The decision to undergo a knee replacement is a major step toward reclaiming an active lifestyle. It’s important that you feel confident in your choice.
Finding the right surgeon—one with a history of successful knee replacement surgeries—increases the odds that you will experience a positive outcome. It’s also critical that you feel comfortable with the surgeon and feel that you can discuss your concerns and questions openly while obtaining the information you require to comfortably move forward with the procedure.
Here’s what you can do to increase the odds of finding the right surgeon:
Ask for Referrals
Your Current Clinicians
Check with your primary care physician or general practitioner for a list of orthopedic surgeons who specialize or are experienced in knee replacement. Be sure to ask why he or she recommends the surgeon and why this person stands out. You can expand your list of possible surgeons if you also reach out to other doctors or physical therapists (try other doctors who share an office with your primary care doc) and ask for their recommendations.
You will likely want to know if the surgeon is within your insurance plan's provider network and is covered by your insurance. The choice of your surgeon may impact your out-of-pocket costs, depending on your insurance coverage and if the doctor is in- or out-of-network.
Local Orthopedic Departments of Excellence
Some hospitals in your region may have a department of excellence for orthopedic surgery. If so, you may be able to identify a specialist for specific surgical approaches.
Check With Friends and Acquaintances
If you know anyone who has received a knee replacement, ask that person who performed the surgery and whether the procedure went well. A friend or family member who has had a knee replacement may have a recommendation about a surgeon or surgery centers. Enquire about the doctor’s willingness to answer questions and talk things through.
Tap Online Resources
A number of online databases provide a way to identify board certified knee replacement surgeons and check their credentials. The American Academy of Orthopedic Surgeons, the American Association of Hip and Knee Surgeons and the American Medical Association provide lists of qualified surgeons. BoneSmart.org offers a database of joint replacement clinics that specialize in knee replacements and other procedures.
Evaluate the Surgeon’s Credentials
Review the Surgeon’s Education and Credentials
Spend some time reviewing the surgeon’s background, including education, degrees, medical degree, credentials and training. Find out whether the surgeon is board certified and by what association—the three most common are those listed above. You can learn more about the certification requirements by visiting that association’s site.
Check on the Surgeon’s Experience Levels
It’s wise to ask a surgeon how many procedures he or she performs annually. Studies show that surgeons who conduct 12 or more knee replacements per year are more likely to have a record of success. Likewise, hospitals that perform 25 or more TKRs annually have a better track record. The best surgeons often perform hundreds of procedures each year.
Specialty & Training
Specialists in knee replacement gain valuable experience by performing operations. However, they can also expand their knowledge through continuing education. This includes learning about new technologies, cutting-edge surgical approaches, and new devices.
If you believe that a specific device or surgical approach may be right for you, it is important to determine if the prospective surgeon is trained in that area or is able to implant that device. Typically, in order to use a specific surgical method or device, a surgeon will have received training from the manufacturer. Also, hospitals sometimes prefer certain manufacturers and devices. By visiting a manufacturer’s site, you will likely find a surgeon near you trained in the desired technology. Yet, at the same time, it’s important to respect your surgeon’s recommendations. He or she is best equipped to determine which implant is right for you. Work with your surgeon to understand the choice he or she makes. Don’t be afraid to ask plenty of questions. It’s important to be comfortable with the technology used.
Experience With Special and/or High-Risk Cases
It’s reassuring to know that you’re in the hands of a surgeon who can address your special needs or deal with complications. Be sure to discuss your complete medical history with your surgeon prior to surgery in order to ensure that he or she is able to handle any special needs and so that you avoid any potential complications.
For example, if you have pre-existing condition like anemia or diabetes, or if you have had other trauma that will complicate your surgery, you should inquire about the surgeon’s experience to handle these types of cases.
Meet with the Surgeon One-on-One
Once you have compiled a short list of potential surgeons, you will want to schedule a consultation with each one. During these sessions you should discuss your situation, solicit their opinion, and decide if they are the right surgeon for you.
Before the Appointment
Make sure that you have a thorough understanding of your pain level and knee history. It may be helpful to take an online knee pain evaluation or assessment and print out the results to bring with you.
In addition, you should prepare a set of questions, including questions focusing on his or her experience with cases like yours and the technology that will be used.
During the Appointment
Ask about the surgeon’s success rates and his or her experience with similar cases to yours. Also, ask the surgeon if and how often they have needed to bring their past TKR patients back for revision surgery, and why this occurred. Also ask if the surgeon prepares a surgical plan prior to a procedure and what he or she includes in it. Finally, check on whether the surgeon uses computer-assisted technology and whether minimally invasive techniques are a possibility.
Share your questions and concerns and ask about the benefits and risks of the procedure.
The Cost of Surgery
Finally, ask where your surgery will be performed, so that you can make sure that the hospital your doctor will use is an in-network facility for your insurance. You may want to call the billing office of the hospital and enquire about costs directly. If you have a preference in hopsital, this may also be a good opportunity to ask about each hospital's track record with this procedure, and/or to research online about the hospital's quality records. Lastly, you may also want to ask about physical therapy clinic options after the surgery. Don’t be afraid to ask about what to expect in terms of costs.
Take Notice Of…
Surgeon Bed Side Manner
Monitor your interactions with the doctor, and how you feel. A good surgeon will spend adequate time discussing your options and possible outcomes.
Office Staff and Environment
The nurses and office staff will be your gateway to the surgeon and will be helping you to schedule and prepare you for surgery and recovery. Among other things, the nurses will be registering you for your pre-surgical prep course, arranging your physical therapy, and ordering your recovery equipment. The staff will be handling all your appointments and any dealings with your insurance provider. It’s important that you feel they have genuine concern for your wellbeing and will address your needs and provide you with good service. If the service isn’t up to par, it could negatively impact your experience.
Getting a Second Opinion
Lastly, consider a second opinion. Even if you feel totally comfortable with the first orthopedic surgeon you consult, a second opinion—preferably at a different clinic, can help you gain valuable insights and perspective. You may want to visit three or four doctors…or more. If you receive conflicting information don’t be shy about going back to each doctor and asking additional questions.
You shouldn’t make a choice and move forward with surgery until you feel completely comfortable with the surgeon, device and the procedure. Your future health depends on it.