The curious case of increasing wait times in orthopedic surgery

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VANCOUVER – Azza Sedky has been living with increasing pain in both knees for four or five years.

“Where do I start?” the retired teacher, 72, told me on the porch of her North Vancouver home when I asked them how they were feeling.

Last summer, she says, her orthopedist looked at her X-rays and told her it was time to replace both or she would face a future in a wheelchair.

“I used to walk at least an hour,” Sedky said, “and now I can’t walk around the block.”

Doctors scheduled her first shift at Lions Gate Hospital for March 27, but when the pandemic hit, it was canceled.

And when BC health officials announced a plan to resume elective surgeries and start catching up with a backlog of 30,000 procedures across the province, Sedky figured she’d soon be thinking less about the pain and more to recovery.

Her orthopedist’s office called in late May and told Sedky she was number 20 on the list, and she thought it would take a few weeks.

But a few days later, Sedky received a letter from surgeons at Pacific Orthopedics and Sport Medicine.

Sedky was shocked.

The letter said more than 1,000 of their patients were currently awaiting surgery, but surgeons were only assigned a total of three elective operating rooms per week at Lions Gate Hospital, a third of the volumes normal.

“This is not a return to normal and differs significantly from the expectations expressed by Minister Dix and his administration,” the letter read.

In May, Health Minister Adrian Dix promised those awaiting surgery a “100% commitment” from the healthcare system, while unveiling a $250 million plan to catch up in the 17 to next 24 months.

North Vancouver-Seymour Liberal MP Jane Thornthwaite, whom Sedky contacted, called the delays at Lions Gate Hospital an “expectation problem” and that the expectations expressed by the NDP government were, for some patients , “obviously a gross exaggeration.”

Sedky’s orthopedic letter told him to prepare for a “considerably longer” wait, potentially over a year.

“I can live with lameness, but I can’t live with getting out of bed,” Sedky said.

To make matters more curious, the surgeons had interviewed colleagues from 14 other hospitals and all planned to resume normal delivery of orthopedic surgeries in early June.

Lions Gate Hospital seems to be the exception.

For Sedky and his surgeon, it made no sense.

The British Columbia Ministry of Health has deferred requests for comment to Vancouver Coastal Health (VCH), the administrator of Lions Gate Hospital.

The health authority told CTV News that due to a COVID-19 outbreak at Lions Gate, a higher proportion of surgeries have been canceled compared to other hospitals.

“Cancer surgeries and vascular surgeries, which may have a higher degree of poorer outcomes if not performed in a timely manner, are prioritized over orthopedic procedures,” the statement said.

VCH also said that one of the operating rooms is reserved for COVID-19 patients.

Sedky’s best guess on when she’ll have her first knee replacement?

“Oh, I think it won’t be until March,” she said.

And finding another doctor operating at another site would probably make her wait even longer.

So what does she plan to do in the meantime, I asked.

“Hobble,” Sedky said with a smile.

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