Randomized Trial of Long Versus Short Wait for Primary Total Hip and Knee Arthroplasty

Description:

Waiting lists for high-demand medical treatments like hip replacement and cataract eye surgery are frequently discussed but little is known about their impact on the success of treatment. Long waits are bad enough since they prolong periods of compromised health, but it may also be true that they prevent the awaited treatment from having its full effect. There is some evidence that patients with overly long waits for their hip and knee replacement may not receive the same long-term benefit that they would have received with earlier access. This study focuses directly on that question using the effective methods of a randomized trial.

Methodology:

Patients will be randomized to one of two waiting groups. One will wait for eight months (slightly shorter than the normal wait of 11 months). The other will have surgery almost immediately (within two months.) At the end of two years we will compare the absolute and relative benefit in terms of pain relief and improved function, between these two groups.

Participant Recruitment:

The study is open to all patients having a first-time hip or knee replacement at Vancouver Hospital.

Impact For People With Arthritis:

Improved knowledge about the full consequences of waiting for joint replacement will have two important effects. If it shows an advantage to early surgery it can be used by planners to raise the resources needed for prompt treatment. It can also indicate when in the natural history of osteoarthritis it is appropriate to intervene with surgery. If waiting does not matter if can be later in the disease. If waiting has consequences then earlier is better.

Time Frame:

January 2002 - December 2005

Funding Agency:

The Arthritis Society

Team Members

Principal Investigator

Donald Garbuz  MD, MHSc
Research Scientist, ARC

Co-Investigators

Aslam Anis  PhD
Research Scientist, ARC

Clive Duncan  MD

John Esdaile  MD, MPH
Scientific Director, ARC

Nelson Greidanus  MD, MPH
Research Scientist, ARC

Jacek Kopec  MD, PhD
Research Scientist, ARC

Matt Liang  MD, MPH
Harvard Medical School

Bassam Masri, MD

Study Coordinator

Min Xu  MSc
Research Coordinator, ARC

Other Institutions Involved:

Vancouver Hospital
Vancouver, Canada