<p>There is criticism that surgery is performed too frequently and too quickly in Germany. There seems to be some uncertainty or even differing opinions regarding the indications for surgery. The question remains whether there is such a&#xa0;thing as surgery being performed too early or too late. The guideline provides clear guidelines that should be followed. If this is done, there should no longer be any problems with indications. It is undisputed that early surgery is more likely to lead to patient dissatisfaction than late surgery. In the case of late surgery, the initial findings for the surgery are ultimately worse and the operation is more demanding, but the results are often better than those of surgery performed too early. There are a&#xa0;number of predictors that can be used to assess the postoperative outcome. It is advisable to take these into account when making a&#xa0;decision. The expectations of today’s patients are very high and the goals are ambitious. It is important to convey that a&#xa0;total knee replacement is not a&#xa0;fountain of youth, but only leads to improved function of the affected joint. It is striking that the highest growth rates across the Organization for Economic Co-operation and Development (OECD) countries are found in patients under the age of&#xa0;65, even though timely and indication-appropriate surgery is the goal. Despite all economic considerations, care must be taken to avoid long waiting times, as the literature clearly shows that long waiting times lead to significantly greater discomfort and affect quality of life and mental health.</p>