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Diagnosis to surgery time frame

Discussion in 'Knee Replacement Pre-Op Area' started by Chillimac, Mar 30, 2018.

  1. Chillimac

    Chillimac junior member
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    Hi, being a UK resident and having had two knee replacement surgeries a Uni on the left knee and TKR on the right, I'm wondering what's the time frame difference between US and UK patients from the initial diagnosis to being in for surgery?

    My experience is in the UK, for osteoarthritis sufferers like myself it's around 18 months. There seems to be a set protocol that's followed, certain steps and treatments used before you are finally referred for surgery. That's been the case in both mine and my sister-in-law is currently going down the same route. Unless you can go private, this seems standard under the NHS.

    What's the time frame in the US? I realise you have a completely different system over there but a comparison will be interesting.
     
  2. Mutti3

    Mutti3 senior

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    I can only tell you about myself. I was diagnosed with advanced arthritis about 7 years before surgery by mri. October 2013 got my first steroid injection, then every 4 months there after. October 2016, the steroid stopped working. It was always my choice when to get the total replacement.
    The difference in system is Insurance. I did not have to get prior authorization, or placed on a waiting list. I waited until the “ stars where aligned” in my personal life, and had it done!
     
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  3. SusieShoes

    SusieShoes FORUM ADVISOR Forum Advisor

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    I was told both of my knee needed replacement several years before I had the surgery. I opted instead to treat my knee pain with cortisone for a few years, followed by Synvisc injections for another few. The last couple of years, those didn’t work well at all. At last I made the decision to have the surgery. From that decision to the day of surgery was about four months: two to get an appointment with the surgeon of my choice, and two more to get the surgery on the schedule and allow for pre-op testing. My surgeon is busier than some and not as busy as others, so I think my experience is typical. My insurance agreed to pay for the surgery without hesitation.
     
  4. Needhope

    Needhope senior

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    My right knee had been monitored and treated with Synvisc injections a couple years before my tkr. I had endured enough and made the decision in July 2017 and had RTKR September 2017. My left knee was deteriorating quickly and by Jan 2018 I had Synvisc injection followed immediately by physical therapy for 5 weeks. It didn’t help. So in Mid March I set the date for my LTKR April 4... in a few days from now.
     
  5. Diva68

    Diva68 junior member

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    I had been seeing my OS for about 2 years, we were attempting to delay the TKR by using cortisone injections. The injections were working well, then I started only getting a couple of weeks relief. I made the decision to have the TKR at an appointment with my OS in mid November and scheduled my surgery for the end of December. I was offered an earlier date in December, but after Christmas worked best for me and allowed me more time to arrange my work schedule.
     
  6. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Actually it varies greatly from district to district. @Jaycey can tell you more about this, I think?

    And you can always quote NHS choice: Patient's Charter and your right to choose to get yourself better treatment. I've advised many UK members to do this with varying results. Certainly it's not a case of private or nowt!
     
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  7. Chillimac

    Chillimac junior member
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    Josephine that was something I wasn’t aware of. I knew I could choose which surgeon I wanted to do the surgery but I’m not sure if it would’ve made the process any quicker. Like I say going through the process twice I kind of knew what to expect second time around. If the target is you’re supposed to be seen or have an appointment within an 8 to 12 week time scale, in my experience it’s always been a lot closer to the 12 week mark than the 1 week mark. That’s what makes the experience so drawn out.
     
  8. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    As Josephine says the wait time for treatment varies widely. You can look up the wait time on NHS Choices. The data is available via the hospital site.

    The problem is that many areas are now introducing roadblocks to care. There are all sorts of "hurdles" to jump including trying physio, injections, pain meds. If the patient suffers through that stage the next roadblock may be their BMI (standard varies by area as well), whether the patient smokes and even age. Bottom line many patients are waiting in pain for surgery. Sad because getting a patient back to independent living actually saves the NHS money!

    BTW - the avenue I chose for both my THRs was to see the consultant privately for the first consultation. Once they confirmed an op was needed I asked to be put on the NHS list. This saves the long wait for a referral and gets you on the list - often at your chosen hospital.
     
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  9. Jajakio

    Jajakio senior

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    The US is very much a patchwork as we all have different insurances. My insurance insists on a minimum of 6 months of trying other treatment like steroids or synvisc injections before approving surgery. After the surgeon sends in all the paperwork requesting surgery, approval time is supposed to within 1 month and then depending on surgeons schedule probably somewhere between 2 weeks and 3 months to a surgery date. But i got turned down the first time due some missing paperwork, approved another month later, then we had trouble coordinating a surgeon and hospital both approved by insurance. My surgery was 6 months from the date I sat in the surgeon's office and we both agreed it was time but it was 4 years from my initial 'my knee hurts' consult followed by steroid shots, synvisc and anything else they could think of. Others in US might have had a totally different experience especially if they had better insurance. Those on Medicare have a totally different set of rules.
     
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  10. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I didn't have any problems getting my knee replacements approved by my insurance company here in New Zealand.
    Based on X-ray and physical findings, together with my history, my surgeon recommended knee replacement and insurance approved that.

    I didn't have to have PT, Synvisc or steroid injections. Nor was I asked my BMI.

    I did my replacements privately, not through the NZ national health system. The waiting time would probably be longer through the NHS.

    Once the knee has reached a stage where it needs replacement, I believe that the "stalling" treatments are a waste of time and money. They might buy you a little more time with less pain, but they aren't going to cure anything.
     
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  11. Jamie

    Jamie ADMINISTRATOR Administrator

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    It does vary widely in the US and sometimes the wait can be a factor of what insurance one has. Some insurances do require that a patient tries non-surgical treatments first. But we don't generally have those horrible waits of 6 months or more with a patient in pain waiting for a surgery date.

    If you are curious about the scheduling time for surgery once the decision has been made, my experience has been that most surgeons book out about 3-6 weeks.
     
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  12. Mutti3

    Mutti3 senior

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    Very true, most surgeon do book out 4-6 weeks to allow for preop clearance, classes, and scheduling. That was my husband case when he decided for knee replacements. I booked out 4 month by choice.
     
  13. Eeek

    Eeek member

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    I’d been thinking about having my surgery and avoiding it for 5-6 years. Spoke to different surgeons, had PT, etc. finally after hemming and hawing about, called the practice I wanted. As a new patient, it took about 5 weeks for an appointment. Saw the surgeon beginning of December. He told me once I decided, I needed to contact them six weeks before I wanted surgery. End of December, I decided I wanted surgery end of February. They gave me a date a few weeks later.

    I’m in Switzerland. There are some limitations in who I can choose, but there was plenty of choice. No authorization process once I choose an appropriate facility and doctor.
     
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  14. Chillimac

    Chillimac junior member
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    Jaycey, I was very, very lucky with this surgery. My company paid for a private consultation with the surgeon the reason being I waited 9 months to have my knee cleaned out ( I had a badly torn meniscus and it was constantly locking on me. It happened twice at work and I work in a relatively dangerous environment, thankfully it didn't lead to any accidents either time but easily could have) the surgery was cancelled 4 times! My company took the view the private consultation would help speed things up a little when after the meniscus surgery it was determined I did indeed need a TKR. I did the same as you, went on the NHS list after the consultation but with both cases added together it was still around the 18 month mark.
     
  15. NDSunshine

    NDSunshine junior member

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    I was booked out 6 weeks, and have one week until surgery. On a Monday, yay! I needed that time to arange things, amd to wrap my head around the idea.

    Sent from my SM-J100VPP using Tapatalk
     
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