Professor Colin Howie retired a year ago after more than 40 years as NHS Lothian's leading orthopaedic surgeon, says that with more than 400,000 people on waiting lists and the worst ever staffing crisis, the service is in critical condition.
He says the situation was dire even before the pandemic hit.
"Things have got so out of control, when the NHS first started, patients were looking at a five-year wait for a hip replacement. Today, we're right back where we started,” he said.
"Patients will be lucky to be seen within the next five years unless they literally have a leg almost hanging off. There is no theatre space or beds available. We'll be dealing with this backlog for a decade. Only day-care cases that don't require overnight stays are being seen.
Elderly patients who can't just get up and go home immediately are likely to be left waiting five years."Howie said that, despite hip and knee replacements being one of the most cost-effective ways of treating patients and most successful in restoring quality of life, the longer they have to wait, the harder it becomes for them to recover and regain full mobility.
He said health boards are pushing through quick procedures to keep their operation figures up, masking the reality of the crisis. "It is my understanding that they are only prioritising grade 1 and 2 procedures - operations that require no hospital stays," said Howie.
"Patients who have difficulty getting out of a chair because they have hip pain are considered only grade 4, so the chances of them being seen and operated on is infinite."
The number of people waiting for a range of the most common operations has increased since last December, the most recent figures from June show.
There were 32,388 patients on orthopaedic waiting lists across Scotland last December. By June there were 36,301. The latest staffing figures show Scotland is short of 542 doctors, and nursing vacancies are at an all-time high at 4,854.
Howie said: "It's catastrophic. And it's not all down to the pandemic. Things were bad long before that. I retired a year ago because I'd spent the year before doing virtually nothing because there were no theatres or staff available. There were lots of plans for a number of treatment centres to deal with demand, but virtually all of those have come to nothing. We have a Covid Recovery Programme that has achieved nothing at all over the past 18 months when that should have been a golden opportunity to plan for an NHS that is fit for purpose for future generations."A senior doctor added the NHS in Scotland "is in full blown crisis".
Dr Graeme Eunson, chair of the British Medical Association Scotland's Consultant Committee, said he cannot recall a time in his career "when things have been this tough".Writing on his blog, he said: "The system is at capacity - there are few beds available, all the staff I know are stretched to the limit.”