Medscape reports on new guidelines from the American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) on optimal timing for elective hip and knee arthroplasty. 

Patients with moderate to severe osteoarthritis (OA) or osteonecrosis (ON) eligible for total joint arthroplasty (TJA) who have failed one or more nonoperative therapies should proceed directly to surgery, according to the new guideline. 

"One of the reasons for creating this guideline was that many patients have been subjected to delays for surgery after completing nonoperative therapy, despite persistent moderate to severe pain, loss of function, and moderate to severe radiographic OA or ON," said co-authors Susan M. Goodman, MD,  rheumatologist at HSS, and Charles Hannon, MD, orthopedic surgeon at Washington University. "This guideline supports surgery being performed in an expeditious fashion after the decision has been made to proceed with surgery by both the physician and patient through a shared decision-making process," they said.

Read the full article at medscape.com.