Canadian Joint Replacement Wait Time Lengthens

Despite the best efforts of hospitals and doctors the wait times for hip replacement surgery in eastern Ontario has gotten longer instead of shorter—according to a report in the Ottawa Citizen. Patients in eastern Ontario have the longest wait time of anyone in the province. Those desiring knee replacements are ranked 10th among 14 health regions in waiting time.

From the time a hip replacement is ordered to the time surgery is scheduled, 9 out of 10 eastern Ontarians wait up to 343 days, according the September 3 article by Pauline Tam in the Ottawa Citizen. Of the three regional hospitals performing this surgery, the longest wait is at The Ottawa Hospital (421 days), followed by the Cornwall Community Hospital (303) and Queensway Carleton Hospital (218). The wait for a knee replacement is now 281 days.

Two of the hospitals, which perform the bulk of the region’s 3, 350 joint replacements annually, attribute the longer delays to a higher volume of surgeries as a result of an aging population. One hospital, which in 2008 performed 450 replacement surgeries a year, now does over 1, 200 annually.

Ottawa Hospital’s head of orthopedic surgery, Geoffrey Dervin, M.D., said the improvements being made to shorten wait times cannot keep up with the number of seniors needing joint replacements. “With the demographic shift and the increasing demand, it has just pretty much kept us at a plateau, ” he said.

Health officials in the province disagree and say that it is the unequal caseloads among surgeons causing the problem. Some surgeons have waits of no more than 3 months, while patients of other doctors wait more than18 months for their surgery.

“If you are an average 70-year-old patient who needs a generic hip or knee replacement and you don’t need anything fancy, like a partial knee-replacement or a hip-resurfacing, you really should be able to get it done within six months, ” said Dervin.

Hospitals would like to put their patients on a hospital-wide waiting list and assign them to the first surgeon available to do the procedure. That has not been popular with patients who want to go to a surgeon about whom they have heard good things. Dervin indicated, “It’s consumer choice. Once they’re on someone’s list and they’ve met the surgeon, they seem reluctant to get off the list.” The Ottawa Citizen writer notes that surgeons themselves are sensitive to the issue because any changes to the referral system can affect their surgical volumes, and thus their livelihoods.