You should consider referring a patient with osteoarthritis for surgical evaluation by an orthopaedic surgeon if their joint symptoms, such as pain, stiffness, reduced function, or progressive joint deformity, are substantially impacting their quality of life NICE CKS,NICE NG226. This is particularly relevant when non-surgical management has been unsuitable or ineffective, typically after 3 months NICE CKS,NICE NG226.
Additional reasons to consider referral include diagnostic uncertainty, the presence of atypical features, or a sudden worsening of symptoms NICE CKS.
It is crucial that the decision to refer for joint surgery is based on clinical judgment and not on factors such as the person's age, sex or gender, smoking status, comorbidities, or body mass index (BMI) NICE CKS,NICE NG226. Furthermore, the use of numerical scoring tools to assess disease severity for referral is not recommended; instead, clinical assessment should be used NICE CKS,NICE NG226.