title: Is longer waiting time for total knee replacement associated with health outcomes and medication costs? Randomized clinical trial.
abstract: BACKGROUND
  The aim of this prospective randomized study was to evaluate the effect of waiting time (WT) on health-related quality of life (HRQoL), knee pain and physical function, and the use and costs of medication of patients awaiting total knee replacement.
  
  
  METHODS
  When placed on the waiting list, 438 patients were randomized into a short waiting time (SWT ≤ 3 months) or a nonfixed waiting time (NFWT > 3 months) group. HRQoL was measured by the 15D, and pain and physical function by modified Knee Society Clinical Rating System at baseline, admission, and 3 and 12 months postoperatively. The costs of medication due to osteoarthritis were calculated at the same measurement points. All analyses were performed using the intention-to-treat principle.
  
  
  RESULTS
  The mean WT was 94 and 239 days in the SWT and NFWT groups, respectively. Apart from higher weekly cost of medication in the SWT group at admission and better HRQoL in the NFWT group 1 year postoperatively, there were no statistically significant differences between the groups in other outcomes during the follow-up.
  
  
  CONCLUSIONS
  Those in the SWT group had higher weekly costs of medication at admission, and reached better HRQoL 3 months earlier than those in the NFWT group, but the latter had better HRQoL after operation. Otherwise, the length of WT was not associated with different health and HRQoL outcomes in the groups.
authors.affiliation: Research Department, National Social Insurance Institution of Finland, Helsinki, Finland. ulla.tuominen@thl.fi
authors.forename: Ulla
authors.initials: U
authors.lastname: Tuominen
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
authors.forename: Johanna
authors.initials: J
authors.lastname: Hirvonen
authors.forename: Seppo
authors.initials: S
authors.lastname: Seitsalo
authors.forename: Pekka
authors.initials: P
authors.lastname: Paavolainen
authors.forename: Matti
authors.initials: M
authors.lastname: Lehto
authors.forename: Kalevi
authors.initials: K
authors.lastname: Hietaniemi
authors.forename: Marja
authors.initials: M
authors.lastname: Blom
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000191:economics*; D019057:Quality-Adjusted Life Years; D013997:Time Factors; D014850:Waiting Lists
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal