Last reviewed and updated: September 2026

Hip and knee replacement surgeries are often described as “elective” because they are usually scheduled rather than performed as emergencies. For a patient living with advanced arthritis, however, waiting for joint replacement can have a very real impact on daily life.

Pain may continue, walking can become more difficult, physical activity may decrease and everyday tasks can require progressively more effort. For some patients, the uncertainty of not knowing when surgery will happen can also become an emotional burden.

Research increasingly shows that the effects of waiting for hip or knee replacement should not be measured only in weeks or months. Function, mobility, independence and quality of life also matter.

How Long Are Canadians Expected to Wait for Joint Replacement?

The Canadian Institute for Health Information (CIHI) uses a national benchmark for planned hip and knee replacement surgery of:

This measurement does not necessarily include the entire period from the first family physician referral to surgery.

A patient may already have spent time:

• obtaining diagnostic imaging;
• receiving a referral to an orthopedic surgeon;
• waiting for the first orthopedic consultation;
• trying physiotherapy, injections, medications or other treatments;
• completing additional medical investigations.

CIHI's surgical wait-time measurement generally begins after the patient and appropriate physician have agreed to proceed with joint replacement and the patient is considered ready for treatment.

For current province-by-province information, see our guides to hip replacement wait times across Canada and knee replacement wait times across Canada.

What Can Happen While You Wait for Hip or Knee Replacement?

Not every patient will deteriorate at the same rate, and the impact of waiting varies according to the severity of arthritis, overall health, activity level and other factors.

However, several areas can be affected during a prolonged wait.

1. Joint Function May Decline

One of the clearest findings in the medical literature is that joint-specific function can deteriorate while patients wait for hip or knee replacement.

Tasks that were initially difficult may become increasingly challenging, including:

• walking longer distances;
• climbing stairs;
• standing for extended periods;
• getting in and out of a car;
• putting on shoes and socks;
• shopping;
• household activities;
• recreational exercise.

The 2024 systematic review examining nearly 90,000 patients found measurable deterioration in joint-related function during the presurgical waiting period.

2. Quality of Life Can Be Affected

Advanced hip or knee arthritis is not limited to the joint itself.

When pain and mobility restrictions interfere with sleep, work, exercise, social activities and independence, overall quality of life can decline.

The same large systematic review found deterioration in health-related quality of life as patients waited for joint replacement.

Arthritis Society Canada has also emphasized that prolonged joint-replacement waits can affect mobility, quality of life, the ability to work and independence.

3. Physical Activity May Decrease

When every step hurts, patients may naturally begin doing less.

Reduced activity can contribute to:

• loss of muscle strength;
• reduced cardiovascular fitness;
• stiffness;
• reduced balance;
• lower walking tolerance;
• greater difficulty performing daily tasks.

This does not mean patients should simply “push through” severe pain. The appropriate level of exercise should be discussed with a physician or physiotherapist.

4. Pain May Continue or Increase

Joint replacement is typically considered after significant arthritis or other joint disease is causing persistent symptoms and non-surgical treatment is no longer providing adequate relief.

While waiting, patients may continue to experience:

• pain with walking or standing;
• pain at night;
• joint stiffness;
• difficulty with stairs;
• limitations in work or recreation.

Pain management should be reviewed periodically with the treating medical team, particularly if symptoms are changing.

5. Sleep Can Be Disrupted

Hip and knee arthritis can interfere with sleep, especially when pain occurs at rest or makes it difficult to find a comfortable position.

Poor sleep can in turn affect energy, concentration and overall wellbeing.

6. Work and Independence May Be Affected

For working-age patients, prolonged mobility restrictions can interfere with physically demanding jobs as well as jobs requiring prolonged standing, walking or commuting.

For older patients, declining mobility may affect the ability to:

• shop independently;
• prepare meals;
• maintain the home;
• drive;
• participate in family and social activities.

In some cases, family members and caregivers may need to provide increasing assistance.

