title: The Manitoba arthroplasty waiting list: impact on health-related quality of life and initiatives to remedy the problem.
abstract: BACKGROUND
  With the aging population, arthritis of the hip and knee is increasing exponentially. While total joint replacement of the hip and knee have been proven to provide excellent outcomes for this debilitating clinical entity, the demand in Canada has grown to such an extent that there are thousands of people suffering on wait lists across the country. There have been numerous recent studies focusing on the effects that waiting have on patient post-operative subjective and objective clinical outcomes.
  
  
  OBJECTIVE
  This commentary attempts to provide a review of the relevant data on the impact that waiting has on the health related quality of life of these patients. Additionally, the hip and knee arthroplasty wait list in Manitoba is illustrated to provide an example of interventions that have helped to combat a potential crisis situation in the province.
  
  
  METHODS
  The literature on the impact of waiting times on health-related quality of life in hip and knee arthroplasty patients is reviewed. The example of the Manitoba arthroplasty waiting list is then provided to illustrate potential measures that can be implemented to decrease waiting times.
  
  
  RESULTS
  The literature shows that health-related quality of life declines as patients wait for surgery. The interventions that the province of Manitoba has implemented in the last seven years seem to be reducing waiting times and the number of patients on the waiting list.
  
  
  CONCLUSIONS
  The framework used in Manitoba may serve as an example for other provinces and potentially countries that find themselves faced with the same problem. However, more measures are required to build on the positive results encountered with these initial successes.
authors.affiliation: Section of Orthopaedic Surgery, University of Manitoba, Winnipeg, Canada. mascarer@hotmail.com
authors.forename: Randy
authors.initials: R
authors.lastname: Mascarenhas
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D008350:Manitoba; D011788:Quality of Life; D014850:Waiting Lists