343 patients with radiographic osteoarthritis considering hip or knee arthroplasty were randomized to one of two groups for the purpose of investigating the efficacy of educational patient decision aids (PtDAs) on the overall decision-making process and access to total joint arthroplasty when compared to a standard information protocol. Results demonstrated that patients who were given PtDAs were more likely to reach good decision quality (improved comprehension of benefits/risks, relevant factors, and complications) despite comparable completed surgery rates and surgery wait times.