Consequences for preoperative pain and function when postponing elective knee and hip arthroplasty

Area of Science:

• Orthopaedic Surgery
• Public Health

Background:

• The coronavirus pandemic led to the postponement of elective surgeries, including knee and hip arthroplasty.
• This study investigated the impact of these postponements on patients with osteoarthritis.

Purpose of the Study:

• To evaluate the effects of postponed elective knee and hip arthroplasty on patient pain, function, and general health.
• To assess patient concerns and perceived changes in condition during the waiting period.

Main Methods:

• 194 patients with postponed elective knee or hip arthroplasty participated.
• Patient-reported outcomes were collected using Oxford Knee and Hip Scores (OKS, OHS) and EuroQol 5-dimension scale (EQ5D).
• Data were collected at surgery cancellation and before rescheduled surgery, assessing pain, function, general health, and patient concerns.

Main Results:

• Complete data were available for 110 patients (57%), with a median postponement of 98 days.
• 34% of patients worried about poorer outcomes, and 68% felt their condition had deteriorated.
• Mean OKS/OHS and EQ5D index differences showed no significant change from cancellation to rescheduled surgery.

Conclusions:

• Patients awaiting knee and hip arthroplasty expressed significant pre-operative anxiety regarding treatment outcomes due to surgical delays.
• Despite subjective feelings of deterioration, patient-reported outcome measures for pain and function remained largely unchanged.
• This highlights a discrepancy between patient perception and objective outcome measures following postponed arthroplasty.