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Waiting for total hip arthroplasty: avoidable loss in quality time and preventable deterioration
Marieke Ostendorf1, Erik Buskens, Henk van Stel
1Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
The Journal of Arthroplasty
|April 7, 2004
Summary
Waiting for total hip arthroplasty significantly worsens patient-reported outcomes and leads to a loss in quality-adjusted life years. Delayed surgery impacts disease progression, affecting long-term recovery potential.
Area of Science:
- Orthopedic Surgery
- Health Economics
- Patient-Reported Outcomes
Background:
- Long waiting times for total hip arthroplasty (THA) are a growing concern in healthcare systems.
- The impact of these delays on patient quality of life and functional outcomes requires further investigation.
Purpose of the Study:
- To quantify the loss in quality-adjusted life years (QALYs) associated with THA waiting times.
- To assess the effect of waiting duration and preoperative function on postoperative outcomes in THA patients.
Main Methods:
- Prospective cohort study of 161 patients awaiting THA.
- Utilized validated instruments: Oxford Hip Score, WOMAC, SF-36, and EuroQol.
- Data collection at baseline, preoperatively, and 3 and 12 months post-surgery.
Main Results:
- Disease-specific scores significantly deteriorated during the waiting period.
- A substantial loss of QALYs was observed due to postponed surgery.
- No direct impact of waiting time on postoperative outcomes was found, but poorer preoperative function correlated with less improvement.
Conclusions:
- Waiting times for THA result in significant patient burden and loss of quality-adjusted life years.
- While waiting time itself may not directly affect immediate postoperative scores, advanced disease at the time of surgery limits functional recovery potential.