Spike in pre-op patients living life ‘worse than death’ during pandemic – study

The number of patients awaiting orthopaedic surgery who are in such pain their quality of life is considered “worse than death” has spiked during the pandemic, research suggests.

A study led by the University of Edinburgh surveyed people waiting for hip and knee replacements.

It assessed 843 patients on waiting lists across the UK using EuroQol-five dimensions (EQ-5D) – a quality of life survey that includes questions on mobility, pain, and the ability to participate in daily life.

EQ-5D is scored on a scale from -0.6 to 1, where 1 is full health and 0 is considered death.

Negative scores are considered “worse than death”, with people saying they could not bear to survive in this condition.

More than a third (35%) of patients waiting for a hip replacement and 22% of patients waiting for a knee replacement rated their scores below zero, researchers found.

This was almost double figures found in a study conducted of more than 4,000 patients in Edinburgh from 2014 to 2017.

That research found negative scores for 19% of those awaiting hip operations and 12% for knee operations.

The majority of non-emergency orthopaedic surgery was delayed during the coronavirus pandemic, leading to a backlog.

More than 580,000 patients were on an orthopaedic waiting list in the UK at the end of December last year, according to the British Orthopaedic Association.

Chloe Scott, a consultant hip and knee surgeon – and honorary senior clinical lecturer at the University of Edinburgh, said: “These patients are suffering. Because of the pandemic, elective surgery such as hip and knee replacements has all but stopped.

“Orthopaedic patients have been disproportionately affected by cancellations of surgery during the pandemic as we have been allowed to do the least amount of operating compared to normal levels of all surgical specialties.”

She added: “This study shows how severe living with arthritis is. We know that joint replacements can be life changing and, in our view, these operations are not ‘elective’ and our patients should not be at the bottom of the pile as we restart surgery.”

The study is published in The Bone and Joint Journal. Research was conducted between August and September 2020.