The wait for total hip replacement in patients with osteoarthritis.
OBJECTIVE
We documented the following components of waiting time for total hip replacement (THR): first surgical consultation, date of decision to operate and date of surgery. We then explored whether these intervals differed by age, sex, occupation or quality-of-life score.


METHODS
We used a cross-sectional design and collected the primary data from patients 2 to 4 weeks before they underwent THR. Trained interviewers administered the Medical Outcomes Study Short Form-36 and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which included data on event dates, conservative treatment, demographic information and quality of life. We illustrated waiting times, quality of life and past use of conservative treatment (i.e., cane, exercise, physiotherapy) with descriptive statistics (mean [standard deviation] or median [intraquartile range]) for continuous variables and with percentages for categorical variables. We plotted KaplanMeier graphs for each waiting time component and employed log-rank analysis to determine whether any of these delays differed by age, sex, occupation or disability. We also performed a Cox regression to adjust for all covariates simultaneously.


RESULTS
The median wait from surgical consultation to decision to operate was 0 months. There was no difference between age, sex or occupation. The median wait from decision to operate to the date of surgery was 6 months and did not differ by age, sex or occupation. However, subjects with more severe symptoms (WOMAC) underwent surgery earlier than did those with less severe disease.


CONCLUSIONS
Although neither of the waiting time components were associated with age, sex or occupation, patients with more severe symptoms appear to be prioritized for surgery.
Gaudet
Marie-Claire
MC
Division of Santé communautaire, Université de Montréal, Montréal, Qué., Canada.
Ehrmann Feldman
Debbie
D
Rossignol
Michel
M
Zukor
David
D
Tanzer
Michael
M
Gravel
Charles
C
Newman
Nicholas
N
Dumais
Réjean
R
Shrier
Ian
I
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011788:Quality of Life; D011792:Quebec; D012737:Sex Factors; D013997:Time Factors; D014850:Waiting Lists