How do we measure quality of life? According to the European Union, there are eight main indicators that contribute to a person’s quality of life and one of these is health.
In its article ‘Quality of life indicators – measuring quality of life’ the EU states “Poor health can affect the general progress of society. Physical and/or mental problems also have a very detrimental effect on subjective wellbeing.”
Living with pain
In orthopaedics, one of the primary factors that we see impacting a person’s quality of life is pain. Living with chronic and worsening pain can be exhausting, and it can have a significant impact on someone’s ability to do the things they enjoy. Osteoarthritis of the knee or hip, for example, may affect the kind of exercise you can do – even walking or swimming when the pain is intense. And, as the condition worsens it can make the most basic everyday things difficult, like climbing stairs or getting in and out of a car.
Treatments for osteoarthritis
Osteoarthritis is a degenerative disease, which means it gets worse over time. But the good news is that there are effective treatments for osteoarthritis at any stage so there’s no need to suffer in silence. A new year can be a good time to take stock of your life and to ask yourself what you’d like to change. Deciding to improve your quality of life by taking control of your health can be a fantastic gift to yourself.
If you have mild to moderate arthritis, you might want to make some lifestyle changes, such as taking regular low-impact exercise like yoga, walking or swimming, to keep your joints supple and flexible. A physiotherapist could suggest some exercises that could help strengthen the muscles around the affected joint. Your doctor might offer you an injection of corticosteroids into the joint to reduce inflammation and relieve pain. There are also other types of painkilling injections, such as Platelet-rich Plasma (PRP) and hyaluronic acid injections, that could help you to manage the condition and improve your quality of life. For knee arthritis, Arthrosamid® injections are also an option, which may help relieve pain.
For the most severe forms of osteoarthritis, joint replacement surgery offers effective long-term relief from pain. Once the condition reaches this stage, the pain, stiffness and loss of function can significantly impact all areas of your life.
Research into quality of life
This was underlined by a cross-sectional multicentre study published in The Bone and Joint Journal in November 2022. Researchers set out to examine whether patients waiting six months or longer for a total hip replacement or total knee replacement experienced a deterioration in their health-related quality of life. Some states are assessed to be ‘worse than death’ (WTD) and the report also looked at how many patients had such serious changes to their quality of life and frailty that they were living in a WTD state.
The research looked at 326 patients, 54% of whom were women and 46% of whom were men. They were randomly selected from waiting lists at four centres and had been waiting for six months or more for either a total hip replacement or a total knee replacement. The researchers found that patients waiting for more than six months had a significant deterioration in their health-related quality of life as well as increased frailty. One hundred and ten patients stated that their health was ‘much worse’ compared with the previous six months and 107 said it was ‘somewhat worse’. There was also an increase in those living in a state WTD during the previous six months.
When to have joint replacement surgery
The timing of joint replacement surgery is determined by a range of different factors. If someone is undergoing surgery on the NHS, the length of the waiting list is a key factor and, unfortunately at present, this can lead to long delays. Some patients who are able to may choose to go private.
Additionally, those patients who choose to go private could have the option of a Mako robotic arm assisted joint replacement, which uses the latest technology to help plan and execute the surgery, resulting in greater accuracy with the surgical implantation of the new prosthesis, which typically results in less pain, a quicker recovery and overall higher patient satisfaction.
At 60, I had a robot assisted total hip replacement on my left side, the damage caused by a birth defect. Andrew Carrothers is amazing, I hobbled in and 24 hours later I was up and on crutches. After 2 physio appointments I was signed off and told to continue my exercises, after 4 weeks I walked unaided in to Andrew Carrothers consulting rooms. I was fortunate to have a fabulous surgeon, and a determination to follow the exercise regime and advice. 6 months on you would not know I ever had a problem.
Written by a private patient at Nuffield Hospital Cambridge8th January 2025
Whether private or on the NHS, orthopaedic surgeons generally recommend waiting until osteoarthritis is severe before undergoing surgery because artificial implants do eventually wear out and need to be replaced (called revision joint replacement surgery). The older a person is when they have their initial joint replacement, the less likely they are to need revision surgery at a later date.
However, the timing of joint replacement surgery is a balance between avoiding the risk of revision surgery at a later date and potentially experiencing a significant downturn in quality of life.
For advice about undergoing joint replacement surgery, including the best time to have it, contact us.
Talk to an orthopaedic consultant | Cambridge
We are always happy to provide information and guidance about the various treatment options, both surgical and non-surgical, including Mako robotic arm assisted surgery and conventional surgery.
For more information, please contact us.
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For your convenience, we offer appointments at both Nuffield Hospital Cambridge and Spire Cambridge Lea Hospital.
