Choosing a Hip Replacement Surgeon

You’ve suffered through pain and discomfort related to your hip degeneration and have finally decided to consult with an orthopedic surgeon. Choosing the right orthopedic surgeon is very important to a successful surgery and recovery.

A few considerations when selecting an orthopedic surgeon and scheduling your hip replacement surgery:

  • Experience: How long has the surgeon been practicing? In what disciplines? How many hip replacements has he or she performed? How many does he perform per year?
  • Talk to your family doctor: Ask your primary care physician for a referral to a respected local surgeon based upon his or her experience in referring other patients.
  • Talk to your friends: Ask people you know which surgeon they have seen for orthopedic needs.  Arthritis and joint-replacement surgeries are common today — you likely already know someone with first-hand experience. (Though don’t depend entirely upon this information. Even less experienced surgeons will have some satisfied clients!)
  • Education: Review the surgeon’s education, degrees, training and fellowship. Consider what areas of study he/she undertook and what board certifications he or she has achieved or is eligible for.
  • Check online: Check with your national Medical Association to verify his/her credentials. For instance, in the US, check with the American Academy of Orthopedic Surgeons, the American Medical Association and state disciplinary board for a surgeon’s disciplinary record. In the UK, check with the Royal College of Surgeons, the British Orthopaedic Association and the General Medical Council for disciplinary history. Also, search our joint replacement clinic locator.
  • Take questions in written form and make sure you ask them: Do not feel uncomfortable or intimidated asking your doctor about his or her experience and credentials. Make sure to ask any questions you might have about your condition and about surgical options. Any good surgeon will take the time to understand your concerns and answer all of your questions to make sure you understand the procedures and the risks.
  • Consider getting a second opinion: A second opinion may help put your mind at ease. Most good surgeons will have no problem with a request for a second opinion and will be happy to review and discuss that second opinion with you if necessary. Ideally, this should be from a doctor who has in a different practice or hospital from the first surgeon.
  • Trust your instincts: If you walk away from the initial consultation/meeting with a surgeon and you do not feel confident in that surgeon for any reason, trust yourself and keep looking for the right surgeon for you.

Questions to consider discussing with prospective surgeons:

  • Are you board certified/qualified?
  • How many of these surgeries have you performed in the past and how many do you do per year? (Studies have shown “high-volume” surgeons and facilities generally have lower complication rates. Some consider “high-volume” to be 200 or more total hip arthroplasties per year, for one surgeon. With new technologies such as navigation and computer- or robotic-assisted surgeries, some elite surgeons are able to perform 400 to 600 replacements each year.)
  • What type of implant will be used? How long does it last? What else do I need to know about it?
  • How long have you used your current prosthesis and what are your reasons for selecting it?
  • What is your infection rate? (0.5% or less is good)
  • What risks are involved and how likely are those risks to actually occur?
  • What is your incidence of short-term complications – dislocations, wound infections?
  • What is your incidence of long-term complications – infections, loosenings, breakages of prosthesis, clicking, clunking, unidentifiable pains, need for manipulations?
  • How will I be anesthetized? What are the risks of anesthesia?
  • What kind of approach do you favor (posterior, micro-posterior, lateral/antero-lateral, direct anterior, MIS with or without robotics)? Why?
  • How long will I stay in the hospital?
  • How long is the recovery process?
  • Will I experience a lot of pain? If so, what kind of pain relief will be available to me?
  • Will I need physical therapy? For how long?
  • Will there be any post-surgical restrictions on everyday activities? For how long?
  • How much improvement should I expect following surgery?

Discuss in the forum: How to choose a surgeon and a prosthesis

image credit: Tulane Publications