Questioning Medicine

 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