Questioning Medicine

Episode 268: 268. New Guidelines For Total Hip and Knee Joint Replacement


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  •  TJA should not be delayed for trials of physical therapy, anti-inflammatory drug use, bracing, intra-articular steroid injections, or hyaluronic acid injections.

  • For patients with obesity, proceed to TJA without delay, regardless of BMI.

  • For patients with poorly controlled diabetes, recommend delaying TJA to improve glycemic control, but don't define poor control or specific HbA1c requirements.

  • For smokers, recommend delaying TJA for a trial of smoking reduction or cessation.


  • https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr.25175


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