Abstract
In 2002 the UK government in its attempt to reduce long total joint arthroplasty waiting lists, arranged for local councils via NHS trusts to send patients abroad for their surgery. In theory it was a win-win situation where pressures upon surgeons were reduced, trusts could reach government targets and of course, patients got their operation with a bonus holiday! Unfortunately, it was not until patients had returned from their surgery that problems with this method of waiting list reduction were realised. The majority of patients were discharged after only one check up and often had very little in the way of post operative physiotherapy. A few presented to our clinic with more serious complaints with two cases eventually requiring revision surgery.
We undertook a case-control study looking at an age and sex matched group of patients who underwent total knee arthroplasty, Group A (Belgium) and Group B (Local Institution) during the same time period from November 2003 to November 2004. We compared their Oxford knee score (OKS), Knee society score (KSS) and SF12 physical and mental component scores.
Results
Follow up was a minimum of 28 months. No significant difference was noted with the OKS and KSS (Group A-average OKS 24.68, average KSS 72.72, Group B-average OKS 25.04, average KSS 79). However, SF12 figures revealed a statistically significant difference between the two groups in both the physical (PCS) and mental components (MCS) (Group A - mean PCS 40, mean MCS 48, Group B – mean PCS 47, mean MCS 57, P<0.05).
Conclusion
Our results show that although the majority of patients operated upon abroad had got comparable functional results as patients operated locally, they often felt dissatisfied with the overall experience of going abroad for their operation, especially in terms of post operative care received including physiotherapy and follow up.
