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Review Panel: Principal Member John Harris, Dr
Ian Cameron and Dr Trudy Rebbeck
- The Panel accepted that further tearing of an already
degenerate lateral meniscus caused by the accident was a partial
rupture of the meniscus, and that such injury was not a minor
injury for the purposes of the Motor Accident Injuries Act
The Claimant in Venizelou v AAI Ltd  NSWPICMP
215 fell when the Insured bus she was travelling on broke
suddenly on 4 February 2020. It was accepted that she fell directly
onto her left knee.
Pre-accident records revealed that the Claimant attended her GP
on multiple occasions in 2017 for left knee complaints. In August
2017 the Claimant attended an Orthopaedic Surgeon when a total knee
replacement was recommended. However, the Claimant did not undergo
surgery and did not complain of left knee pain again until 18
November 2019 when there was a reference to bilateral knee
Post-accident records revealed that the Claimant complained of
left knee pain and bruising within days of the accident. An MRI
performed post-accident showed:
- moderate degenerative changes in the ACL and PCL;
- a macerated lateral meniscus with a large radial
- moderate to severe chondropathy in the patellar femoral
compartment; and a
- likely old tear of the medial meniscus.
The Claimant alleged that following the accident, her symptoms
were such that she decided to proceed with the total knee
replacement – whereas before the subject accident she had hoped to
put the surgery off for 5 years.
At first instance Assessor Woo determined that the Claimant
sustained only minor injuries. The Claimant’s Application for
Review was accepted.
The Review Panel Decision
As far as the Minor Injury Dispute was concerned, the issue for
determination by the Review Panel was confined to whether the
Claimant’s left knee injury was a minor injury.
The Review Panel were also tasked with determining whether a
knee replacement undertaken on 19 July 2021 was reasonable and
necessary. The Review Panel determined that a physical examination
was not required, particularly given that the Claimant was
recovering from surgery.
The Panel considered it relevant that at the time of the
accident, the Claimant was:
- independent in care;
- able to walk for several kilometres;
- in full-time employment; and
- was not taking pain medications for her left knee.
The Panel also noted that the Claimant fell onto her left knee
in the subject accident, and was prescribed Naprosyn immediately following the accident.
She also continued to complain of a severe increase in pain in the
left knee with swelling, locking, reduced range of movement and
loss of function.
The Panel considered the onset of locking significant. They also
considered the Claimant’s treating orthopaedic surgeon’s
finding that there had been an increase in malalignment between
April and May 2020 to be significant.
They noted that locking was often due to an internal derangement
of the knee, allowing for the probability that in addition to an
aggravation of the existing arthritis, there had also been some new
internal mechanical damage.
The Panel accepted that a direct fall onto a degenerate knee
could easily further tear a degenerate lateral meniscus – and that
the fall did cause further tearing, which
was not a minor injury.
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