Oral Presentation ANZBMS-MEPSA-ANZORS 2022

A meta-analysis examining the impact of wait time for orthopaedic consultation on pain levels in individuals with osteoarthritis (#131)

Rhiannon Patten 1 , Alexander Tacey 1 , Matthew Bourke 1 , Cassandra Smith 1 2 , Michaela Pascoe 1 , Sara Vogrin 3 , Alexandra Parker 1 , Michael McKenna 1 , Phong Tran 1 4 , Mary De Gori 5 , Catherine Said 6 , Vasso Apostolopoulos 1 , Rebecca Lane 1 , Mary Woessner 1 , Itamar Levinger 1
  1. Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia
  2. School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
  3. Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
  4. Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia
  5. Department of Physiotherapy, Western Health, Melbourne, Victoria, Australia
  6. Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia

Objective

Time spent waiting for access to orthopaedic specialist health services has been suggested to result in increased pain in individuals with osteoarthritis (OA). We assessed whether time spent on an orthopaedic waiting list resulted in a detrimental effect on pain outcome measures in patients with knee or hip OA.

Methods

We searched Ovid MEDLINE, EMBASE and EBSCOhost databases from inception until September 2021. Eligible articles included individuals with OA on an orthopaedic waitlist and not receiving active treatment, and reported pain outcome measures at two or more time points. Random-effects meta-analysis was used to estimate the pooled effect of time on pain outcome measures. Meta-regression was used to determine predictors of effect size.

Results

Thirty-three articles were included (n = 2,490 participants, 67 ± 3 years and 62% female). The range of waiting time was 2 weeks to 2 years (20.8 ± 18.8 weeks). There was no significant longitudinal change in pain (effect size = 0.082, 95% CI = -0.009, 0.172), nor was the length of time associated with longitudinal changes in pain (β = 0.004, 95% CI = -0.005, 0.012). Body mass index was a significant predictor of pain (β = -0.043, 95% CI = -0.079, 0.006), whereas age and sex were not.

Conclusions

Patients with OA who were on an orthopaedic waitlist did not report a change in pain levels for up to 2 years. As such, this presents an opportune time to deliver non-surgical, interventions to improve patient wellbeing and reduce the burden on the healthcare system.