Total Knee or Hip Replacement: Shared Decision-Making: Trial of Conservative (Non-
Percentage of patients regardless of age undergoing a total knee or total hip replacement with documented shared decision-making with discussion of conservative (non-surgical) therapy (e.g., non-steroidal anti-inflammatory drug (NSAIDs), analgesics, weight loss, exercise, injections) prior to the procedure.
Last updated: January 15, 2026
🧮MIPS Score Simulator
Estimate only — actual CMS scoring may vary based on reporting method, data completeness, and annual rule updates.
📖Clinical Rationale
A trial of non-surgical therapy should be used prior to surgery, when possible. Non-surgical therapy may include the use of NSAIDs, other analgesics, exercise, or injections. For patients with severe disability, the patient and surgeon may decide after a thorough review of conservative options that the optimal treatment is to proceed with the operative intervention.
This measure is designed for use by physicians and eligible health care professionals managing ongoing care for all patients undergoing a total knee or hip replacement. This measure addresses the preoperative period.
📝Clinical Recommendations
AAOS recommends self-management programs to improve pain and function for patients with knee osteoarthritis. (Strong Recommendation) AAOS recommends patient education programs to improve pain in patients with knee osteoarthritis. (Strong Recommendation) AAOS recommends supervised exercise, unsupervised exercise, and/or aquatic exercise over no exercise to improve pain and function for treatment of knee osteoarthritis.
(Strong Recommendation) AAOS recommends sustained weight loss to improve pain and function in overweight and obese patients with knee osteoarthritis. (Moderate Recommendation) AAOS recommends topical nonsteroidal anti-inflammatory drugs (NSAIDs) be used to improve function and quality of life for treatment of osteoarthritis of the knee, when not contraindicated.
(Strong Recommendation) AAOS recommends oral NSAIDs to improve pain and function in the treatment of knee osteoarthritis when not contraindicated. (Strong Recommendation) AAOS recommends NSAIDs to improve short-term pain, function, or both in patients with symptomatic osteoarthritis of the hip. (Strong Recommendation) AAOS recommends the use of intraarticular corticosteroids to improve function and reduce pain in the short-term for patients with symptomatic osteoarthritis of the hip.
(Strong Recommendation) AAOS recommends the use of physical therapy as a treatment to improve function and reduce pain for patients with osteoarthritis of the hip and mild to moderate symptoms. (Strong Recommendation) For patients with Hip OA, only structured land-based exercise programs were considered eligible for Core Treatment designation. Arthritis education was considered a standard of care.
Structured land-based exercise programs, dietary weight management in combination with exercise, and mind-body exercise (such as Tai Chi and Yoga) were considered by the panel to be effective and safe for all patients with Knee OA, regardless of comorbidity. These treatments are recommended for use alone or along with interventions of any recommendation level, as deemed appropriate for the individual.
Education about OA is considered a standard of care.
📋Implementation Notes
This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this procedure measure is submitted each time a procedure is performed during the performance period.
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