A shortage in medical cement is likely to lead to delays in some patients getting joint surgery, NHS bosses say.
It comes after Heraeus Medical, the main supplier of bone cement to the health service, has had to temporarily halt production at its main site for two months.
The German firm supplies about three-quarters of the bone cement needed in the NHS. The product is used in about 1,000 operations a week by the NHS, mostly in knee replacements, but also in some hip and shoulder replacements.
Hospitals are being told to prioritise emergency patients ahead of those on the waiting list.
These are likely to be older patients who have suffered falls and those with broken bones.
Currently there are 850,000 patients on the waiting list in England requiring treatment to their joints – the largest of any speciality.
Guidance from NHS England calls on hospitals to focus on providing care to those in the most pain or with the most complex conditions.
Hospitals have about two weeks supply of bone cement in stock.
NHS England and counterparts in the rest of the UK are seeking to increase supplies from four other manufacturers that supply the NHS.
Deborah Alsina, chief executive of Arthritis UK, said: « This is a crushing blow for those individuals who have finally made it to the front of the orthopaedic surgery queue after a long time waiting.
« We urge hospitals to communicate quickly with those affected to avoid additional worry and uncertainty.
« Aside from the personal toll on people with arthritis, the stakes are high for government who have an uphill challenge to bring down waiting lists to meet ambitious targets. »
Heraeus Medical said it had experienced a critical machine failure at its main site when it was in the process of upgrading its production processes.
An NHS England spokesman said the problem was affecting supply globally.
« The NHS is issuing immediate guidance to hospitals to ensure trauma and urgent care can safely continue, enable the use of alternative suppliers where possible and to support prioritisation of orthopaedic waiting lists based on patients’ needs over the coming weeks. »
NHS England said it was working closely with government and leading professional bodies to ensure that effective care could be provided while supply is resolved.
It also said it wants to reduce delays for patients requiring less urgent care as far as possible.
Fergal Monsell, of the British Orthopaedic Association (BOA), which represents joint surgeons, said his organisation was working with NHS bosses to limit the impact on patients.
He said it was likely hospitals would start using surgeons and theatres more to carry out operations that do not require bone cement.
« The BOA will update surgeons with developments so they can treat their patients as the situation develops, » he added.
