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IMPORTANCE OF ASSESSMENT AND FOLLOW-UP FOR THE PATIENTS WAITING FOR THE MAJOR ARTHROPLASTY.



Abstract

Introduction: 4525 THRs and 1071 TKRs were performed in the eight-health board region of Ireland in the year 2001. The demand continues to increase and long waiting lists for surgery are common. In September 2002, 3258 public patients were waiting for orthopaedic surgery and many of these are joint replacement procedures.

We have developed a system of assessment and reassessment and for the patients who are on the waiting list for hi p and knee arthroplasty. We have evaluated the changes in hip and knee scores in cohort of patients while waiting for surgery.

Method: 153 patients who waited I excess of 6 months for surgery were assessed. Changes in Harris Hip Score and American Knee Society Score while waiting were analyzed. The range of scores for HHS is from 0 (severely disabled) to 100 (normal), and similarly for AKSS is 0 to 200, depending on the symptoms, disabilities and physical findings of the patient.

Result: Out of 153 patients for arthroplasty 105 (68.62%) were waiting for the THR and 48 (31.37%) were waiting for the TKR. Patients for THR (n=105) ranged in age from 30–90 years, with a mean age of 60 years. The average initial hip score was 63.70 and the average hip score in assessment clinic was 53.00 so the average scores deteriorated in score of 24.42 on reassessment.

Conclusion: Above result shows that there is significant deterioration in both hip (10.7) and knee (24.42) scores in patients waiting for hip and knee replacement over a six-month period. This emphasises the importance of regular review and reassessment of waiting list to allow reprioritisation according to changing clinical needs.

The abstracts were prepared by Raymond Moran. Correspondence should be addressed to him at the Irish Orthopaedic Assocation, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.