Intended for healthcare professionals

Letters Knee and hip surgery refusals

Patients should not be denied access to hip surgery

BMJ 2018; 362 doi: (Published 10 September 2018) Cite this as: BMJ 2018;362:k3801
  1. Andrew Manktelow, consultant orthopaedic surgeon and president of the British Hip Society
  1. Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham NG5 1PB, UK
  1. a.mank{at}

Patients having to apply for exceptional funding when referred for hip surgery, which is increasingly refused, is concerning.1

Although many patients with hip arthritis are successfully managed conservatively, symptoms worsen with compromised function and increasing pain. Prolonged waiting times lead to worsening deformity, muscle wasting, and bone loss, which compromise outcomes and increase complications. Timing of referral is critical.

Anecdotally, surgeons …

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