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Change in pain and function while waiting for major joint arthroplasty.
K D Kelly1, D C Voaklander, D W Johnston
1Department of Rural Health, University of Melbourne Shepparton, Victoria, Australia. k.Kelly@medicine.unimelb.edu.au
The Journal of Arthroplasty
|April 18, 2001
Summary
Patients awaiting hip or knee replacement surgery experienced minimal changes in pain and physical function during their wait. Waiting times did not negatively impact pain or dysfunction levels for most patients undergoing major arthroplasty.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Health Services Research
Background:
- Major arthroplasty (hip or knee replacement) is a common procedure for debilitating joint pain.
- Patients often face significant waiting times for elective arthroplasty, raising concerns about potential worsening of symptoms.
- Understanding the impact of waiting periods on patient-reported outcomes is crucial for managing expectations and optimizing care pathways.
Purpose of the Study:
- To prospectively evaluate changes in pain and physical function in patients awaiting major hip or knee arthroplasty.
- To determine if waiting times greater than one month negatively affect patient-reported pain and functional status.
- To assess the impact of waiting on psychosocial function in the arthroplasty waiting population.
Main Methods:
- Prospective cohort study involving 313 patients scheduled for total hip arthroplasty or total knee arthroplasty.
- Data collection included validated instruments: WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and SF-36 (Short Form 36 Health Survey).
- Assessments were performed at two time points: upon placement on the waiting list and immediately prior to surgery.
Main Results:
- Minimal changes in pain levels were observed for both hip and knee arthroplasty patients during the waiting period.
- Physical function showed only slight alterations, with no significant negative impact attributed to the waiting time.
- Psychosocial function also remained relatively stable, indicating that waiting did not substantially worsen these aspects for the majority of patients.
Conclusions:
- Waiting for major hip or knee arthroplasty, for periods exceeding one month, is associated with minimal deterioration in pain and physical function.
- The findings suggest that current waiting times for arthroplasty do not significantly exacerbate patient-reported pain or functional limitations.
- This study provides evidence that supports the current management of arthroplasty waiting lists, indicating a low risk of significant negative impact on patient outcomes during the wait.