjusted multivariable logistic regression models. We identified 951,568 patients for analysis; 46,703 (4.9%) patients underwent UKA, 607,221 (63.8%) underwent TKA, and 297,644 (31.3%) underwent THA. Overall, 9.6% of procedures were outpatient. Patients with Medicaid were less likely than privately insured patients to receive outpatient UKA or THA (UKA: odds ratio [OR], 0.729 [95% CI, 0.640-0.829]; THA: OR, 0.625 [95% CI, 0.557-0.702]) but more likely than patients with Medicare to receive outpatient TKA or THA (TKA: OR, 1.391 [95% CI, 1.315-1.472]; THA: OR, 1.327 [95% CI, 1.166-1.506]). Patients with Medicaid were more likely to experience complications and revision procedures. Differences in site of service and complication rates following hip and knee arthroplasty exist based on type of insurance, suggesting a disparity in care. Further exploration of drivers of this disparity is warranted and can inform interventions (eg, progressive value-based payments) to support equity in orthopedic services. [Orthopedics. 2024;47(3):179-184.].

PoCUS identification of distal biceps tendon rupture: a case report

BackgroundIn the Emergency Department (ED), patients may present with various injuries that damage muscles, tendons, ligaments, and bony structures. Fractures, joint dislocations, strains, and sprains are prevalent among them. However, distal biceps tendon ruptures are uncommon.Case ReportHere, we report a case of a young man presented to the ED with a complaint of left arm pain following a martial arts activity. The diagnosis of distal biceps tendon rupture was made using a point-of-care ultrasound (PoCUS), and an early referral to the orthopedic service was provided.ConclusionThis case highlights the utility of point-of-care ultrasound in assessing musculoskeletal injuries in the ED. Early incorporation of PoCUS into routine clinical practice can potentially improve the overall care of musculoskeletal injuries.

The economic and resource burden of e-scooter-related orthopaedic injuries: A district general hospital's experience

PurposeElectric scooters (e-scooters) are an increasingly popular method of transportation worldwide. However, there are concerns regarding their safety, specifically with regards to orthopaedic injuries. We aimed to investigate the overall burden and financial impact on orthopaedic services as a result of e-scooter-related orthopaedic injuries. MethodsWe retrospectively identified all e-scooter-related injuries requiring orthopaedic admission or surgical intervention in a large District General Hospital in England over a 16-month period between September 2020 and December 2021. Injuries sustained, surgical management, inpatient stay and resources used were calculated. ResultsSeventy-nine patients presented with orthopaedic injuries as a result of e-scooter transportation with a mean age of 30.1 years (SD 11.6), of which 62 were males and 17 were females. A total of 86 individual orthopaedic injuries were sustained, with fractures being the most common type of injury. Of these, 23 patients required 28 individual surgical procedures. The combined theatre and recovery time of these procedures was 5500 min, while isolated operating time was 2088 min. The total cost of theatre running time for these patients was estimated at £77,000. A total of 17 patients required hospital admission under Trauma and Orthopaedics, which accounted for total combined stay of 99 days with a mean length of stay of 5.8 days. ConclusionWhile there are potential environmental benefits to e-scooters, we demonstrate the risks of injury associated with their use and the associated increased burden to the healthcare system through additional emergency attendances, frequent outpatient clinic appointments, surgical procedures, and hospital inpatient admissions.

