Abstract Perspective: “You’d be better off to do the keyhole and make a good job of it” a qualitative study of the beliefs and treatment expectations of patients attending secondary care with degenerative meniscal tears


“This qualitative work was prompted by our observations in the orthopaedic clinic of numerous  patients referred to the surgeon from primary care with degenerative meniscal tears despite clinical recommendations against a surgical intervention. We wanted to better understand what patients expected from this orthopaedic appointment and explore also their attitudes towards conservative management. We found a strong biomedical understanding prevailed amongst participants often informed by specific abnormalities identified on knee MRI. This drove assumptions  that surgery was a necessity  to restore normal knee function and prevent future decline. Participants negative attitudes to exercise suggests a need to further educate both patients and primary care clinicians about the safety and efficacy of exercise as the first-line therapy for degenerative meniscal tears. This along with the role of MRI in prompting secondary care referral and creating surgical expectations will be addressed in the next stage of our research through a primary care knowledge  translation and exercise intervention. Funding has been secured from the Health Research Board Ireland to make this possible.”

-Dr. Helen O’Leary, study author