Related Experiment Video
Updated: Jun 18, 2026
In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
Unmet needs and waiting list prioritization for knee arthroplasty
Mercè Comas1, Rubén Román, José Maria Quintana
1Evaluation and Clinical Epidemiology Department, Hospital del Mar-IMIM, Passeig Marítim, 25-29, Barcelona 08003, Spain.
Background:
There is a high volume of unmet needs for knee arthroplasty in the population despite the increase in surgery rates. Given the long waiting times to have a knee arthroplasty, some governments have proposed prioritization systems for patients on waiting lists based on their level of need.
Questions/Purposes:
We therefore estimated the needs and demand of knee arthroplasty in four regions of Spain during a 5-year period.
Methods:
We developed a discrete event simulation model to reproduce the process of knee arthroplasty. The prioritization system was compared with the usual waiting list management strategy (by waiting time only).
Results:
Under the prioritization system, patients saved an average of 4.5 months (95% confidence interval, 4.4-4.6 months) adjusted by level of need. The proportion of patients who experienced excessive waiting times was small and was associated with low levels of priority. The 5-year projection of the volume of unmet needs for knee arthroplasty remained stable; however, although the volume of need for the first knee arthroplasty decreased by 12%, the volume of need for an arthroplasty in the contralateral knee increased by 50%.
Conclusions:
The data suggested the prioritization system was more beneficial than assigning surgery by waiting time only. The 5-year projection of the volume of unmet needs for knee arthroplasty remained stable, despite the increase in the need for contralateral knee arthroplasty.
Level Of Evidence:
Level II, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
