Orthopedic Wait Times in Canada 2020

In our previous blog we talked about 2020 medical wait times in Canada. In this blog, we will look in more details at one of the 12 specialities examined by Fraser Institute – Orthopaedics.

Across Canada, for orthopaedics, the total wait time in 2020 was 34.1 weeks. This is a decrease of 5 weeks, compared to 2019 when the wait was 39.1 weeks. Chart 1 shows Orthopedic surgery wait times 10 years back and also includes 1993 when it was 19.5 weeks.

The report further breaks down wait times into two different segments. Segment 1 is the wait time from referral by a general practitioner to consultation with a specialist. Segment 2 is the wait time from the consultation with a specialist to point at which a patient receives treatment.

The wait time from GP to a specialist was 13.2, again, less than in 2019 when it was 14.6. The wait time from specialist to treatment was 20.9 weeks down from 24.5 weeks in 2019. Although it is one of the longest wait time for the 12 specialities surveyed in 2020 (shared by Plastic Surgery and Ophthalmology), it is definitely an improvement over the last year.

As far as which province fares the best, the report lists ON, where the median patient wait to see a specialist after referral from GP takes 8 weeks, and median wait to get treatment after the appointment with a specialist is 18.2 weeks. In other words, the median time to get an orthopaedic surgery in Ontario is 26.2 weeks. The province of Saskatchewan came very close, it takes longer to see a specialist (median 20 weeks), but faster to get surgery (6.3 weeks) a total of 26.3 weeks.

The longest wait time was in NS – a total of 57.6 weeks from referral by GP to surgery. Please refer to Chart 2 for the rest of the Canadian provinces numbers.

If you are unwilling to wait and would like to explore your private options, we are here to connect you to a reputable medical facility in the US or Canada. Give us a call to find out your options – toll-free 877 344 3544

Chart 1

Chart 2

Recovery After Private Knee or Hip Replacement

If you are going for joint replacement surgery, one of the things that could be on your mind is your recovery time. Knowing how long it will take is helpful to set the right expectations about your mobility and activity levels. Unfortunately, there is not an exact answer to this.

In general, a complete recovery for a knee replacement is 3-12 months and for a hip replacement is 2-6 months.  Complete recovery means that the surgical wounds and soft tissue are healed, you feel well enough to return to your activities, and your joint’s functions and range of motion are considerably improved. As you can see the range of time is quite wide.

Speedy recovery depends on many things. One of the more important ones is your overall health going into surgery. Another one is the level of your physical fitness prior to surgery. When arthritis attacks, our mobility is decreased, and therefore we use fewer muscles and they deteriorate.

Your overall health and your level of fitness can both be improved prior to surgery. Losing excess weight, quitting smoking, and eating a well-balanced and healthy diet are within our control. After meeting with your doctor, discuss what you can do to be better prepared.

Pre-hab is widely recommended nowadays for people who will be undergoing joint replacement surgery. It is an exercise program, with a physiotherapist, that you would do before the surgery to get your muscles in a better shape, thus allowing a faster recovery. Many physiotherapists offer it.

Joint replacement is one of the safest surgeries. Recovery from it requires commitment and realistic expectations on your side. There is always someone who could say they were back to playing golf 5 weeks after surgery, but everyone is different. Discuss the recovery with your doctor and be prepared to work hard at helping your body heal after.

 

Tips For a Faster Joint Replacement Recovery

Tips For a Faster Joint Replacement Recovery

Joint replacements used to leave people in agonizing pain taking weeks, sometimes months to recover.  It was not uncommon to be hospitalized 3 to 7 days.  Now, newer techniques allow for the patient to be up and walking right after surgery and to be released from the hospital on the same day.  The goal in getting someone up and moving right away benefits the patient in a huge way.  They are less likely to develop blood clots, experience increased pain and lose muscle mass.

Do not mistake this for an easy ride though.  There is still a lot of work that goes in before, during, and after the surgery.  The more prepared you are, the better  your outcome will be.  Keeping everyone involved, ie. support person, facilitator, surgeon, nursing staff and anesthesiologist, all on the same page will only benefit you.  Here are some things you can do to make your recovery go faster:

  • Set realistic expectations on your recovery BEFORE you even have the surgery.  Go in to it knowing it will take time for you to heal.  Research shows that even though you feel great and are able to get around fairly easy, the muscle tissues and bone still take a full 6 weeks to heal properly.  For some, it can be even more than 6 weeks.  Keeping that in mind will prepare you mentally to accept that you will not be running a marathon within a month’s time after your joint replacement.  
  • Eat a healthy diet, stop smoking and continue a strengthening exercise routine before the big day.  Doing this will have you fit and healthy for surgery.  By continuing the exercise or physiotherapy prior to the surgery, you will be that much more ahead of the game when you start the routine back up.
  • Prepare your home ahead of time before the surgery.  Making some meals you can keep in the freezer will make eating time less stressful and easier.  Get your sleeping area set up.   For example, if your bedroom is in an upstairs area, it might make more sense to set something up downstairs for a couple of days until you feel like you can safely climb stairs.  Clear away any unnecessary items on the floor to prevent the chance of tripping over them.
  • Most importantly, ALWAYS do what your doctor has instructed and follow through with any preparation required or limitations they have set for you. 

