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      The number of patients “worse than death” while waiting for a hip or knee arthroplasty has nearly doubled during the COVID-19 pandemic : a UK nationwide survey

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          Abstract

          Aims

          The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic. Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery.

          Methods

          During the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Patient demographic details, procedure, and date when listed were recorded. Patients scoring less than zero for their EQ-5D score were defined to be in a health state “worse than death” (WTD). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group.

          Results

          The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively; p < 0.001). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117).

          Conclusion

          Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. Increasing length of time on the waiting list was associated with decreasing quality of life. Level of evidence: Level III retrospective case control study

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          Author and article information

          Journal
          The Bone & Joint Journal
          The Bone & Joint Journal
          British Editorial Society of Bone & Joint Surgery
          2049-4394
          2049-4408
          March 23 2021
          : 1-9
          Affiliations
          [1 ]Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
          [2 ] Department of Orthopaedics, University of Edinburgh, Edinburgh, UK
          [3 ] Avon Orthopaedic Centre, Southmead Hospital & University of Bristol, Bristol, UK
          [4 ] Department of Orthopaedics, Freeman Hospital, Newcastle, UK
          Article
          10.1302/0301-620X.103B.BJJ-2021-0104.R1
          33752468
          06003b5c-0fe5-4e7d-835b-1d993d17acbb
          © 2021
          History

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