General practitioners' views on the challenges of managing knee pain attributed to degenerative meniscal tears in primary care: a qualitative study

Knee pain is estimated to affect at least 25% of people older than 50 years. In Ireland, knee pain accounts for the greatest number of new consultations seen in publicly funded orthopaedic clinics and meniscal pathology is the most common knee diagnosis after osteoarthritis. Exercise therapy is recommended as first line treatment for degenerative meniscal tears (DMT), while clinical practice recommendations advise against surgery. Nonetheless, arthroscopy rates remain high internationally for menisectomy in middle aged and older adults. While Irish knee arthroscopy figures are not available, referral in substantial numbers to orthopaedic clinics suggests surgery may be considered a treatment option for patients with DMTs by some primary care practitioners. This warrants further investigation with the GPs themselves; therefore, the aim of this qualitative study is to explore GPs' views on managing DMT and factors influencing their clinical decision making. Ethical approval was granted by the Irish College of General Practitioners. Semi-structured interviews were conducted online with 17 GPs. Question topics included assessment and management approach, role of imaging and factors influencing referral to orthopaedics, and future supports that would enhance management of this type of knee pain. Transcribed interviews are being analysed using an inductive approach to thematic analysis guided by the research aim and Braun and Clarke's six-step approach. Data analysis underway. Results available for WONCA in June 2022Discussion: These results will contribute to the development of a knowledge translation and exercise intervention for the management of DMT in primary care.