Patients in Alberta, Canada with painful hips and knees are feeling good about their health service. The reason? The wait time for a joint replacement has dropped three weeks to 19.2 weeks thanks to a new Hip and Knee Replacement Program that was launched in 2010.
Canadians Cut Surgery Wait Time

Wait time for surgery is not all that has changed. Over the same period, according to Markham Hislop, of the Beacon News, hospital stays dropped from 4.9 days for hip replacements and 4.6 days for knees to 4.1 days for both surgeries. The patient satisfaction rate went from 86% to 98% and the rate of hospital readmission following surgery, already low at 4.3%, dropped to 4.1%.
The man behind this improvement is Don Dick, M.D., Senior Medical Director of Alberta Health Services’ Bone and Joint Health Strategic Clinical Network, which operates the program.
“This program has far exceeded our goals, ” Dick said. “It really is a win-win project. We are always focused firstly on improving care for patients but we also need to ensure we get the best value for our health care dollars and help make our system sustainable. The hip and knee replacement program does both.”
Hislop noted that the reductions in the length of hospital stay have freed up about 33, 000 days of hospital bed space since 2010, enabling the Alberta Health Service to perform more than 1, 600 additional hip and knee surgeries with the same bed capacity.
Health Minister Fred Horne said, “As a government, we’re committed to improving the performance of our health care system and today’s update on hip and knee surgeries shows that we’re moving in the right direction. I’m sure this is welcomed news for the many Albertans that have this type of surgery every year and are able to get back to their normal lives sooner because of this program.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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