Psychological determinants of accelerated health decline while waiting for joint replacement surgery

Osteoarthritis is a disabling health condition affecting over 4 million Canadians. This number is expected to increase dramatically over the next two decades. Joint replacement surgery has been shown to be an effective intervention for individuals who have advanced osteoarthritis of the knee or hip. Unfortunately, the majority of individuals who are considered candidates for joint replacement will wait more than 6 months for their surgery, some might wait more than one year. Since individuals are only considered for joint replacement surgery when they suffer severe symptoms of pain, swelling and disability, the waiting period can be long and arduous. There are indications that the health status of many individuals will decline while waiting for surgery and poor health status prior to surgery often contributes to poor recovery following surgery. In the proposed research we are hoping to identify individuals who are at high risk for declining health while waiting for surgery. Individuals with osteoarthritis of the knee or hip who have been placed on waiting lists of joint replacement surgery will be invited to participate in the research. Participants will be recruited from three different hospitals in Montreal and Halifax. Participants will be invited to complete assessments of physical and psychological function at three different time points while waiting for their joint replacement surgery. Based on the results of these assessments, we are interested in examining whether it is possible to identify individuals whose health status is most likely to decline over the waiting period. It might be possible to use this information to develop treatments that could prevent declining health during the wait list period. In addition, information gathered in this research might help us develop better criteria for settings priorities or urgency for individuals who are referred for joint replacement surgery.