title: Delays worsen quality of life outcome of primary total hip arthroplasty.
abstract: Although there are indications of health status deterioration for patients while waiting for elective total hip arthroplasties, controversy exists regarding the effect of waiting on postoperative outcomes. We hypothesized that longer waiting times are detrimental to achieving the full benefit of surgery. We prospectively examined 201 patients with osteoarthritis who were on the waiting list for primary total hip arthroplasties. The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire was used to assess patients at surgical consultation (preoperative) and 1 year postoperative. The study included regression models to determine the expected outcome for an individual's preoperative score. Logistic regression models were used to assess the relationship between waiting time and the probability of a better than expected outcome. We found that the odds of achieving a better than expected postoperative functional outcome decreased by 8% for each month on the waiting list. Expedited access resulted in a larger proportion of patients with better than expected function 12 months after surgery.
authors.affiliation: Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada. garbuz@shaw.ca
authors.forename: Donald S
authors.initials: DS
authors.lastname: Garbuz
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.forename: Clive P
authors.initials: CP
authors.lastname: Duncan
authors.forename: Bassam A
authors.initials: BA
authors.lastname: Masri
authors.forename: Boris
authors.initials: B
authors.lastname: Sobolev
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001955:British Columbia; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011336:Probability; D011446:Prospective Studies; D011475:Prosthesis Failure; D011788:Quality of Life; D012044:Regression Analysis; D018570:Risk Assessment; D012720:Severity of Illness Index; D013315:Stress, Psychological; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists