Are Longer Waits Associated with Lower Satisfaction and Worse Recovery? A Retrospective Observational Study of Hip and Knee Replacement in England

Longer average Referral to Treatment waits for NHS hip and knee replacement in England are linked to higher post-operative dissatisfaction and smaller Oxford Score improvement.

• Why it matters: The study addresses whether variation in surgical waiting time is associated with patient-reported outcomes, and whether satisfaction reflects recovery or only experience of care.
• What they did: It linked 107,700 hip and 122,756 knee replacement PROMs respondents to provider-year RTT waiting times in England (2017, 2018, 2022, 2023), using dissatisfaction (fair/poor) and Oxford Score improvement.
• The result: Each additional 30 days of average wait increased dissatisfaction log-odds by 0.05 (hip) and 0.04 (knee) and reduced Oxford improvement by -0.26 and -0.11 points, respectively, with Oxford improvement falling monotonically across satisfaction categories.

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