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Are too many people with arthritis having to wait for surgery?

Arthritis Today Spring 2018 Issue 175An older woman sat next to a younger woman on a sofa looking at paperworkEvery year tens of thousands of people with osteoarthritis find joint replacement surgery offers them a new lease of life, enabling them to be more independent. But as the growing pressures on NHS resources hit the headlines again this winter, and stories of surgery rationing become increasingly common, are more and more people with arthritis having to wait too long for the treatment they need?

Growing numbers of people are getting in touch to tell us about their operations being delayed or restricted. Sometimes this is due to lifestyle factors, such as their weight or whether they smoke, but it can also be because of winter pressures on the NHS.

What you’re telling us is borne out by statistics; the latest figures (November 2017) on waiting times for Trauma and Orthopaedics, which includes joint replacement and other types of surgery, show only 86.5% of people received treatment within 18 weeks after referral, well below the 92% target. This suggests thousands of people each year aren’t getting the treatment they need when they need it.

Each person waiting for joint replacement surgery is living with pain and stiffness that can restrict their ability to live life to the full, meaning any delay to treatment is frustrating and distressing. However, for people with severe osteoarthritis there's evidence that significant delays can lead to their surgery being less successful and to the need for more costly procedures, outcomes which are not only bad for people with arthritis but also for the NHS.

"Any delay can be difficult"

Mark Wilkinson, Professor of Orthopaedic Surgery at the University of Sheffield, explains: "Any delay to joint replacement surgery can be difficult and distressing. People waiting for this surgery are living every day with pain and poor mobility and so it’s vital we offer treatment as quickly as possible.

"Experiencing a short wait for this surgery doesn’t necessarily affect people’s chances of a good recovery, but if someone with severe osteoarthritis faces a prolonged delay it can cause long-term problems. If while waiting for your operation your pain and stiffness get worse, for example you move from walking with a stick to crutches, then it can affect how much of your mobility and independence you get back after your joint replacement.

"Waiting longer for surgery is tough, and it can make you feel low, increasing the risk of depression and anxiety. We also know poor mental health can impact on a person’s ability to recover and feel the full benefits of their surgery."

How you can help

At Arthritis Research UK we believe once a person has been assessed by an orthopaedic surgeon as suitable for, and in need of, joint replacement surgery, they should have access to this life-changing treatment as quickly as possible. Neither your postcode, weight or smoking status should determine whether you're eligible for this surgery or how quickly you receive it.

Arthritis Research UK is committed to doing everything it can to influence the Government, and the NHS, to ensure that people with arthritis get the right treatment at the right time. But to do this we need your help.

Sharing your story with us will strengthen our campaigning on this issue. So, if you've had your operation delayed and would be willing to tell us how this has had an impact on your life, please get in touch with our team at for an informal chat.

Lyn’s story

Lyn Hughes"About 6 years ago, I was diagnosed with osteoarthritis in both my knees and rheumatoid arthritis all over my body, but particularly in my hands. Since then, my condition has deteriorated.

"I don’t have a moment when I’m not in pain which is exhausting. I’m pretty much housebound. I use crutches indoors and have a wheelchair for when I go outside. Cooking is difficult; with no strength in my hands I can’t do simple things like cut vegetables or open jars. I got stuck in the bath a few months ago, and my husband had to come and pull me out. Arthritis affects every part of my life.

"Three years ago, I was told I was in desperate need of two full knee replacements, and my surgeon put me on his list of high-priority patients.

"Several operations were cancelled the day before my surgery was due. This was very disheartening as it was my first surgical procedure, and I was extremely nervous. I was also in extreme pain, and had waited so long to get my operation, that the thought of more sleepless nights and agonising pain made me very depressed and tearful. This also put a strain on my relationship with my husband.

"I finally got one of my knees replaced in 2017, but my other knee is extremely painful. When I asked about my second operation I was told I now have to meet new criteria before being put on a waiting list for the operation.

"When I explained I’d already been on the waiting list to get both knees replaced for almost three years, the doctor said that due to the new criteria I had to go back to the beginning of the process.

"The new criteria is around my body mass index (BMI). My local clinical commissioning group have changed their requirements. Before, people had to have a BMI of 40 or under to qualify for the operation, whereas now it’s been changed to 35 and under. This is really worrying me. I don’t eat a lot, but on top of my arthritis which makes exercise very difficult, I also have a thyroid condition which makes me gain weight. If I don’t meet this new threshold, they won’t let me have the operation.

"I can’t understand how they can think a knee replacement isn’t an essential operation, I desperately need it to improve the quality of my life."

Read next: Giving people with arthritis 'Access to Work'

An older man wearing a hard hat on a building site

We know finding and staying in work can be a challenge for people with arthritis, so we’re campaigning for increased investment in these services and for changes to be made to ensure they work for everyone who needs them.

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