Waiting for elective orthopaedic surgery: A qualitative scoping review of the patient experience

Public health waiting lists for elective or planned orthopaedic surgery are increasing to the point where demand far exceeds our ability to treat. This is largely due to ageing populations, rising obesity and the continued impact of delays caused by the COVID-19 pandemic. While waiting, patients suffer debilitating physical pain, functional limitation, social isolation and associated mental health impacts while some are unable to work. This qualitative scoping review explored and mapped the experiences of patients of waiting for elective or planned orthopaedic surgery.

This review was conducted according to the Joanna Briggs Institute Scoping Review methodology and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A comprehensive database search was conducted to identify English language articles from 2009 until June 2025. Data extraction was informed by the Standards for Reporting Qualitative Research. Results were thematically analysed and presented using the Quality Health Outcomes Model.

The initial search identified 4713 articles, of which, 21 manuscripts met inclusion criteria. The 21 articles comprised 17 primary qualitative research studies and four review articles published within the designated time period (2009 to 2025). Two key themes were identified: 1. Patients waiting for elective orthopaedic surgery need psychosocial support and 2. System-level, multi-factorial communication issues with the waiting list leave patients feeling lost between primary and specialist care. These themes suggest that the challenges faced due to lengthy elective surgery waiting lists are not simply a capacity issue, but also a challenge of coordinated, patient- centred care.

Waiting for surgery is consistently described by patients as a source of anxiety and distress. With waiting list times for elective surgery increasing, the experience can be improved in part with adequate communication from healthcare providers. A re-focus on what matters most to the patient and their family is required in order to deliver adequate patient-centred care while patients wait for surgery.