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What Time Is the Right Time for THR?

Posted on: 11/30/1999
Total hip replacement (THR) can effectively relieve pain and restore function in hip joints with osteoarthritis or other diseases. Still, THR is usually postponed for as long as possible. Any major surgery has risks. And artificial joints don't last forever. So waiting as long as possible before THR surgery makes sense. But how long is too long?

The question of waiting periods for surgery is especially important in countries like the Netherlands, where this study was done. Countries with publicly funded health systems often have long waits for surgery. Studies that pinpoint when a wait for THR becomes too long could help set limits on waiting periods. This could help improve patient outcomes.

This study looked at results for 161 patients who had THR. Most had osteoarthritis of the hip. On average, they waited six months for THR surgery after being put on the waiting list. The authors compared their pain levels, hip function, and general health during the waiting period and for the year after THR. The scores went down significantly during the waiting period. This time was very hard on many of the patients. After THR, the scores went up significantly.

The results showed that waiting time had no direct link to worse outcomes after THR. However, patients who were further along in the disease process did not improve as much as patients who were doing better before surgery. The authors recommend that doctors rethink the policy of waiting as long as possible to for THR, especially in older patients. In this study, too many patients had much worse quality of life for too long.

Marieke Ostendorf, MSc, et al. Waiting for Total Hip Arthroplasty: Avoidable Loss in Quality Time and Preventable Deterioration. In The Journal of Arthroplasty. April 2004. Vol. 19. No. 3. Pp. 302-309.

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