What to expect at your first consultation

Most clinics ask you to fill out a questionnaire beforehand — about your pain, how long you've had it, what you've already tried, and how it's affecting your daily life. It's worth taking this seriously; it gives your surgeon a head start and means less time in the appointment spent on paperwork.

Bring a list of your current medications, any previous imaging (X-rays or MRIs, if you have them on a disc or referral), and a short mental note of your main goal — walking the dog without pain, getting back to golf, sleeping through the night.

If you haven't already had one, a weight-bearing X-ray of the affected joint is typically done at or before the visit. Weight-bearing matters — an X-ray taken lying down can understate how much cartilage has actually worn away, since it doesn't show the joint under load the way standing does.

Your surgeon will check the joint's range of motion, look for swelling or deformity, test the strength of the surrounding muscles, and often watch you walk. They're looking for the pattern of your particular arthritis — which movements are limited, where exactly the pain is, and whether other joints (spine, opposite hip or knee) might be contributing to how you feel.

A good consultation isn't a verdict — it's a discussion. Most surgeons will walk through where things stand (mild, moderate, or advanced arthritis), what non-surgical options remain reasonable, and, if the joint has reached that point, what surgery would involve. You should leave with a clear sense of:

• What's actually causing your symptoms.
• Whether non-surgical treatment is still worth trying, and what that would look like.
• If surgery is being considered, roughly what the procedure and recovery involve.
• What the realistic timeline looks like from here.

It's entirely normal for a first consultation not to end in a surgery date. Many patients are seen once, given a plan for conservative treatment, and return months or years later when the joint has progressed further.

Consultations go better when you arrive with a short list rather than trying to remember questions on the spot. Useful ones include: What's the source of my pain? What are my options besides surgery? If I do need surgery eventually, is there a benefit to doing it sooner rather than later? What would recovery look like for someone in my situation?

Depending on what's found, next steps might be a trial of physiotherapy or medication, a referral for further imaging, or — if the joint is clearly beyond conservative measures — a discussion of surgical timing. If you want to read ahead, our articles on non-surgical treatments worth trying first and preparing for surgery cover what typically comes next in each direction.

A first consultation is really about building an accurate, shared picture of your joint — not about being talked into anything. Walking in with your history organised and your questions ready is the single best way to get the most out of the time.