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Joint Instability N065

Document
Last amended 
26 November 2015
Current RMA Instruments:
Reasonable Hypothesis SOP

32 of 2010

Balance of Probabilities SOP

33 of 2010

Changes from previous Instruments:
SOP Bulletin 142
ICD Coding:
  • ICD-9-CM Codes: 718.3,718.8,728.4
  • ICD-10-AM Codes: M22.0, M22.1, M24.2, M24.4, M25.3, M43.3, M43.4, M43.5
Brief description:

This SOP covers on-going joint problems, that may be chronic or intermittent, where damage to the joint has resulted in instability that manifests as recurrent dislocation, subluxation, or sprain. One-off episodes of dislocation or acute sprain are covered by the respective SOPs for those conditions. A diagnosis of joint instability may subsume an earlier diagnosis of dislocation or acute sprain.

Confirming the diagnosis:

Diagnosis is based on a history of joint instability as evidenced by repeated dislocations, subluxation or strain along with clinical findings on examination of joint instability or laxity.

The relevant medical specialist is an orthopaedic surgeon.

Additional diagnoses that are covered by this SOP
  • Recurrent dislocation of a joint
  • Recurrent subluxation of a joint
  • Recurrent sprain of a joint
Conditions that are not covered by this SOP
  • Congenital dislocation#
  • Initial episode of dislocation* - dislocation SOP
  • Initial episode of acute sprain* - sprain and strain SOP
  • Internal derangement of the knee*
  • Fracture*

* another SOP applies  - the SOP has the same name unless otherwise specified

# non-SOP condition

Clinical onset

Clinical onset may date from the intital episode of injury/dislocation or from a subsequent episode.  This will depend on the nature of each episode, the time between episodes and other circumstances of the particular case.  

Clinical worsening

Clinical worsening will generally be the result of some further event or injury and may be evidenced by increased frequency of episodes or ease of dislocation/subluxation.  The condition may be amenable to surgery.