Most people choose a surgeon because their GP suggested one. That is a reasonable starting point and it is how the system is designed to work. It is also worth knowing what separates one surgeon from another, because the differences are real and they are not visible from a website alone, including this one.
A declaration first: this is written by a surgeon, about how to evaluate surgeons, and published on his own site. Read it with that in mind. The questions below are ones you should ask here as readily as anywhere else.
1. How many of these do you do a year?
Volume is one of the few surgeon-level factors consistently associated in the literature with better outcomes in joint replacement. Registry analyses show revision rates falling as annual caseload rises, and the effect is particularly marked for partial knee replacement.
It is a fair question and it should get a specific number, not an adjective. Ask for the figure for your operation, not for orthopaedics generally.
2. What else do you operate on?
A general orthopaedic surgeon covering several body areas is a legitimate and necessary model, particularly in regional practice. But narrow practices accumulate volume faster, and the surgeon who does two operations repeatedly encounters the unusual variants of those two operations sooner.
There is no correct answer here. What matters is that you know which model you are choosing.
3. Who will actually perform the operation?
In teaching hospitals, part or all of an operation may be performed by a trainee under supervision. That is how surgeons are produced and it is not a criticism. But you are entitled to know, and in private practice you are entitled to expect that the surgeon you consulted is the surgeon who operates.
Ask directly. Ask who does the consultation, who does the operation, and who reviews you afterwards.
4. What is the total cost, in writing, before I commit?
A joint replacement generates at least four bills: surgeon, surgical assistant, anaesthetist and hospital. A quote covering only the surgeon's fee is not a quote.
You should receive written informed financial consent covering all four, with the expected Medicare and health fund contributions and the out-of-pocket amount, before anything is booked. If you do not have that document, ask for it. See fees and no-gap cover.
5. What happens if it goes wrong?
An uncomfortable question and a revealing one. Complications happen to every surgeon. What differs is whether there is a plan.
Ask what the infection rate is in their practice, what happens if the knee does not bend, who you call at 9pm on a Saturday, and whether they perform revision surgery or refer it on. Neither answer to that last question is wrong, but a surgeon who does not do revisions should be able to tell you where you would go.
6. What would make you say no?
Possibly the most useful question of all. Every good surgeon declines operations, and they should be able to describe the circumstances readily: the person who has not tried non-operative management, the person whose symptoms do not match their imaging, the person whose expectations cannot be met by the operation, the person too medically unwell for the risk.
A surgeon who cannot name circumstances in which they would advise against surgery is worth thinking about.
What matters less than people think
- Which brand of implant. Most implants in wide use in Australia have good registry data. How accurately it is positioned matters more than whose name is on it.
- Whether a robot is used. Robotic assistance improves the accuracy of component positioning, which is well established. That it improves long term implant survival has not been shown, because the technology has not been in use long enough.
- Online star ratings. Small numbers, heavily skewed by factors like parking and waiting times, and in Australia the use of testimonials in advertising a regulated health service is restricted. This site publishes none, which is a legal position rather than a claim about quality.
The one thing to take away
You are allowed to ask all of this, and you are allowed to seek a second opinion. A surgeon who is uncomfortable with either is telling you something useful.
This page provides general information about a medical condition and a surgical procedure. It is not individual medical advice and does not replace consultation with a qualified practitioner. Outcomes vary between individuals and all surgery carries risk. A referral is needed for a consultation with Professor Daevyd Rodda; without one, you can start with the practice nurse practitioner, who can provide it.