Sandringham Orthopaedic Specialists
Suite 1, 60 Bay Road, Sandringham VIC 3191. Please address referrals to Dr Vishal Pai.
For GPs, Physiotherapists and Osteopaths
What Dr Vishal Pai accepts, when to refer urgently, what to send with your letter, and how to come and watch an operation.
Consulting in Sandringham
Suite 1, 60 Bay Road, Sandringham
Suite 1, 60 Bay Road, Sandringham
Operating at
Which patients to refer
Dr Vishal Pai’s practice is dedicated exclusively to elective knee surgery. Choose an operation to see the indications and the investigations to send with your letter.
Knee replacement
Robotic-assisted partial and total knee replacement, and revision
Initial management
- Exercise and educationStructured exercise therapy, such as the GLA:D program
- Weight lossIf overweight, losing 5–10% of body weight improves pain and function
- Anti-inflammatoriesTopical or oral if suitable; avoid opioids
Refer when
- Symptomatic knee osteoarthritis with joint-space loss on X-ray
- Pain affecting sleep, walking or work despite at least 3 months of exercise therapy, weight management and analgesia
- For a partial knee, arthritis confined to the medial compartment, a functioning ACL and a correctable deformity
- Painful, stiff or unstable existing knee replacement (revision)
Recommended investigations
Weight-bearing AP, lateral and skyline X-rays from the last 12 months.
An MRI is not needed for arthritis.
ACL reconstruction
Primary, revision and paediatric ACL surgery
Initial management
- Early physiotherapySettle swelling, restore full extension and activate the quadriceps
- Avoid pivoting sportNo pivoting or contact sport until reviewed
- Crutches and iceCrutches, ice and compression for the first few days as needed
Refer when
- ACL rupture in a patient who wants to return to pivoting or contact sport
- Recurrent giving way despite a structured rehabilitation program
- ACL rupture with a repairable meniscal tear or another ligament injury
- Failed previous ACL reconstruction, or ACL injury in a skeletally immature patient
Recommended investigations
An MRI is recommended. X-rays are not necessary. Physiotherapy before surgery can start while waiting.
Patellofemoral stabilisation
MPFL reconstruction, tibial tubercle osteotomy and trochleoplasty
Initial management
- Early movementWeight bearing as comfort allows; avoid prolonged immobilisation
- PhysiotherapyFocused on quadriceps, hip and core strength
- Graded return to sportOnce strength and control return; bracing is optional
Refer when
- Two or more lateral patellar dislocations
- First dislocation with an osteochondral fragment or loose body (urgent)
- First dislocation with risk factors such as trochlear dysplasia or patella alta
- Ongoing apprehension or instability despite rehabilitation
Recommended investigations
An MRI is recommended. X-rays including an AP, true lateral (with femoral condyle overlap) and skyline views are also recommended.
Meniscal repair
Dr Vishal Pai repairs rather than removes the meniscus wherever the tear allows
Initial management
- PhysiotherapyRestore range of motion and quadriceps strength
- Activity changesAvoid deep squatting and twisting while symptoms settle
- Pain reliefIce and simple analgesia for swelling and pain
Refer when
- Traumatic meniscal tears in younger, active patients
- Displaced bucket-handle tear or a locked knee (urgent)
- Meniscal root tears with well-preserved cartilage
- Start degenerative tears with exercise therapy. Refer if the knee truly locks, or if symptoms last beyond about 3 months of supervised rehabilitation
Recommended investigations
An MRI is recommended.
Osteotomy
Realignment surgery that unloads one side of the knee
Initial management
- Exercise and weightExercise therapy and weight management
- Unloader braceA trial of an unloader brace
- Low-impact activityCycling and swimming, with simple analgesia as needed
Refer when
- Younger, active patients with single-compartment arthritis and malalignment, usually varus
- Malalignment or a steep tibial slope alongside ligament or cartilage surgery
- Patients who want to delay knee replacement and keep a high activity level
Recommended investigations
Weight-bearing AP, lateral and skyline X-rays. A long-leg alignment view of both lower limbs is useful prior to the appointment.
How to refer
We are a digital practice and prefer referrals by email or HealthLink. Please attach any relevant imaging. Once we receive the referral, the rooms will contact the patient to arrange an appointment.
Two ways to refer
Private patients
Refer to his rooms at Sandringham Orthopaedic Specialists
Patients need private health insurance. Dr Vishal Pai does not see WorkSafe or Transport Accident Commission (TAC) patients in his private practice.
Public patients
Refer to the orthopaedic outpatient clinic at Sandringham Hospital
You can address the referral to Dr Vishal Pai.
What to include
Imaging
X-rays for arthritis, MRI for ligament, meniscal and patellar problems. Reports and image links both help.
History
Mechanism of injury, rehabilitation so far, injections, and relevant comorbidities and medications.
Operating at
- Calvary Holmesglen Private Hospital, Moorabbin
- The Avenue Hospital, Windsor
HealthLink EDI
drvishal
For secure electronic referrals.
When to refer urgently, and when to wait
Most knee problems can start with good rehabilitation. A few should be seen within days.
Urgent referrals, call the rooms(03) 8657 0595
Call for an urgent appointment
- Locked knee that cannot fully straighten
- Displaced bucket-handle meniscal tear
- Patellar dislocation with an osteochondral fragment
- Multi-ligament injury or suspected knee dislocation
- Acute posterolateral corner injury
- Suspected infection in a knee replacement Dr Vishal Pai has performed
Suspected fractures, a hot swollen joint with fever, or a cold or numb leg should be referred to the emergency department.
Refer routinely
- ACL rupture in a patient wanting to return to sport
- Two or more lateral patellar dislocations
- Knee arthritis not controlled by non-operative care
- A painful, stiff or unstable existing knee replacement
Dr Vishal Pai aims to see acute sports injuries within 2 weeks.
Try rehabilitation first
- Degenerative meniscal tears without locking
- Early or mild osteoarthritis
- Chondromalacia patellae
Refer if symptoms are not improving after about 3 months of supervised exercise therapy.
Not seen in this practice
- Hip, spine, shoulder, foot and ankle problems
- Acute fractures and trauma
Our commitment to you
As a referrer, you can expect:
Timely communication
Dr Vishal Pai writes to you after the first consultation and after surgery, and your patient receives a concise summary of their visit.
Direct access to Dr Vishal Pai
If you have a concern about a patient you have referred, you can speak with him directly. He shares his mobile number and email with referring practitioners.
Evidence-based recommendations
Each patient receives a balanced opinion on the benefits and risks of surgery, with treatment recommendations based on current evidence.
Join Dr Vishal Pai in theatre
See the operation your patients will have.
Education is a passion for Dr Vishal Pai. During a theatre visit he will take you through the operation so you understand what it involves, and discuss the rehabilitation and the clinical aspects of each case. Choose the procedure you would most like to see, and the rooms will arrange a date.
- Send the form with your preferred operation
- The rooms contact you with available theatre dates
- Hospital observer approval is arranged before your visit
- Spend the list in theatre, with time to talk through each case
The knee literature, read for you
Twice a year, Dr Vishal Pai distils the research that changes how knee patients are managed into one short email you can read in five minutes. No journals to chase, nothing to sift.
- Practice-changing evidence, with what it means for your patients
- Updated rehabilitation protocols and return-to-sport milestones
- First notice of CPD evenings and theatre visit dates