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Te Pū rauemi KOWHEORI-19 COVID-19 resource hub

Support for people working in health during the COVID-19 pandemic. Find information about how you can support yourselves and others, including consumers, teams and colleagues which complements and aligns with Ministry of Health resources.

Kia āta kōwhiri Choosing Wisely

The Choosing Wisely campaign seeks to reduce harm from unnecessary and low-value tests and treatment.

In 2020, NZOA and ACC identified several medical interventions as low value care for orthopaedic patients within Aotearoa New Zealand.

ACC and NZOA wrote five statements to reflect the current research, evidence and clinical best practice. The statements were published in 2022.

ACC and NZOA also contacted the Royal Australian and New Zealand College of Radiologists to ensure they support the statements which include advice regarding referrals for radiology. They provided their support to the radiology-related statements.

Recommendations and resources

1) Knee X-ray

Use the Ottawa Knee Rule to determine the need for diagnostic knee joint imaging. Request weight-bearing knee joint X-rays where possible and when patient can tolerate.

2) Knee ultrasound

Do not use ultrasound for evaluation of menisci and collateral or cruciate ligament injuries. Use ultrasound if you are clinically concerned about the integrity of the patella or quadriceps tendons.

3) Knee arthroscopy

Do not perform arthroscopic debridement of the painful knee in the presence of established osteoarthritis.

4) Subacromial injection in the presence of a full thickness rotator cuff tear

Do not perform a subacromial injection in the presence of a full thickness rotator cuff tear, particularly if a surgical solution is going to be needed within 6 months.

5) Ultrasound for screening for shoulder instability

Do not request ultrasound imaging as a screening test for shoulder instability in people under 30 years of age unless there is clinical suspicion of a rotator cuff tear.

Supporting evidence

Last updated: 19th January, 2023