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Referrals

Please note that clinic appointments may be virtual visits. The clinic team will let you know what type of appointment is appropriate for your care. Learn more about virtual visits at UHN »

 What We Do

The Hip and Knee Rapid Access Clinic (RAC) is a provincial healthcare initiative that was put into place to provide ALL Ontarians with timely access to high quality, integrated musculoskeletal (MSK) care for joint pain and disability relating to hip and knee osteoarthritis. At the RAC, patients will be assessed by an Advanced Practitioner who will work with them to determine the appropriate care pathway.

Patients who require a surgical intervention will be referred to an orthopaedic surgeon. Patients who do not require surgery will be provided with an evidence-based self-management plan, streamlined access to specialists and diagnostic services when indicated, and directed to local services if needed.​​​​​​

Learn more about our patient outcomes​ for hip and knee replacements.​

Services

  • Hip and knee assessment – may include diagnostics (x-rays​, MRI, CT scan​)
  • Joint injections
  • Self-care management – e.g., education, exercise prescription, bracing
  • Orthopaedic surgery – e.g., arthroscopic, joint replacement​​​​

Having Surgery?

Our team performs some of the most complex surgeries in Canada. Find out how to prepare and what to expect during and after your hospital stay:

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How to Prepare

It is very important to bring these CDs or DVDs with you for your consult.

  • Hip x-rays – Standing AP pelvis & AP and lateral views of the affected hip
  • Knee x-rays – Standing bilateral knees AP, lateral, tunnel and skyline views

Your first appointment can take 2 hours or more. Follow-up appointments usually take 20 to 30 minutes.

Learn more about what you can expect when you have a clinic appointment.

 Materials and Resources to Help You

The Patient & Family Education Program at UHN offers valuable ​resources to help you understand your condition.​

Find more health information. ​​​​​​​​​​​

 Meet Our Team

​​​​​The Hip and Knee Rapid Access Clinic Team consists of Advanced Physiotherapy Practitioners and orthopaedic surgeons. They work collaboratively to provide you with timely access to assessment and appropriate evidence-based conservative and surgical management to enable you to manage your hip and knee joint related symptoms.

Surgeons

Administrative Team

Stephanie Wyles
Simone Wynia
Phone: 416 603 5800 ext. 6857

Advanced Physiotherapy Practitioners

Marsha Alvares
Phone: 416 268 1383
Email: marsha.alvares@uhn.ca

Emily May
Phone: 416 230 7879
Email: emily.may@uhn.ca

Physician Assistant

Robyn Kapelner
Email: robyn.kapelner@uhn.ca
Phone: 437 214 4560​

 Research, Quality Outcomes and Patient Satisfaction

​​​​​​​​​​​​​​​​Joint Replacement Statistics from LEAP Program

Sample Description

The statistics presented are based on data from 521 total hip replacements (THR) and 608 total knee replacements (TKR). The sample includes hip and knee replacement patients enrolled in the LEAP research program who had surgery on or after January 1 2014, and have complete pre-surgery data and 1 year post-surgery data.

Demographics

Bar graph image of joint replacement gender distribution.
Joint replacement gender distribution.

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Bar
Joint replacement age distribution.
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Satisfaction​

Bar graph image of satisfaction 1 year post-surgery
Satisfaction 1 year post-surgery: "How satisfied are you with the results of your surgery?"

WOMAC Scores​​

Clinically important improvement after surgery

For hip replacements, minimal clinically important difference (MCID) was defined as improvement of at least 29.26 points out of 100 for WOMAC pain, 26.54 points for WOMAC function, and 25.91 points for WOMAC stiffness1. The corresponding definitions for knee replacement were 22.87 points for WOMAC pain, 19.01 points for WOMAC function, and 14.53 points for WOMAC stiffness2.

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Bar graph image of clinically important improvement 12 months after surgery
Clinically important improvement 12 months after surgery.

Quintana JM, Escobar A, Bilbao A, Arostegui I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement. Osteoarthr Cartil. 2005 Dec;13(12):1076–83.
Escobar A, Quintana JM, Bilbao A, Aróstegui I, Lafuente I, Vidaurreta I. Responsiveness and clinically important differences for the WOMAC and SF-36 after total knee replacement. Osteoarthr Cartil. 2007 Mar;15(3):273–80.

Relative change from baseline

The median percentage change from baseline for each WOMAC scale is shown in the chart below. Error bars indicate interquartile ranges (25th to 75th percentile). For example: 12 months after surgery, hip replacement patients have a median 91% improvement in WOMAC pain score, while knee replacement patients have a median 75% improvement in WOMAC pain score.

Bar graph image of median improvement in WOMAC scores 12 months after surgery
Median improvement in WOMAC scores 12 months after surgery.