Pneumocephalus after ankle surgery: A Case Report

Introduction: Pneumocephalus, or air in the cranial cavity, can have various causes. Traumatic brain injury is the most common cause of pneumocephalus, accounting for 75% of all cases, particularly in those with skull base fractures. Spinal trauma-related pneumocephalus is rare but has been reported, and patients with this condition are usually treated conservatively. Tumors, infections, and iatrogenic causes are responsible for the remaining 25% of cases. Proper management and a high index of suspicion are critical when considering pneumocephalus as a possible complication, as it can result in significant morbidity and potentially life-threatening consequences. Accidental puncture of the dura mater is a common cause of pneumocephalus secondary to epidural anesthesia, and air entry into the intrathecal space is another known cause. Case presentation: This is a 64-year-old female patient who underwent elective ankle surgery, the anesthetic technique was epidural-spinal block needle on needle, no complications during procedure. She was discharged from the Traumatology and Orthopedics service the next morning, 24 hours after her hospital discharge, she was brought back, in the emergency area, she was found with psychomotor agitation, disorientation, no auditory hallucinations, paresthesias were denied, no mentation disorder, with a score on the Glasgow Coma Scale of 14: Eye opening 4 points, Verbal response 4 points, Motor response 6 points. After 48 hours the CT brain scan revealed absortion of pneumocephalus. Clinical discussion: The causes of neumocephalus resulting from epidural or spinal anesthesia procedures are not entirely understood. However, it is believed to occur due to the introduction of air or gas into the subarachnoid or epidural spaces during the puncture, accidental or not . Given the potential severity of this condition, early diagnosis and appropriate management are crucial, even if the symptoms differ from the most common. Conclusion: This research paper highlights the importance of anesthesiologists being aware of the potential risks associated with epidural or spinal block. Future research could investigate the long-term outcomes of patients who experience pneumocephalus during anesthesia procedures and identify strategies for preventing and managing this complication.

The need for orthopedic dental services for the elderly population of Kazakhstan

<b>Objective</b>: To determine the orthopedic dental status of the elderly population of Kazakhstan using clinical and diagnostic determinants.<br /> <b>Methods:</b> The dental status of 708 patients from three institutions in Almaty, Kazakhstan, was recorded using WHO dental questionnaires. The patients were divided into groups according to their age and sex, and modern statistical methods were used to process the data. Through the construction of tables and graphs, calculation of relative values, and assessment of the reliability of the differences in the data, we determined if there were any differences between the groups.<br /> <b>Results: </b>The study revealed that most patients who needed orthopedic dental care were 60 years of age and older. The older the age of patients with registered diagnoses of partial and complete adentia, the greater the need for removable prosthetics. The most common type of orthopedic treatment required for these patients was removable dentures. Analysis of the quantitative relationship between the need for orthopedic dental care and patients’ gender revealed the following patterns: the critical value of Chi-square at the significance level p≤0.0001 was 23.95, the exact Fisher criterion was 0.0000 (p=0.0000), and the calculated Cramer’s V criterion and the conjugacy coefficient showed the relationship between the variables were at the levels of 0.17 and 0.18, respectively.<br /> <b>Conclusions:</b> Owing to the aging population in Kazakhstan, and indeed the world, the problem of medical adaptation and social rehabilitation of older age groups is pertinent, and our findings argue that the introduction of geriatric dental services in Kazakhstan is warranted.

The economic costs of orthopaedic services: a health system cost analysis of tertiary hospitals in a low-income country

BackgroundTraumatic injuries are rising globally, disproportionately affecting low- and middle-income countries, constituting 88% of the burden of surgically treatable conditions. While contributing to the highest burden, LMICs also have the least availability of resources to address this growing burden effectively. Studies on the cost-of-service provision in these settings have concentrated on the most common traumatic injuries, leaving an evidence gap on other traumatic injuries. This study aimed to address the gap in understanding the cost of orthopaedic services in low-income settings by conducting a comprehensive costing analysis in two tertiary-level hospitals in Malawi.MethodsWe used a mixed costing methodology, utilising both Top-Down and Time-Driven Activity-Based Costing approaches. Data on resource utilisation, personnel costs, medicines, supplies, capital costs, laboratory costs, radiology service costs, and overhead costs were collected for one year, from July 2021 to June 2022. We conducted a retrospective review of all the available patient files for the period under review. Assumptions on the intensity of service use were based on utilisation patterns observed in patient records. All costs were expressed in 2021 United States Dollars.ResultsWe conducted a review of 2,372 patient files, 72% of which were male. The median length of stay for all patients was 9.5 days (8–11). The mean weighted cost of treatment across the entire pathway varied, ranging from $195 ($136—$235) for Supracondylar Fractures to $711 ($389—$931) for Proximal Ulna Fractures. The main cost components were personnel (30%) and medicines and supplies (23%). Within diagnosis-specific costs, the length of stay was the most significant cost driver, contributing to the substantial disparity in treatment costs between the two hospitals.ConclusionThis study underscores the critical role of orthopaedic care in LMICs and the need for context-specific cost data. It highlights the variation in cost drivers and resource utilisation patterns between hospitals, emphasising the importance of tailored healthcare planning and resource allocation approaches. Understanding the costs of surgical interventions in LMICs can inform policy decisions and improve access to essential orthopaedic services, potentially reducing the disease burden associated with trauma-related injuries. We recommend that future studies focus on evaluating the cost-effectiveness of orthopaedic interventions, particularly those that have not been analysed within the existing literature.

Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation

BackgroundHip fracture has a devastating impact on individuals and is an increasing burden for health systems and society. Compared to usual care, increased physiotherapy provision has demonstrated efficacy in improving patient and health service outcomes in this population. However, physiotherapy workforce challenges prevent sustained implementation.MethodsOur aim was to evaluate the safety, feasibility, acceptability, effectiveness and implementation cost of thrice daily physiotherapy for patients in the acute care setting after hip fracture at two public hospitals. We added twice-daily exercise implemented by an alternative workforce, to usual care consisting of daily mobility practice by a physiotherapist. Sites identified their preferred alternative workforce, with pre-registration physiotherapy students and allied health assistants chosen. We used a mixed methods approach, using the Consolidated Framework for Implementation Research (CFIR) as a determinant framework to guide implementation planning and data collection. We compared hospital length of stay data to a reference cohort.ResultsWe recruited 25 patients during the study period. Acute care hospital length of stay decreased from 11 days in the reference cohort to 8 days in the BOOST cohort (mean difference − 3.3 days, 95%CI -5.4 to -1.2 days, p = 0.003). Intervention fidelity was 72% indicating feasibility, no safety concerns were attributed to the intervention, and uptake was 96% of all eligible patients. The intervention was acceptable to patients, carers and healthcare providers. This intervention was cost-effective from the acute orthopaedic service perspective.ConclusionHigher daily frequency of physiotherapy can be safely, feasibly and effectively implemented by an alternative workforce for patients in the acute care setting following hip fracture surgery.

Orthodontic-Surgical Correction of a Skeletal Class III Malocclusion: Case Report

Introduction: Class III malocclusions and anterior crossbites are disturbing for patients because they are very apparent and often cause aesthetic and functional damage. Description: The clinical case describes a 19-year-old patient in good general health attended the dento-facial orthopedics service at the Rabat Hospital Center for Dental Consultation and Treatment presenting an anterior crossbite. The clinical examination and the cephalometric analysis showed that the patient had a Class III malocclusion of maxillary and mandibular origin with hyperdivergent facial type. An orthodontic-surgical treatment was well indicated for correction of the skeletal discrepancy in three phases: presurgical orthodontic preparation, orthognathic surgery and orthodontic finishing. Results: In reviewing the patient’s final records, the major goals set at the beginning of treatment were successfully achieved; the facial profile and proportion were significantly improved with solid functional occlusion Conclusion: In class III malocclusion when facial aesthetics is altered, the surgical-orthodontic treatment is the most indicated for patients who do not present facial growth.

Can we develop consensus on long-term follow-up and surveillance of primary shoulder arthroplasty? A study protocol using a real-time Delphi technique among expert clinicians in the UK

BackgroundShoulder arthroplasty incidence is projected to continue its exponential growth and the resultant burden of monitoring patients with shoulder arthroplasty implants creates significant pressure on orthopaedic services. Surveillance offers the...

