If you live in Nova Scotia and need a new knee, prepare to wait a lot longer than do citizens in other part of Canada. The average Canadian national waiting time for a joint replacement is about six months. In Nova Scotia it is three times that, according to Jean Laroche, writing for the CBC News.
Nova Scotia’s Wait Lists Longest
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Over the last two years the Nova Scotia government spent an additional $6 million in an attempt to catch up with the waiting list. Doctors performed 1, 000 more procedures. Still they could not catch up. So what is going on?
Part of the problem, says Peter Vaughan, a Nova Scotia senior health officer, is that people who need surgery are joining the wait list as fast as people come off it. Reason? Unhealthy lifestyles. “We’re seeing more people in the relatively younger group in their 40s who are getting hip and knee replacements and that’s related to some of the lifestyle choices that people make, ” said Vaughan. “Increased weight for example.”
If a patient refuses to change his eating habits or does not begin to exercise, Vaughan says that too can further add to the wait list. Laroche quoted Vaughan as saying that if you have to have a hip or knee joint replaced in your 40s, you may have to wait until you are in your 60s to actually have the surgery.
Uff da!
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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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