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.ca

Anterior or Posterior Approach to Hip Replacement: What Is Right For You?

We wrote about private hip replacements a few times in our blogs. As new techniques or robotic are introduced, our clients want to know their options. We explained the SuperPATH technique in hip replacement. In another blog, we talked about the use of robotics.

There are a couple of surgical approaches to hip replacement. In this blog, we mention both posterior and anterior approaches. In the past, there were studies claiming that the anterior approach had better outcomes.

A recent study of patients treated at HSS (Hospital for Special Surgery) looked at 138 patients who had total hip replacements and were discharged the same day. Half of the group had an anterior and the other half had a posterior total hip replacement. Age, sex and body mass index of each group were matched. They found that the outcomes did not differ significantly. Time to walking, length of surgery, pain at discharge and rates of complications/readmissions at 90 days post-surgery were similar.

From our conversations with different orthopaedic surgeons, what matters is the surgeon expertise at a certain approach. The number of surgeries that she or he did in the past, years in practice and surgeries per year are usually the stats we look at and provide to our clients to help them make a better decision. We also set up a phone call with doctors so that they can better explain how they do surgeries.

In your initial consultation with an orthopaedic surgeon, it will be determined if you are a good candidate for the same-day discharge and usually that depends on your general health. The doctor will also go over what is suitable for you and what to expect. This is an opportunity to ask questions about different approaches and what is right for you.

If you are interested in setting up a virtual consultation with one of the orthopaedic surgeons we work with, please give us a call toll-free 1 877 344 3544.

Microport for Hip Replacements

Hip replacement surgeries are very common.  Many people experience numbness and weakness after the surgery.  New technology may be able to eliminate this with a new technique called Microport.  

Doing an anterior approach has become a popular way to do hip replacement surgery.  The anterior approach was designed to preserve the muscles that prevent dislocation of the hip post surgery. During surgery, an incision is made over the cup and the hip is typically dislocated. This allows for the ball to be cut off easily before putting the implant in. Although, by doing the incision over the cup, it makes it harder to see the ball part of the hip.  

Dr. Matt Seidel has come up with a way to avoid this.  He has developed a technique where a cannula, a thin tube, can be placed through an incision in the groin.  The advantage to moving the incision allows the surgeon to clean out the cup without having to put an incision right over it. This approach avoids dislocation of the hip during surgery by cutting the ball off first and then removing it from the socket.  

Microport also provides a lower risk of cutting sensory nerves, which would cause numbness.  It moves the procedure away from the femoral nerves that lower the chances of weakness even further.  Doing a more natural incision allows for fewer wound complications and reduces pain levels by quicker healing.  

If you are interested in this technique, contact Health Vantis and we can connect you to a surgeon trained to do this technique at 877-344-3544.

Health Vantis

877-344-3544

www.healthvantis.ca

New Digital Device for Knee Replacement Physiotherapy

Physiotherapy after a knee replacement is absolutely essential for a successful rehabilitation.  A new digital support device is currently being developed to assist in this.  It is a mobile app  that will make information about the knee available to the physiotherapist.  It will allow them to closely monitor the progress and amend the rehabilitation plan accordingly.  

The technology is designed for the patient to wear the device on their ankle after surgery.  It links to their smart phone to analyze the range of knee movement progression and any pain associated with it.  The information is sent to the physiotherapist to give them a clear picture of the patients’ progress and any issues they may be having.  Patients are also able to bring any concerns to their physiotherapist via the app from the comfort of their own home.  

Trials are currently being done and the hope is to streamline the recovery process so be looking for more information in the coming months!

 

Health Vantis

877-344-3544

www.healthvantis.ca

SuperPATH for Total Hip Replacements

SuperPATH for Total Hip Replacements

SuperPATH (Super capsular percutaneously-assisted total hip replacement) is a recently developed technique that is less invasive than traditional approaches. It only requires a 3” incision, which reduces the number of muscles and tissues that are normally cut or damaged. 

During a traditional hip replacement, hip dislocation is done.  This increases your chances of having a dislocated hip post operatively.  With SuperPATH, there is no hip dislocation.  It allows the surgeon to build the implant in place, therefore, resulting in zero risk of dislocation after surgery.  By having the ability to protect all of the important structures around the hip joint, it will protect critical tendons from stretching or traumatizing the muscles that are so important to your hip function.

An additional benefit of this technique is faster recovery time.  Patients are normally able to walk with little or no assistance within a couple hours of having the surgery.  Pain level postoperatively is low.  Because it is such a small incision, scarring is kept to a minimum and rate of infection is low.  There are little or no limitations on activity. You are still able to cross your legs or bend forward.  

