Hip arthroplasty: a free FRCS (Tr & Orth) Section 1 question

NICE NG226 advises referral for consideration of joint replacement when joint symptoms substantially affect quality of life and non-surgical management has been ineffective or is unsuitable, and that referral should come before prolonged, established functional limitation and severe pain. It states explicitly that people should not be excluded from referral because of age, sex or gender, smoking, comorbidities, or overweight or obesity, and that scoring tools should not be used to set thresholds. Body mass index limits are therefore not a reason to delay referral, although weight and smoking are then addressed as risks during shared decision making. A steroid injection gives only short-term relief and is not a required step. Reference: NICE NG226, Osteoarthritis in over 16s (2022).