Knee pain attributed to degenerative meniscal tears (DMT) is one of the commonest joint conditions seen in Irish orthopaedic clinics. Exercise is effective for improving pain and functional and is the recommended first-line therapy. Despite this patients are frequently referred to secondary care clinics to access a specialist orthopaedic opinion. The expectation of treatment with arthroscopic surgery persists amongst these patients, despite lack of evidence for its effectiveness. Pilot qualitative work exploring patient experiences identified that GP beliefs may be partly responsible for creating negative patient expectations in relation to the role of exercise therapy in managing DMT. Overall, the underuse of exercise in primary care needs addressing combined with setting more positive expectations amongst patients and health professional for the conservative treatment of DMT, thereby reducing unnecessary secondary care referrals. This study aims to investigate the feasibility and acceptability of delivering a two-stage intervention for managing DMT in primary care, consisting of a knowledge transfer (KT) intervention for GPs and an exercise intervention for patients. Firstly semi-structured interviews will be conducted with GPs, for the purpose of understanding treatment decisions for DMT, and identifying knowledge gaps and behaviours which may run counter to current best evidence. These findings will inform learning needs and behavioural change goals for designing a KT intervention for GPs. A process of stakeholder consultation (i.e. patients, clinicians, manager) will be undertaken to elicit views on the design and delivery of the GP KT and exercise intervention. A feasibility cluster RCT with 6 GP practices and 32 patients with DMTs will pilot the KT intervention and group exercise programme. Patients will be allocated to the intervention arm or ‘usual care’ control arm based on their GP practice. Finally the acceptability of the study design and the intervention will be explored with GPs and patient participants.
