Need-based waiting lists for hip and knee arthroplasty

Background Need-based waiting lists have been shown to offer advantages over traditional time-based waiting lists. This study investigated the effect of their introduction in our orthopaedic practice. Methods Each patient on the waiting list for total hip replacement (n=240) and total knee replacement (n=98) was invited to attend a dedicated assessment clinic. At the clinic each patient had a joint score (Harris Hip Score or American Knee Society Score) calculated. Patients with the lowest joint scores were moved to the top of the waiting lists. Scores were repeated postoperatively. Results Validation of the hip replacement and knee replacement waiting lists reduced them by 20% and 11% respectively. The efficiency and transparency of the service were increased. Conclusion Need-based waiting lists are easily introduced and offer significant advantages over time-based waiting lists. We advocate their introduction in other centres.