This observational study is conducted to assess patients’ willingness to undergo joint surgery for OA (osteoarthritis) after three to twelve months of first-line intervention, besides analyzing the characteristics of both willing and unwilling patients before the intervention. The correlation of willingness of undergoing surgery with walking struggles, pain significance, movement anxiety, and self-efficacy was to be investigated.

Thirty thousand five hundred seventy-eight participants with either hip or knee OA shared in first-line interventions, including exercise and education. Swedish register data were used in the study. At baseline, before the intervention, 40% of men and patients with critical disability and symptoms showed a willingness to undergo surgery. However, after the first-line intervention, 30% and 45% of people with hip and knee OA, respectively, became unwilling. Moreover, similarly, 19% of hip OA patients and 35% of knee OA who were willing became unwilling after twelve months (by the end of the study). Moreover, there was a higher likelihood of willingness to undergo surgery in patients who suffered pain significance, movement anxiety, and walking struggles. On the other hand, the opposite was true for patients with increasing self-efficacy.

In conclusion, it is observed that first-line OA interventions are correlated with a decrease in willingness to undergo joint surgery, with a higher percentage in knee OA patients than patients with hip OA. Willingness to undergo surgery is chronologically flexible, and thus, it should be approached with meticulousness to regard the suitability of surgery.