Adult patients with moderate to severe osteoarthritis in need of assessment for primary hip or knee arthroplasty (joint replacement).
MSK CIAC Hip and Knee Referral Form
Referrals are to be faxed to MSK CIAC Central Intake at 1-888-556-0966. Please use the standard MSK CIAC Hip and Knee Referral form. This document opens in a PDF. We do not accept consult notes or any other referral forms.
An MRI is not required.
Patients must have an x-ray, of their affected joint, taken within the last 6 months. They can choose to have this done at either a community x-ray clinic or at a hospital.
Patients, who have their x-ray taken at a community x-ray clinic, need to bring the CD or film x-ray to their assessment appointment. If they do not, their appointment may be rescheduled as the MSK CIAC team needs to view x-rays to be able to provide the right diagnosis and care plan.
Patients who have their x-ray taken at a hospital in Hamilton, Burlington, Niagara, Haldimand Norfolk, Brant or Burlington, do not need to bring a CD or film x-ray, as there is a hospital system in place for the team to view x-rays.
Standard Hip/Knee X-ray Images Required
Standard hip and knee x-ray imaging is required to confirm a diagnosis of moderate to severe osteoarthritis for triage to an arthroplasty assessment. Please include the required x-ray imaging report with the referral. Imaging requirements are based on current clinical practice guidelines.
All x-rays must be taken within the last 6 months
Hip X-ray Images Required
- Ortho pelvis, AP and lateral shoot through of affected hip(s)
Knee X-ray Images Required
- Standing AP, lateral and skyline of affected knee(s)
Patients will be assessed by an Advanced Practice Provider. The referring Primary Care Provider will receive a consult note detailing patient assessment and treatment recommendations within 7 business days.
Assessment Centre Locations
Assessments take place in MSK CIAC Hip and Knee Assessment Centres. The MSK CIAC Hip and Knee Program has four Assessment Centres located in hospitals in Hamilton, Brantford, Burlington and Niagara.
Patients will be booked for an assessment at the location closest to their home or they may choose the first available assessment at any of the locations or at a preferred location. Please indicate patient preference on the referral form.
Patients who are deemed surgical primary hip or knee arthroplasty (joint replacement) candidates will be offered consultation with an orthopedic surgeon who will determine if they are appropriate and ready for surgery. Patients will be offered choice of the first available surgeon with a shorter wait time, or a surgeon or hospital of their choice. Please indicate patient preference on the referral form.
Resources for Patients That Don't Meet the Referral Criteria
Please refer to our Conservative Management Resources for Hip and Knee Osteoarthritis Management. Please check out our Helpful Links and Exercises for resources. This document opens in a PDF.
Patients are fully covered by OHIP