The American College of Rheumatology (ACR), in collaboration with the American Association of Hip and Knee Surgeons (AAHKS), announced a new guideline regarding optimal timing for elective total arthroplasty procedures in patients with symptomatic moderate to severe osteoarthritis or osteonecrosis of the hip or knee who did not respond to nonoperative therapies. In the new guideline, ACR and AAHKS advised against delaying total hip or knee arthroplasty to trial additional nonoperative therapies—including physical therapy, gait aids, oral anti-inflammatory medications, and injections—for those with advanced osteoarthritis or osteonecrosis; however, patients who have a history of smoking should quit, and those with diabetes should improve their glycemic control prior to the procedure. Additionally, the guideline emphasized the importance of involving patients in the decision-making process, as well as discussing potential surgical risk factors and methods of reducing patients’ risks prior to total knee or hip arthroplasty.
May 25, 2023