Waiting for total hip arthroplasty: avoidable loss in quality time and preventable deterioration

This study was conducted to determine the effect of waiting times for total hip arthroplasty in terms of loss in quality-adjusted life years and additional burden perceived. A second goal was to study the effect of waiting times and preoperative function scores on postoperative outcome scores. Data were collected prospectively from a cohort of 161 patients waiting for total hip arthroplasty. The Oxford Hip score, Western Ontario and McMaster Universities Osteoarthritis Index, SF-36, and the EuroQol health status instruments were administered when the patient was placed on the waiting list, preoperatively, and 3 and 12 months after surgery. The disease-specific scores especially showed a significant deterioration during the waiting time. Moreover, a considerable loss of quality-adjusted life years occurred simply by postponing surgery. Although we found no direct effect of waiting time on postoperative outcomes, patients in a later phase of the disease process did not improve to the level achieved by patients with better preoperative function.