Model of multidisciplinary teamwork in hip fracture care: a qualitative interview study

ObjectivesHip fractures are common injuries in older age with high mortality requiring multidisciplinary clinical care. Despite guidance, there is considerable variation in hip fracture services and patient outcomes; furthermore, little...

AOA Critical Issues Symposium: So, You Want to Be a Department Leader: Essentials for Success.

Most health systems are vertically integrated, and the leaders of orthopaedic surgery departments or service lines must have a comprehensive understanding of their role in the strategic plan of the health system. Orthopaedic surgery departments must be profitable while supporting the tripartite mission of excellence in clinical care, research, and education. This symposium had 4 specific objectives: to discuss how to (1) create synergy between the department or service line and the health system, (2) develop a strategy to enhance financial stability and revenue growth, (3) develop a comprehensive plan to enhance recruitment and retention of a diverse faculty, and (4) consider alternative strategies to foster education and research, even when the health system may be more focused on revenue generation.

Traumatic brain injury is common and undertreated in the orthopaedic trauma population

IntroductionTraumatic brain injuries (TBIs) can be difficult to diagnose and are often marginalized when compared to more obvious physical injuries. Despite this, recognition and early treatment can lead to improved outcomes. Even mild TBIs have the potential to cause significant long-term consequences for patients, which may affect their physical recovery from orthopaedic injuries. The objective of this study was to examine the incidence and treatment of TBI within the orthopaedic trauma population. MethodsInclusion criteria were all patients presenting after an acute trauma with an orthopaedic surgery consult over a continuous 3 month timeframe (n = 187). A retrospective review was completed at an academic tertiary referral trauma center. The primary outcome was the rate of TBI. Secondary outcomes included rate of TBI listed as a discharge diagnosis and rate of follow up plan. Several secondary variables were noted and their associations with TBI evaluated. Results27 % of the 187 patients had an acute TBI. 61 % of TBI patients had the diagnosis listed in their discharge summary. 6 % had a follow up plan. The positive TBI group was associated with more high energy injuries (p = 0.032), average limbs involved (p = 0.007), upper extremity injury (p < 0.001), bilateral lower extremity injury (p = 0.004), and Injury Severity Score (p < 0.001). 82 % of patients with an acute TBI had an occupational therapy consult and 39 % had a neurosurgery consult. 24 % of patients with a TBI were admitted to the orthopaedic primary service. ConclusionsPatients presenting after an acute trauma with orthopaedic injuries have high rates of TBI, but low rates of diagnosis and treatment. This lack of diagnosis and treatment can negatively impact recovery from orthopaedic injuries. Orthopaedic providers should be aware of the diagnostic criteria and initial treatment steps for TBI to ensure prompt and effective treatment, which has been shown to improve outcomes.

Digitalization in orthopaedics: a narrative review.

Advances in technology and digital tools like the Internet of Things (IoT), artificial intelligence (AI), and sensors are shaping the field of orthopaedic surgery on all levels, from patient care to research and facilitation of logistic processes. Especially the COVID-19 pandemic, with the associated contact restrictions was an accelerator for the development and introduction of telemedical applications and digital alternatives to classical in-person patient care. Digital applications already used in orthopaedic surgery include telemedical support, online video consultations, monitoring of patients using wearables, smart devices, surgical navigation, robotic-assisted surgery, and applications of artificial intelligence in forms of medical image processing, three-dimensional (3D)-modelling, and simulations. In addition to that immersive technologies like virtual, augmented, and mixed reality are increasingly used in training but also rehabilitative and surgical settings. Digital advances can therefore increase the accessibility, efficiency and capabilities of orthopaedic services and facilitate more data-driven, personalized patient care, strengthening the self-responsibility of patients and supporting interdisciplinary healthcare providers to offer for the optimal care for their patients.

