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The COVID-19 pandemic has had a significant impact on elective arthroplasty in the UK, with the cessation of nonurgent cases in mid to late March 2020. Level of evidence: Level III retrospective case control studyĬite this article: Bone Joint J 2021 103-B(4):672–680. Increasing length of time on the waiting list was associated with decreasing quality of life. Over one-third of patients waiting for THA and nearly one-quarter waiting for a KA were in a state WTD, which was approaching double that observed prior to the pandemic. There were 117 (13.9%) patients who wished to defer their surgery and the main reason for this was health concerns for themselves and or their family (99.1%, n = 116/117).
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Each additional month spent on the waiting list was independently associated with a decrease in quality of life (EQ-5D: -0.0135, p = 0.004). Over 80% (n = 680/843) of the 2020 group felt that their quality of life had deteriorated while waiting. Over one-third (35.0%, n = 138/394) of patients waiting for a THA and nearly a quarter (22.3%, n = 100/449) for KA were in a health state WTD, which was significantly greater than the control group (odds ratio 2.30 (95% confidence interval (CI) 1.83 to 2.93) and 2.08 (95% CI 1.61 to 2.70), respectively p < 0.001). The 2020 group had a significantly worse EQ-5D score compared to the control group for both THA (p < 0.001) and KA (p < 0.001). Data from a retrospective cohort (January 2014 to September 2017) were used as the control group. Patients scoring less than zero for their EQ-5D score were defined to be in a health state “worse than death” (WTD). Patient demographic details, procedure, and date when listed were recorded. Methodsĭuring the study period (August and September 2020) 843 patients (THA n = 394, KA n = 449) from ten centres in the UK reported their EuroQol five dimension (EQ-5D) scores and completed a waiting list questionnaire (2020 group). Secondary aims were to assess whether length of time on the waiting list influenced quality of life and rate of deferral of surgery. The aim of this study was to assess the quality of life of patients on the waiting list for a total hip (THA) or knee arthroplasty (KA) during the COVID-19 pandemic.