Over the last 18 months, many hospitals were forced to postpone elective surgeries to make room for COVID-19 critical care. In the UK alone, 100,000 people had their joint replacement procedures cancelled during first wave, leaving them with untreated pain and mobility challenges. More than one-third of those waiting for a total knee or hip arthroplasty described their state of being as “worse than death”, a situation twice as bad as that observed prior to the pandemic. The picture is similar across Europe.
Osteoarthritis (OA), a degenerative joint condition that affects approximately 350 million people worldwide, is one of the most frequent conditions for which patients may need a total knee replacement. We know that as populations age, the risk of OA increases – leading to higher demand for care.
Medical professionals face huge challenges in addressing the decreasing quality of life and the mounting quantity of cases. I believe that our industry should focus on helping surgeons, patients, nurses, and healthcare systems work through this backlog.
Ultimately, our goal is to achieve and maintain a high throughput of patients without compromising on either the outcomes or the standards of care. Since it’s unlikely that hospitals can double the number of surgeons or that they will receive extra resources, what remains within their control is to perform orthopedic procedures more effectively and efficiently.
In essence, patient throughput is a function of three factors: operating time, complications, and length of stay (LOS).
Consistently shorter procedure times allow hospital planners to put more patients on a list, maximizing the use of available operating theatre space. Choosing one implant over another could reduce surgery time allowing an additional patient to be added to each operating list.
Each complication is likely to block a bed and to affect operating capacities and hospital personnel. The quality of implant used is one of the ways to decrease the rate of complications. The latest digital technologies designed to reduce surgical variation and improve consistency of outcomes can also contribute to a reduction in those rates. This can translate directly into shorter hospital stays and bypassing rehabilitation centers.
The choice of surgical approach can result in significant LOS reduction. For many patients LOS could be as short as 24 hours in a hospital. This shift from inpatient to outpatient care can alleviate pressure on the hospital system and reduce associated costs.
With the right support, hospitals can optimize and streamline the patient pathway from pre-admission to post-discharge care. Education of the hospital team plays a crucial role in ensuring every patient gets a consistent high level of care, but it is important that the patient also understands what they can do to contribute to a successful outcome following surgery. A combination of in-person and virtual events, along with online platforms, virtual reality and tele-mentoring, can all be used to support the learning of everyone involved.
As we mark World Osteoarthritis Day (12 October), it is vital that we work together to tackle lengthy waiting lists for joint replacement. Together, we can accelerate access to surgery and recovery – getting patients back on their feet and improving their quality of life.