• function;
  • health organization;
  • health-related quality of life;
  • knee replacement;
  • pain;
  • waiting lists


Objective  The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 months after surgery.

Method  A total of 141 patients scheduled for TKR were recruited from three hospitals in Quebec City, Canada, and followed up until 6 months after surgery. Pre-surgery wait, defined as the time between enrolment on the pre-surgery waiting list and surgery, was considered in four categories (≤3, >3–6, >6–9, >9 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC). HRQoL was measured with the SF-36.

Results  Mean pre-surgery waiting time was 184 (SD: 120.8) days. Six months after TKR, a significant difference was seen between the four groups of pre-surgery wait in terms of HRQoL SF-36 role physical [F(3, 136) = 2.74, P = 0.046] and contralateral knee WOMAC pain [F(3, 136) = 5.78, P = 0.0009] scores. Participants with the longest pre-surgery wait (>9 months) showed the worst scores 6 months after TKR.

Conclusions  Longer pre-surgery waiting time had a negative clinically important impact on HRQoL and contralateral knee pain 6 months after surgery.