Warning Signs From Increasing Wait Times for Total Hip and Knee Joint Replacement-Opportunities to Stay Ahead of the Wave and Improve Care.

SYNOPSIS: Access to timely care for hip and knee osteoarthritis (OA) is a growing issue. In Canada and Australia, wait times for total hip and knee joint replacements have risen steadily over the past decade, leaving many patients experiencing increased frailty, and reduced function and quality of life while waiting for surgery. These issues are often framed as problems of surgical capacity. We argue they are warning signs of health care systems failing to deliver effective nonsurgical care earlier in the OA disease continuum. OA is a complex chronic condition that requires ongoing care. Unfortunately, many patients are passively placed on waiting lists without support. This Viewpoint makes the case for physical therapists taking a leading role in hip and knee OA care, from primary care management through surgical triage, to ensure patients receive the right care at the right time. J Orthop Sports Phys Ther 2026;56(5):277-281. Epub 18 February 2026. doi:10.2519/jospt.2026.13577.