'Waiting poorly' for hip and knee arthroplasty - unmet needs and lack of support while waiting for surgery : findings of the multicentre WAIT-DATA study.

AIMS: In socialized health systems, prolonged waiting times for hip and knee arthroplasty lead to progressive decline in patients' health-related quality of life. This multicentre study aimed to evaluate patients' experience of the information, advice, and support received during the waiting period, and to identify which groups feel least supported.

METHODS

This study was a multicentre prospective observational audit including 851 patients undergoing elective hip or knee arthroplasty across 14 hospitals in the UK. Participants completed a standardized questionnaire assessing satisfaction with nine domains of preoperative information and support, each rated on a five-point Likert scale. Composite scores for information and advice and support were generated, and associations with demographic, clinical, and psychosocial variables were examined using multivariable linear regression.

RESULTS

Overall satisfaction was moderate. Patients were generally well informed about their condition (mean 4.14 (SD 0.92)) and operation (mean 4.34 (SD 0.88)), but less satisfied with support for weight management (mean 3.49 (SD 0.98)), general health (mean 3.54 (SD 1.01)), and mental wellbeing (mean 3.46 (SD 1.02), p < 0.001). Older age, obesity, socioeconomic deprivation, and new physical or mental health diagnoses were associated with lower satisfaction, though most effects were small. Larger effects were seen between self-reported deterioration in health and quality of life and dissatisfaction with waiting time. Almost half of the patients reported opioid use, and most described worsening function and activity while waiting.

CONCLUSION

Patients awaiting hip or knee arthroplasty experience substantial physical and psychological decline, compounded by limited holistic support. While procedural information is generally adequate, guidance on lifestyle, wellbeing, and self-management is lacking. The waiting period should be reframed as an active phase of care, with coordinated, multidisciplinary input and clearer responsibility among care providers to ensure patients receive appropriate support.