7. The Emotional Burden of Waiting Can Matter

Living with chronic pain and uncertainty around treatment can be frustrating and stressful.

Patients may worry about:

• losing additional mobility;
• being unable to work;
• becoming more dependent on family members;
• missing important activities or travel;
• not knowing when surgery will take place.

The psychological impact will differ from person to person, but it is an important part of the overall patient experience.

Does Waiting Cause More Joint Damage?

Osteoarthritis and other degenerative joint conditions can progress over time, but the rate of structural progression varies substantially between patients.

It is therefore too simplistic to say that every month of waiting causes a predictable amount of additional joint damage.

The more consistent evidence is that pain, function and quality of life can deteriorate during the waiting period.

Patients whose symptoms or function change substantially while waiting should inform their physician or surgical team rather than assuming their original assessment still reflects their current condition.

Does Waiting Longer Make Joint Replacement Surgery More Difficult?

Not necessarily.

The current evidence does not support telling every patient that a longer wait will automatically make their operation more complex.

Surgical complexity depends on many factors, including:

• the underlying diagnosis;
• severity of deformity;
• bone quality;
• previous surgery;
• joint stiffness;
• overall medical health.

Some individual patients may experience changes that alter the eventual surgical plan, but this should be assessed clinically rather than assumed simply from the number of months spent waiting.

Does Waiting Longer Lead to a Worse Result After Surgery?

This is an important question, and the answer requires some nuance.

Therefore, the strongest evidence-based message is:

Patients can lose function and quality of life while they wait, but longer waiting does not automatically mean that the eventual joint replacement will have a poor result.

This distinction is important when discussing the risks of delayed surgery.

Why Is Joint Replacement Considered “Elective”?

The word “elective” can be misleading.

In medicine, an elective procedure generally means that it can be scheduled rather than requiring immediate emergency surgery.

It does not mean the operation is unnecessary.

For someone with advanced osteoarthritis who has severe pain and major limitations in mobility, a total hip replacement or total knee replacement may be medically appropriate even though the procedure is classified as planned or elective.

What Can You Do While Waiting for Joint Replacement?

The waiting period does not have to be completely passive.

Depending on your medical condition, several strategies may help maintain health and prepare for surgery.

Stay as Active as Your Condition Safely Allows

Appropriate exercise can help maintain strength, mobility and cardiovascular fitness.

Low-impact activities may include:

• walking within tolerable limits;
• stationary cycling;
• swimming or aquatic exercise;
• strengthening exercises;
• physiotherapy-guided exercise.

The right program should be individualized, particularly when pain or mobility limitations are significant.

Work on Overall Health Before Surgery

The preoperative period can be used to address factors that may influence surgical recovery.

Depending on the patient, this may include:

• managing diabetes;
• controlling blood pressure;
• stopping smoking;
• maintaining appropriate nutrition;
• addressing anemia;
• improving strength and conditioning;
• reviewing medications with the medical team.

Review Pain Management

If pain is no longer adequately controlled, discuss the situation with your physician rather than increasing medication independently.

Prepare Your Home

Patients can also prepare for recovery by thinking ahead about:

• stairs;
• bathroom safety;
• transportation;
• meal preparation;
• family or caregiver support;
• mobility aids if recommended.

Arthritis Society Canada provides additional information about preparing physically and practically while waiting for joint surgery.

Keep Your Surgical Team Updated

If your pain, walking ability or overall medical condition changes significantly, contact your physician or orthopedic team.

Do not assume that a wait-list status assigned months earlier will automatically be reassessed without new information.

Can You Ask About Another Surgeon or Hospital?

Depending on the province and referral system, another hospital or orthopedic surgeon may have a different wait time.

Patients can ask their referring physician or surgical office:

• whether another facility has earlier availability;
• whether they can be placed on a cancellation list;
• whether another orthopedic opinion is appropriate;
• how their current wait compares with other programs.

