• Patient preferences;
  • Osteoarthritis;
  • Joint arthroplasty;
  • Population study



To examine perceptions of total joint arthroplasty (TJA) and how they relate to willingness to consider TJA.


A population-based survey in Oxford County, Ontario, Canada identified 1,735 subjects ≥55 years with disabling hip or knee arthritis; 435 English-speaking respondents with no prior TJA and not on a TJA waiting list were invited to participate, and 379 (37.1%) agreed. We assessed demographics; comorbidity; evaluated and perceived arthritis severity; perceived risks, benefits, indications for, and knowledge of TJA; preferred decision-making style; self efficacy; and willingness to consider TJA by questionnaire.


Participants' mean age was 67.6 years; 33.5% were willing (definitely or probably) to consider TJA as a treatment option. Willingness was independently associated with younger age (odds ratio [OR] <75 versus ≥75 years 2.42, P = 0.01); worse perceived arthritis severity (OR per unit increase 1.30, P < 0.001); perceiving TJA as appropriate for moderate, controlled joint pain (OR 3.29, P = 0.004); walking limited to <1 block (OR 1.99, P = 0.015); the risk of revision as acceptable (OR 3.73, P < 0.001); and friends as an important health information source (OR 2.49, P = 0.01).


Participants overestimated the pain and disability needed to warrant TJA. These misperceptions were strongly associated with unwillingness to consider TJA and should be addressed at a population level.