Are Ottawa Knee rules useful in actual trauma care?

Kamal Nagpal; Mandar Marathe

doi:10.2478/s11536-007-0013-7

Original Research (Clinical) Emergency Medicine & Trauma

Are Ottawa Knee rules useful in actual trauma care?

Kamal Nagpal, Mandar Marathe

Central European Journal of Medicine, 2(2), 216-221 · 2007 · doi:10.2478/s11536-007-0013-7

Cited by 2+ (per Google Scholar, Aug 2026 — check live count)

Plain-language summary

The Ottawa Knee Rules are a clinical decision tool meant to reduce unnecessary knee X-rays after injury. This study tested whether a simple checklist sticker prompting UK emergency clinicians to apply the rules actually changed X-ray ordering, studying 118 patients before and after the sticker was introduced. It found essentially no difference in X-ray rates between the two groups (46.7% vs 50%).

Why this matters

Clinical decision rules only work if clinicians change their behaviour when using them. This study is one of two from this research group (see also the related 2006 paper on this site) showing that simply having a rule — even with a prompt — doesn't guarantee it changes real-world imaging practice, a finding relevant to anyone designing decision-support tools for emergency medicine.

Published abstract

Acute knee injuries are a common presentation to the emergency department (ED). Ottawa Knee Rules (OKR) have shown to reduce the number of radiographs in these patients in North American studies. We tested the hypothesis that it was possible to decrease the number of x-ray films obtained after a knee trauma without delayed fracture diagnosis by means of the Ottawa Knee Rules in a British set-up. A total of 118 adult patients with acute knee injuries were studied, using a checklist sticker to encourage clinicians to apply the OKR. In the group assessed without an OKR sticker, 28 (46.7%) of patients had knee radiography, compared with 29 (50%) of patients in the group assessed with an OKR sticker. There was no decrease in the number of x-rays after introducing the Ottawa Knee Rules sticker.

Read the full publication

View at publisher (DOI)

Keywords

Ottawa Knee Rules knee injury clinical decision rules radiography

Cite this publication

Nagpal K, Marathe M. Are Ottawa Knee rules useful in actual trauma care?. Central European Journal of Medicine. 2007;2(2):216-221. doi:10.2478/s11536-007-0013-7

Nagpal, K., Marathe, M. (2007). Are Ottawa Knee rules useful in actual trauma care?. Central European Journal of Medicine, 2(2), 216-221. https://doi.org/10.2478/s11536-007-0013-7

@article{NagpalK2007,
  author = {Kamal Nagpal and Mandar Marathe},
  title = {Are Ottawa Knee rules useful in actual trauma care?},
  journal = {Central European Journal of Medicine},
  year = {2007},
  doi = {10.2478/s11536-007-0013-7},
  volume = {2},
  number = {2},
  pages = {216-221}
}

TY  - JOUR
AU  - Kamal Nagpal
AU  - Mandar Marathe
PY  - 2007
TI  - Are Ottawa Knee rules useful in actual trauma care?
JO  - Central European Journal of Medicine
VL  - 2
IS  - 2
SP  - 216-221
DO  - 10.2478/s11536-007-0013-7
UR  - https://doi.org/10.2478/s11536-007-0013-7
ER  -

← Back to all publications