How to Choose a Surgeon

Choosing the Right Surgeon for Hip or Knee Replacement

What Every Patient Should Research and Ask

Choosing the right surgeon for a hip or knee replacement is one of the most important healthcare decisions you will ever make. While implants, technology, and surgical approaches matter, long-term success is driven by judgment, experience, adaptability, communication, and accountability.

Below are the most important factors patients should consider–organized by what most directly impacts safety, recovery, long-term function, and satisfaction.

1. Outcomes and Complication Rates

This is the most important factor.

Hip and knee replacement are highly successful procedures, but complications–particularly infection and early revision–can be life-altering.

What to research and ask:

• What are the surgeon’s infection and revision rates?
• How do these compare with national benchmarks?
• How are higher-risk patients managed (diabetes, obesity, immune-modifying medications, smoking)?
• Are outcomes tracked objectively rather than anecdotally?

A surgeon should be transparent and comfortable discussing outcomes.

2. Surgeon Judgment, Communication, and Trust

Technical skill matters, but how a surgeon listens, explains, and partners with you often determines your experience and satisfaction.

Ask yourself:

• Does the surgeon take time to understand your goals?
• Are risks, tradeoffs, and limitations discussed honestly?
• Will the surgeon personally review your surgery and recovery with you?
• Do you feel informed–not rushed or pressured?

If trust is lacking before surgery, it rarely improves afterward.

3. Safety Optimization Before Surgery

Optimizing risk factors before surgery can dramatically reduce complications and improve recovery.

Ask:

• What are my modifiable risk factors (A1c, nicotine use, BMI, anemia, nutrition)?
• How will these be optimized before surgery?
• Will surgery be delayed if doing so improves safety and long-term outcomes?

Preoperative optimization reflects a surgeon focused on durable success, not just scheduling.

4. Ability to Perform Both Anterior and Posterior Hip Replacement

There is no single “best” hip approach for every patient.

Each approach has advantages and tradeoffs:

• Anterior hip replacement may allow earlier mobility but carries risks such as permanent numbness and higher wound complication rates, particularly in certain body types.
• Posterior hip replacement avoids some anterior-specific risks and may be safer in patients with higher BMI, certain anatomies, or prior surgeries.

Ask:

• Does the surgeon perform both anterior and posterior hip replacement?
• How do they decide which approach is best for me?
• Are there meaningful differences in pain or function at 6 weeks, or do outcomes equalize over time?

A surgeon who only offers one approach cannot fully individualize care.

5. Ability to Perform Both Robotic-Assisted and Manual Knee Replacement

Robotic technology can be beneficial–but it is still only a tool. Also different robots have different outcomes and functions.

Robotics may not always be available due to:

• Insurance denial
• Equipment malfunction
• Intraoperative findings requiring deviation from the plan
• Accuracy of the robot which can be completed by failure of the robot, type of robot, removal of bone spurs after balancing due to the bone spurs not being within the surgical field until bony cuts for the knee are completed.

Ask:

• Can the surgeon perform a well-balanced manual knee replacement if robotics cannot be used?
• How is knee balance and tracking confirmed without relying solely on the robot?
• Are manual adjustments commonly made after robotic planning?

Robotics function much like a smartphone–the user plays a major role in the final result.

6. Experience With Revision Surgery

Surgeons who perform revision hip and knee replacement are often more familiar with:

• Why replacements fail
• How to prevent complications
• How to manage unexpected findings during surgery

Even routine primary surgery may require revision-level techniques if something uncommon is encountered.

Ask:

• Does the surgeon perform revision hip or knee replacement?
• If something unexpected occurs, do they have the experience and tools to adapt safely?

7. Comprehensive Evaluation of Pain (Not Just the X-Ray)

Many patients with arthritis also have other pain generators, including:

• Tendon or muscle disorders
• Bursitis – Spine or nerve-related pain
• Gait, alignment, or biomechanical issues

Replacing the joint alone may not resolve all symptoms.

Ask:

• What portion of my pain is from arthritis versus other causes?
• What symptoms may persist even after a technically successful replacement?
• How will other pain generators be addressed to maximize function?

Clear expectations improve satisfaction.

8. Postoperative Protocol and How It Is Implemented

A successful operation requires a well-executed recovery plan, not just a written protocol.

Ask:

• What is the rehab timeline at 2 weeks, 6 weeks, and 3 months?
• How is pain managed and for how long?
• What is the blood-clot prevention plan?
• Who do I contact with concerns–and how quickly will I be seen?

Access and follow-through matter.

9. Case Volume and Personal Surgeon Involvement

Experience and ownership directly impact consistency and outcomes.

Ask:

• How many hip and knee replacements do you perform each year?
• Will you personally perform the key parts of my operation?
• Who rounds on me in the hospital?
• Who sees me at postoperative visits?

Patients should know who is responsible for their care at every stage.

10. Implant Philosophy and Fixation Strategy

Implants and fixation should be tailored, not one-size-fits-all.

Ask:

• Which implant systems do you use most–and why?
• How do you decide between cemented vs cementless fixation?
• Is implant choice individualized based on anatomy, bone quality, and activity level?

A thoughtful implant strategy reflects long-term thinking.

11. Patellar Management in Knee Replacement

How the kneecap is handled can significantly affect pain and reoperation risk.

Ask:

• Is the patella resurfaced or not–and why?
• How is patellar tracking assessed during surgery?
• What is the surgeon’s rate of reoperation related to patellar pain?

12. Operative Efficiency and Surgical Team Consistency

Operations that are too fast or too slow may increase risk.

Ask:

• What is the typical operative time?
• Do you operate with a consistent, experienced team?
• How is efficiency balanced with precision?

13. Second Opinions Are a Strength, Not a Threat

A confident surgeon should welcome second opinions.

Ask:

• Who is another surgeon you respect and would recommend?
• Can we review differences if I obtain another opinion?

Red flag: defensiveness or pressure not to seek one.

14. Online Reviews (With Context)

Reviews reflect communication and experience, not always technical skill.

Look for patterns related to:

• Listening and empathy
• Accessibility after surgery
• Transparency and trust
• Postoperative support

Final Thought for PatientsThe “best” surgeon is not defined by a single technique or piece of technology, but by consistent outcomes, adaptability, experience, communication, and accountability.