If you’d like to see if the SuperPATH technique is right for you, give Health Vantis a call at 877-344-3544 and we can connect you to a surgeon trained to do this technique.

Private Hip Replacement Cost

The wait times for a hip replacement in the public system can be long. Many Canadians do not wish to wait and are looking for private hip replacement options in Canada, US and other countries.  Cost considerations for a private hip replacement can lead to a long search on internet and phone calls to multiple places. Some medical facilities are able to give the pricing right away and some require multiple follow up and even then, it may not be possible to get the total price.

Health Vantis does all the logistical work for you, so you can focus on your health. We have established relationships with certain facilities in the US and Canada. We are able to provide you with a range for bundled pricing when you call. Bundled pricing includes the facility fee, anaesthesia fee and surgeon fees. Knowing the price for your private hip replacement is very important. However, price alone should not be the deciding factor in your decision where to go for surgery.

Things like surgeon’s reputation, facility accreditation and proximity to your home should be considered. If you are going to fly somewhere, make sure that you select flights that are 4 hours or less. Flights over 4hours increase the risk of DVTs considerably. It may be cheap to go to India, but you will be flying across the world.

In addition, pricing in Canada and the US can be comparable considering all the costs involved. Health Vantis works with accredited, pre-vetted facilities that offer safe and affordable private hip replacement. The price will differ depending on the location you chose to go to and will start at about CAD $25,000. *

If you are considering a private hip replacement, give us a call to get more information toll-free 877 344 3544.

*Prices may change without notice

Do Cortisone Shots Posses Potential Dangers?

Cortisone shots have been used for decades.  In years past, it was thought that there was no real harm or risk involved in having a steroid injection.  There have always been side effects such as dizziness, headaches, trouble sleeping, mood swings, or weight gain but no long term effects identified.  According to a new report, cortisone injections may have more serious side effects than previously reported such as damage to the joints as well as other serious dangers.  

Steroid injections have effectively been used in treating conditions such as back pain, bursitis, gout, osteoarthritis, lupus and tendonitis.  Osteoarthritis (OA) alone affects nearly 5 million Canadians (1 in 6). When medications, physiotherapy and lifestyle no longer work, doctors will often try a cortisone injection to treat the pain.  Although this does not cure the problem, it can be a temporary fix to mitigate pain and swelling to avoid more extreme measures such as surgery.  It can also give you the opportunity to rehabilitate the affected area by reducing the swelling to allow for easier ability to strengthen the joint and surrounding muscles.  

Potential Dangers

Although cortisone has many benefits, there have been more recent concerns identified with regards to knee and hip osteoarthritis.  Some of those include: Rapidly progressive osteoarthritis, subchondral insufficiency ie. a type of stress fracture, osteonecrosis – when bone tissue dies, or causing a delay in surgery.  The study recently done could not provide an exact explanation why these things occur, however, it was thought that the anesthetic that is combined with the injection could be toxic to the cartilage.  More studies would be needed to understand the full effects.

The list of side effects from cortisone shots can be long and exhaustive, however, the advantages can be significant.  It is important to discuss all of the pros and cons with your doctor prior to having one, especially if they are required multiple times or if a surgery may be in the near future.  

Private Shoulder Surgery

Your shoulder is the most flexible joint in your body. It allows you to move your arm in front, above, to the side, and behind your body. Such flexibility also makes your shoulder prone to instability and injury.

If you exhausted all the non-surgical methods to help your shoulder pain, surgery should be considered. In some cases, delaying a surgical procedure of a shoulder can increase the likelihood that the problem will be more difficult to treat later. Early, correct diagnosis and treatment of shoulder problems can make a significant difference in the long run.

There are many shoulder surgeries that exist today. Some of them are minimally invasive, or arthroscopic and some are more traditional open surgeries. Some of the more common private surgeries Health Vantis can facilitate are:

  • Rotator Cuff Surgery

This one repairs the rotator cuff. During the procedure identified damaged parts of the rotator cuff are cleaned and any torn or damaged tendons are reattached. Smaller injuries can be repaired arthroscopically.

  • Subacromial Decompression

Sometimes the tendons of your rotator cuff are intermittently trapped and compressed during movement. This condition is called impingement syndrome. It causes progressive damage to the tendons and the cushions inside the joint space. Another name for this syndrome is rotator cuff tendonitis or bursitis. The condition can be relieved by arthroscopic surgery subacromial decompression.

  • Shoulder replacement

Just like in hip replacement, this surgery replaces the ball and socket joint of the shoulder with artificial parts. The surgery is reserved for severe arthritis or advanced fractures of the shoulder. Partial shoulder replacements are also performed

If you are experiencing a delay in getting a shoulder surgery in Canada, contact Health Vantis to find out your private options in the USA. An initial evaluation is free of charge – call us toll free 1 877 344 3544.