Nobody likes waiting, especially when it comes to a medical procedure they need, like a hip or knee replacement. With our aging population and better implants, more patients are suitable candidates for replacement surgery, and that's boosting demand by about five per cent per year.

But for too long, a hip or knee surgery meant wait of six months or longer. But in some parts of Ontario, wait times for hip and knee replacements are down significantly.

At Toronto’s Sunnybrook Health Sciences Centre's Holland Orthopaedic and Arthritic Centre, the average wait for a knee or hip replacement used to be between 30 to 40 weeks; today, the average wait is about eight weeks from the time you meet with a surgeon.

It’s all thanks to a new system under the Toronto Central Local Health Integration Network. Its Hip and Knee Replacement Program, which began in 2007, uses advanced practice physiotherapists (APP). These physiotherapists provide physical assessments to determine which patients really need replacement surgery and which could be directed to physiotherapy or other types of care. 

The APPs help reduce the time spent by orthopaedic surgeons seeing new patients who are not good surgical candidates. They also develop non-surgical treatment plans for patients.

If it appears that a patient requires a hip or knee replacement, a consultation with an orthopaedic surgeon is then arranged. Patients have the choice of waiting to see the surgeon to whom they have been referred or booking an appointment with the surgeon who has the shortest waitlist.

After the surgery, APPs also see patients for long-term follow-up in a team approach with the surgeon.

"Tens of thousands of people from Toronto and across Ontario have been able to recover faster and better as a result of the Holland Centre's approach to hip and knee replacement surgery,” says Matthew Anderson, the CEO of the Toronto Central Local Health Integration Network.

Dr. John Murnaghan, of the Holland Centre says while the system is working well for patients in Toronto, there is still a lot of room for improvement when it comes to wait times in more rural parts of the province. He says there are a few steps patients can take if they think they need a knee or hip replacement to speed up the process.

"One is to get in touch with your doctor, let him know how severe your symptoms are. Two is to ask for a referral to an orthopedic surgeon for an assessment, and three is to inquire is there a central intake or streamlined way you can get prioritized into this system,” he says.

If you don't have a family doctor, you can get a referral from a walk-in clinic.  

Here's how the system works:

Step 1: Make an appointment with your family doctor to discuss your hip or knee arthritis

Step 2: Ask your doctor to fax a referral to 1-877-411-4577 or 416-599-4577

Step 3: Receive a call for an appointment at the Assessment Centre

Step 4: Visit the Assessment Centre for a physical assessment and to discuss treatment options and whether you need surgery

Step 5: If you do require hip or knee surgery, a consultation will be scheduled with an orthopaedic surgeon – you may ask for the first available appointment or choose to wait for a specific surgeon

Step 6: Meet the orthopaedic surgeon and book the date of your surgery