"Worse than Death" - waiting for a joint replacement

Description

Chloe Scott presents findings on the health-related quality of life in patients awaiting joint replacements, focusing specifically on hip and knee arthroplasties. Expressing gratitude to the British Hip Society for the invitation, she provides disclosures before delving into the public health implications related to joint replacements. She highlights the increasing significance of health-related quality of life measures, particularly in the light of dwindling resources and delays in elective surgeries, such as total hip replacements, exacerbated by the COVID-19 pandemic.



Scott discusses the prevalence of different patient-reported outcome measures and argues that joint-specific outcome scores may be inadequate for evaluating the broader implications of degenerative joint diseases. She details the alarming trend of an increasing percentage of patients reporting negative health-related quality statuses, termed 'worse than death,' on the EQ-5D score, which identifies a significant population awaiting surgery experiencing significantly reduced quality of life.



The analysis provides insight that patients on waiting lists are often subjected to postponements of needed surgeries, which correlate with a decrease in health outcomes. Specifically, Scott reveals that, during the pandemic, the rates of patients categorizing their quality of life in 'worse than death' categories had doubled.



Crucially, Scott underscores that the waiting times and resultant health declines during waiting periods can lead to poorer surgical outcomes, whereby those patients already in worse health experience even greater declines post-operatively. Ultimately, Scott argues that timely joint replacement procedures are essential to prevent further deterioration in these patients' lives, advocating for improved healthcare delivery systems that ensure adequate access to joint replacement surgeries.

DOI: 10.1302/3114-221783

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