I’ve been in orthopedics for 28 years-as a medic in the Air Force and in the industry side and I would tell you to have the surgery once your pain and lack of motion affect things that are important to you. If it is affecting your ability to earn a living, affecting your relationships or your ability to take care of yourself (like being able to tie your shoes) then it is time. Most people recommend waiting as long as possible because the implants do wear and over time can fail due to this wear. But the technology has improved tremendously and going to a non-academic surgeon that does a high volume is key.