Systems issues limiting acute fracture care delivery at a tertiary care hospital in Northern Tanzania.

sub-Saharan Africa experiences a significant musculoskeletal trauma burden. Among patients who receive surgical treatment, there have been no reports as to how often surgical care is determined to be "adequate" or, if "inadequate", then what hospital and orthopaedic specialty-specific systems limitations might be prohibitive. data from patients presenting to the orthopaedic trauma service at a tertiary care center in sub-Saharan Africa were prospectively collected over a 6-week period and then retrospectively reviewed to determine whether the surgical treatment was "adequate" (or otherwise, "inadequate") according to the principle of restoring length, alignment, and rotation. Exclusion criteria included insufficient clinical information; isolated spinal injury; infection; cases involving only removal of hardware; soft-tissue procedures; tumor cases; and medical (non-surgical) conditions. 112 cases were included for analysis. Surgery was indicated in 106 of 112 cases (94.6%), and of those, surgery was performed in 62 cases (58.4%). Among patients who underwent surgery with available post-operative imaging (n=56), surgical treatment was "inadequate" in 24 cases (42.9%). The most common reasons treatment was deemed "inadequate" included unavailability of appropriate implants (n=16), unavailability of intraoperative fluoroscopy (n=10) and incomplete intraoperative evaluation of injury (n=5). several systems limitations prevent the delivery of adequate surgical treatment in patients with acute orthopaedic traumatic injuries, including lack of intraoperative fluoroscopy and lack of implant availability. This study will serve as a useful baseline for ongoing efforts seeking to improve orthopaedic specialty resource availability and facilitate more effective fracture care in this region.

Effect of enforcement of the national referral guidelines on patterns of orthopedic admissions to Kenyatta National Hospital, Kenya: Pre-post intervention study.

Inappropriate utilization of higher-level health facilities and ineffective management of referral processes in resource-limited settings are becoming increasingly a concern in health care management in developing countries. This is characterized by self-referral and frequent bypassing of the nearest health facilities coupled with low formal referral mechanisms. This scenario lends itself to a situation where uncomplicated medical conditions are unnecessarily managed in a high-cost health facility. On July 1, 2021, Kenyatta National Hospital (KNH) enforced the Kenya Health Sector Referral Implementation Guidelines, 2014, which required patients to receive approval from the KNH referral office and a formal referral letter to be admitted at KNH to reduce the number of walk-ins and allow KNH to function as a referral facility as envisioned by the Kenya 2010 Constitution and KNH legal statue of 1987. To determine the effect of enforcing the national referral guidelines on patterns of orthopaedic admissions to the KNH. This was a pre-post intervention study. Data abstraction was done for 459 and 446 charts before and after the enforcement of the national referral guidelines, respectively. Enforcement of the national referral guidelines reduced the proportion of walk-in admissions from 54.9% to 45.1%, while the proportion of facility referrals increased from 46.6% to 53.4% (p = 0.013). The percentage of non-trauma orthopaedic admissions doubled from 12.0% to 22.4% (p<0.001). There was also an increase in admissions through the Outpatient Clinic and Corporate Outpatient Clinic. The proportion of emergency admissions declined, while that of elective admissions increased. The increase in elective cases was mainly driven by the increase in female admissions with active insurance cover, tertiary education, non-trauma-related conditions and older age groups. However, the use of official formal written referral letters did not change despite the enforcement of the national referral guidelines. The enforcement of the national referral guidelines reduced the proportion of walk-ins' admissions to KNH. While the enforcement of the national referral guidelines had no effect on the use of official formal written referral letters, it did limit access and utilization of inpatient orthopedic services for young male patients with no active insurance cover and in need of emergency orthopedic care.

