Abstract
Approximately 70,000 hip and knee procedures are performed in English hospitals each year [1], causing lengthy waiting lists for total joint replacements (TJR) within the National Health Service (NHS). Most patients have to wait for many months for an initial appointment to see an orthopaedic surgeon, and a further 6–18 months before they are put on the TJR waiting list. Some wait for shorter times than others, and a proportion of those referred to NHS surgeons for consideration of joint replacement are not put on the waiting list, being told that surgery is not appropriate for them. These findings imply that choices are being made as to who should have an operation and which cases should be prioritised [2, 3]. There are also concerns about unmet need for treatment of severe arthritis in the UK and underprovision of total knee joint replacements [4, 5]. Recent reviews have highlighted variations in surgical activity at both national [1] and international levels [6], with the US, for example, having much higher rates of total knee replacement (TKR) than the UK. Rates of TJR also vary by age, gender, ethnicity and, socio-economic status [7, 8], despite there being no evidence that such factors affect outcome [7– 9].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Williams MH, Frankel S, Nanchahal K, Coast J, Donovan J. Total Hip Replacement. In: Stevens A, Raftery J, eds. Health Care Needs Assessment, Oxford: Radcliffe Medical Press, 1994, pp. 448–523
Mancuso CA, Ranawat CS, Esdaile JM, Johanson NA, Charlson ME. Indications for total hip and knee arthroplasties. The Journal of Arthroplasty 1996. 11: 34–46
Wright JG, Coyte P, Hawker G, et al Variation in orthopaedic surgeons’ perceptions of the indications for and outcomes of knee replacement. Canadian Medical Association Journal 1995. 152: 687–697
Birrell F, Johnell O, Silman A. Projecting the need for hip replacement over the next three decades: influence of changing demography and threshold for surgery. Annals of the Rheumatic Diseases 1999. 58: 569–572
Tennant A, Fear J, Pickering A, Hillman M, Cutts A, Chamberlain MA. Prevalence of knee problems in the population aged 55 years and over: identifying the need for knee arthroplasty. British Medical Journal 1995. 310: 1291–1293
Dieppe P, Basler HD, Chard J, et al Knee replacement surgery for osteoarthritis: effectiveness, practice variations, indications and possible determinants of utilization. British Journal of Rheumatology 1999. 38: 73–83
Katz BP, Freund DA, Heck D, et al.Demographic variation in the rate of knee replacement: a multi-year analysis. Health Services Research 1996. 31: 125–140
Chaturvedi N, Ben-Shlomo Y. From the surgery to the surgeon: does deprivation influence consultation and operation rates? British Journal of General Practice 1995. 45: 127–131
Hawker GA, Wright JG, Coyte PC, et al Differences between men and women in the rate of use of hip and knee arthroplasty. New England Journal of Medicine 2000. 342: 1016–1022
Pope C, Mays N. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. British Medical Journal 1995. 311: 42–45
Malterud K. Qualitative research: standards, challenges, and guidelines. The Lancet 2001. 358: 483–488
Glaser BG, Strauss AL. The discovery of grounded theory. Chicago: Aldine, 1967
Blaxter M. The causes of disease. Women talking. Social Science and Medicine 1983. 17: 59–69
Hudak PL, Clark JP, Hawker GA, et al “You’re perfect for the procedure! Why don’t you want it” Elderly arthritis patients’ unwillingness to consider total joint arthroplasty surgery: a qualitative study. Medical Decision Making 2002. 22: 272–278
Griffin FM, Scuderi GR, Insall JN, Colizza W. Total knee arthroplasty in patients who were obese with 10 years follow up. Clinical Orthopaedics and Related Research 1998. 356: 28–33
Donell S, Neyret P, Dejour H, Adeleine P. The effect of age on the quality of life after knee replacement. Knee 1998. 5: 125–128
Kennedy LG, Newman JH, Ackroyd CE, Dieppe P. Are our patients waiting too long for their knee replacements? Rheumatology 2001. Suppl 1: 73(Abstract)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 EFORT
About this chapter
Cite this chapter
Woolhead, G., Sanders, C., Dieppe, P. (2009). Patients’ Views on Total Joint Replacement in the UK. In: Puhl, W., Günther, KP., Dieppe, P., Dreinhöfer, K.E. (eds) EUROHIP. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-74137-4_9
Download citation
DOI: https://doi.org/10.1007/978-3-540-74137-4_9
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-74133-6
Online ISBN: 978-3-540-74137-4
eBook Packages: MedicineMedicine (R0)