For detailed regional information, see our current guides:

• Hip Replacement Surgery Wait Times in Canada by Province
• Knee Replacement Surgery Wait Times in Canada by Province

When Do Patients Consider Private Joint Replacement?

Some Canadians facing prolonged public-system waits choose to investigate private orthopedic surgery.

The decision is personal and should consider more than the wait time alone.

Factors may include:

• severity of pain;
• loss of mobility;
• ability to work;
• impact on sleep and daily activities;
• anticipated public-system wait;
• medical suitability for surgery;
• financial circumstances;
• travel and postoperative care requirements.

Dr. John Antoniou provides private hip and knee replacement surgery in Montreal for appropriately selected patients from Quebec and other parts of Canada.

Patients considering hip surgery can learn more about private total hip replacement and our guide to private hip replacement costs in Canada.

Patients considering knee surgery can learn more about private total knee replacement.

Does Private Surgery Guarantee a Better Outcome?

No.

Choosing private surgery changes the access and scheduling pathway, but it does not guarantee a better medical or surgical outcome.

Outcomes depend on many factors, including:

• the patient's diagnosis;
• overall health;
• severity of joint disease;
• surgeon experience;
• appropriate implant and surgical planning;
• rehabilitation;
• postoperative complications;
• individual healing.

The potential advantage for someone considering private care is primarily access to a different scheduling pathway, not a promise of a superior surgical result.

How Does the Private Surgery Process Work?

1. Consultation and imaging review: The patient's symptoms, medical history and imaging are reviewed.
2. Confirm the diagnosis and indication: The surgeon determines whether joint replacement is appropriate or whether another treatment should be considered.
3. Discuss treatment options: The recommended procedure, benefits, risks and alternatives are explained.
4. Medical preparation: Required testing and medical clearance are completed.
5. Scheduling: If surgery is appropriate, current surgical availability is discussed.
6. Surgery and rehabilitation: Postoperative recovery and physiotherapy are planned according to the patient's needs.
7. Follow-up: Clinical follow-up continues after surgery.

Frequently Asked Questions

Is waiting six months for hip or knee replacement considered normal in Canada?

Canada's benchmark for planned total hip and knee replacement is surgery within 26 weeks, or 182 days, once the patient is ready to be treated.

However, actual waits vary substantially by province, region, hospital and surgeon.

Does the six-month benchmark include the time waiting to see an orthopedic surgeon?

No. CIHI's benchmark generally begins after the patient and appropriate physician have agreed to proceed with surgery and the patient is considered ready to receive treatment.

Can my mobility get worse while I wait?

Yes. Research has found deterioration in joint-related function among patients waiting for hip or knee replacement. The degree of decline varies between patients.

Can my quality of life get worse while I wait?

Yes. A large 2024 systematic review found deterioration in health-related quality of life during the presurgical waiting period.

Does waiting longer guarantee a worse surgical outcome?

No.

Although patients can deteriorate while waiting, the same systematic review did not find a clear overall relationship between longer wait duration and poorer postoperative joint function or quality of life.

Should I stop exercising while waiting for joint replacement?

Usually not, unless your health-care provider has advised otherwise.

Appropriate activity can help maintain strength and conditioning. The type and intensity of exercise should be adapted to your symptoms and medical condition.

Should I contact my surgeon if my condition gets worse?

Yes. Significant changes in pain, mobility, function or overall health should be discussed with your physician or surgical team.

Can I ask to be placed on a cancellation list?

Possibly. Availability and policies differ between surgical programs, but patients with flexible schedules can ask whether earlier dates sometimes become available because of cancellations.

Is private hip or knee replacement available in Canada?

Private orthopedic treatment pathways exist in Canada, although regulations, coverage and reimbursement differ by province.

Patients should understand the financial, travel, rehabilitation and follow-up requirements before proceeding.

How quickly can private surgery be scheduled?

There is no single timeline that applies to every patient.

Scheduling depends on medical suitability, imaging, required testing, preoperative clearance, surgeon availability and surgical-centre capacity.