, Volume 169, Issue 2, pp 125-126

Need-based waiting lists for hip and knee arthroplasty

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Need-based waiting lists have been shown to offer advantages over traditional time-based waiting lists. This study investigated the effect of their introduction in our orthopaedic practice.


Each patient on the waiting list for total hip replacement (n=240) and total knee replacement (n=98) was invited to attend a dedicated assessment clinic. At the clinic each patient had a joint score (Harris Hip Score or American Knee Society Score) calculated. Patients with the lowest joint scores were moved to the top of the waiting lists. Scores were repeated postoperatively.


Validation of the hip replacement and knee replacement waiting lists reduced them by 20% and 11% respectively. The efficiency and transparency of the service were increased.


Need-based waiting lists are easily introduced and offer significant advantages over time-based waiting lists. We advocate their introduction in other centres.