Question: How do I decide when I should get joint surgery? (If I wait too long, will it be less effective?)
Answer: The decision about when to proceed with surgical intervention for osteoarthritis is often a complex one, but it's largely driven by pain and dysfunction. When the patient's pain and dysfunction reaches unacceptable levels, one should consider proceeding with surgery. I do think that at times some patients wait too long.
The standard recommendation about waiting as long as possible is probably not optimal. Patients shouldn't wait until they are crippled with the arthritis before they consider surgical intervention. It is pretty clear that if you wait an inordinate period of time to consider surgical intervention, in knee replacement for example, the knee can get quite stiff and the stiffer it gets the results can be impacted by that.
So it has to be a careful weighing of how severe the disease is, how significant is that disease affecting the quality of life of that individual patient and when that pain and dysfunction reach unacceptable levels one should consider intervening in a surgical manner.
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