Eighty percent of Canadians get their hips or knees replacement within six months. Not so in Nova Scotia—the worst place in Canada to sign up for a large joint replacement.
Nova Scotia Wait Times Astonishingly Long
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Waiting time for a new hip or knee in that province is the longest in Canada. As of March, 857 Nova Scotians were waiting for hip replacements, and another 2, 248 were waiting for knee replacements. The Nova Scotia Health Minister, Leo Glavine, says many patients may wait for 18 to 20 months for surgery. The national benchmark for joint replacement in Canada is six months—a standard that Nova Scotia has yet to achieve.
“We know they live in pain and their condition deteriorates, ” says Glavine. “In some cases, I’ve heard that surgery might not improve their case because they have been waiting for such a long time.”
What’s the problem?
According to Dr. David Amirault, chief of orthopedic surgery at the Queen Elizabeth II Health Sciences Centre in Halifax and as quoted in CBC news: “There’s not enough operating rooms, there’s not enough surgeons doing the procedures, there’s not enough money to support those procedures.”
To solve the waiting time problem the Nova Scotia government is planning to spend $4.2 million this year to recruit a more orthopedists for perform hip and knee replacements as well as a foot and ankle sub-specialist surgeon.
The province’s healthcare providers also hope to improve efficiency in orthopedic care. The Health Department is also publishing wait time information on a web site for all surgeries. The Nova Scotia doctors say the website will increase transparency and help physicians referring patients for surgery.
The average wait time for a large joint replacement is currently 337days. For more information, go to: www.waittimes.novascotia.ca
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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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