Transfer of musculoskeletal care from paediatric to adult services for patients with cerebral palsy and chronic neuromuscular conditions: Identifying the unmet need

IntroductionChildren with cerebral palsy (CP) are treated by well-co-ordinated multi-disciplinary neuromuscular teams. With a comprehensive multidisciplinary team, co-ordinating the transfer to adult care is a challenge. Orthopaedic care becomes fragmented as patients transfer from paediatric orthopaedic surgeons with training in multi-joint neuromuscular conditions (NMCs), to adult orthopaedic surgeons where this expertise rarely exists. Orthopaedic and spinal problems are a major unmet health need in this population. There is a lack of research in the literature regarding availability and access to orthopaedic services post transferring, which this study aimed to address. MethodsThis was a cross-sectional study conducted at an NHS referral centre for specialist paediatric services to evaluate the existing transfer program. A 10-item questionnaire was developed by senior clinicians for patients with CP or NMCs and their families to answer. It focused on three domains: Availability of a transfer of care plan, access to healthcare services and satisfaction with the services. ResultsThere were 39 responses from patients, or their families received between December 2021 to April 2022. Patients were aged between 17 and 28 years at the time of answering. Availability of a transfer of care plan was poor, at only 20.5 % (8/39). Sixty-nine percent (27/39) stated there was not an orthopaedic surgeon overseeing their bone and joint health and a further 33.3 % (13/39) reported lack of supervision from a physiotherapist. Fifty-six percent (22/39) of respondents reported a decline in musculoskeletal health. Those that did receive ongoing orthopaedic care reported high rates of satisfaction. ConclusionOur study has shown that the transfer of care for patients with CP and NMCs continues to remain poor, contrary to national guidelines, with lack of access to adequate musculoskeletal healthcare services after transfer to adulthood. The unmet needs of patients with CP or NMCs with orthopaedic and spinal pathologies are higher than previously reported. This area has been critically understudied, but this manuscript has highlighted an urgent need to improve and reform transfer practises, to fulfil the current deficit.

THE CHALLENGE ASSOCIATED WITH THE INTRODUCTION OF NEW SURGICAL SERVICES IN A RURAL HOSPITAL IN TRINIDAD &amp; TOBAGO

The introduction of new services at any institution requires significant input from a myriad of departments and specialties. This paper will explore the various challenges that arose with the implementation of an orthopaedic surgical service at the Point Fortin Hospital in Trinidad and Tobago. It identifies the obstacles faced in terms of resource allocation, infrastructure development, staffing, and collaboration. Additionally, it proposes effective strategies and solutions to overcome these challenges, thus ensuring the successful establishment of a sustainable orthopaedic surgical service at Point Fortin Hospital.

IN TELEHEALTH, PHYSIOTHERAPISTS CAN TRIAGE ORTHOPEDIC WAITING LISTS: PILOT STUDY

Objectives: The purpose of this study is to understand the reasons for long waiting lists in orthopedic screening clinics in terms of duration and quantity, as well as to examine physical therapy visibility as an alternative form of management to improve the patient journey according to individual current needs through Telehealth. Background:In public hospitals, there is typically a significant waiting period for outpatient orthopedic appointments with specialists. Subsequently, patients often face another waiting period if surgery is deemed necessary. Unfortunately, individuals with greater medical urgency are seldom given priority, which can lead to heightened morbidity for those who have to wait. Furthermore, alternative care options are generally unavailable during this waiting period. Methods:The current study implemented a telephone triage method executedby two physiotherapists to evaluate new patients on the waiting list of an orthopedic screening clinic. The research took place at Qatif Central Hospital in the Eastern province of Saudi Arabia, spanning from October to December 2021. Telephone triage involves remotely assessing patients over the phone to determine the nature of their condition and determine if physical therapy could serve as a viable alternative treatment option. To ensure consistency in evaluations, the physiotherapists utilized a standardized instrument consisting of a predetermined set of questions and prompts. Results: It was found that 66% of participants experienced a three-month waiting period for their appointments. Additionally, the study revealed a significant number of referrals originating from primary health centers (81%),withknee osteoarthritis being the most commonly diagnosed condition (45%). Another notable finding is that 72% of cases were considered suitable for physical therapy as an alternative treatment option. Conclusion: Integrating physiotherapists into telephone triage for orthopedic outpatient appointments presents a valuable chance to address and prioritize lengthy waiting lists for orthopedic services. This approach offers cost-effectiveness and substantial benefits for institutions facing challenges in managing their orthopedic waiting lists.