Health tourism in limb reconstruction - a recognised burden on the NHS

There has been an increase in patients travelling from the UK abroad for limb-lengthening surgery. Often patients return to the UK for rehabilitation. Complications are challenging and can require major surgery to correct. The aim of this study is to identify patients returning from abroad following limb reconstruction surgery and estimate the financial cost to the NHS.

All patients referred following limb-lengthening surgery abroad since 2021 were included in the study. Seven patients were identified. Six underwent bilateral femoral cosmetic lengthening, and one lengthening of femur, tibia and foot for congenital deficiency. Total Patient Income, calculated by the total number of contacts in the Trust, subtracted from Total Patient Costs provided a net contribution.

All patients required physiotherapy. Two patients required major surgery for complications, a quadricepsplasty for severe knee stiffness and sequential removal of bilateral broken Femoral Precice nails with renailing for poor bone regenerate. Overall, only one patient contributed a positive income to the Trust, the remaining patients created a loss of -£36,448.

Cosmetic limb-lengthening surgery abroad is attractive to many, but rehabilitation is required to gain the optimal outcome. Undertaken back in the UK this requires resources, increased hugely if there are associated complications that require further surgical treatment. Patient education with full understanding of the consequences of surgery and rehabilitative process remains a challenge, which can lead to poor outcomes and need for further surgery to help restore function, leading to increased cost to the NHS.