The Importance of a Second Opinion

Hip and knee replacement and revision surgeries have become increasingly common, and are very successful at relieving pain and increasing mobility. If your surgeon has recommended this type of surgery, it can be important to get a second opinion.

In some cases, a surgeon might recommend a type of surgery that’s more complicated or extensive than what’s actually needed. For example, a total knee replacement is far more common than partial knee surgery, but sometimes a total replacement isn’t necessary, or is a more extensive surgery, to deliver results that might also be achieved with a less invasive partial, or unicondylar, knee replacement.

Some common reasons patients seek a second opinion are presented below.

• Seeking an alternative surgical technique

In many cases, especially for hip surgery, surgeons use “traditional” surgical techniques that cut muscles around the hip and thus require 6-8 weeks of restricted activity and “hip precautions.” Ultimately, these techniques may deliver a good outcome, but the early recovery for the patient is vastly impacted after the procedure. Modern use of minimally invasive surgery, especially with the Direct Anterior Approach, can improve the early recovery, minimize pain, and reduce the complication rate. In addition, there are few restrictions on the patient’s activity in the early recovery after DAA, which helps make recovery much easier for many patients.

• A prior prosthesis needs to be removed

Hip or knee replacements can fail for several reasons, such as loosening that causes your artificial joint to detach from the bone. This can occur over time because of plastic bearing surface wear or bone erosion. Sometimes, revision can be required if the joint becomes dislocated.

If you need knee or hip revision surgery, you’ll want a second opinion because this is a more complex type of surgery than the original replacement was. Bone loss can make the new implant harder to successfully anchor, and the risk for complications for this type of surgery is greater. It’s important to consult an expert surgeon who has experience specifically with revisions in addition to replacements.

• Patient and family desire surgery in a “Center of Excellence”

There are now many surgeons and hospitals that perform hip and knee joint replacement. Many patients desire to be cared for in a Total Joint Center of Excellence, which has been accredited by the Joint Commission through a process of rigorous inspection. Generally, this requires data tracking, standardized protocols, and a hospital-wide focus on constant improvement in successful patient outcomes after joint replacement surgery.

Dr. Rubin and Yale-New Haven Hospital are proud to have achieved an “Advanced Certification” for their hip replacement and knee replacement programs. Throughout every phase of joint replacement care, a focus on the patient’s experience and outcomes help to drive best practices and achieve superlative results for a wide variety of simple and complex problems.

What questions should you ask when you get a second opinion?

A qualified surgeon should feel comfortable answering any questions related to your surgery. Consider asking the following questions:

• Do you use minimally invasive techniques?
• What is your educational background, and what professional affiliations and certifications do you have?
• Does your recommendation agree with or differ from the other doctor’s opinion, and why?
• When should the surgery be performed? Is it urgent or can it wait?
• How frequently do you perform complex or revision joint replacement surgery?

Are there any drawbacks to getting a second opinion?

In some cases, a patient may be anxious about the diagnosis or treatment and continue to seek third and fourth opinions, which can sometimes delay treatment and relief.

If you’d like a second opinion about a hip or knee replacement or revision, make an appointment today with Dr. Rubin at his New Haven, Milford, or Guilford office. Dr. Rubin is a board-certified, fellowship-trained orthopedic surgeon with extensive experience in complex cases of failed joint replacement surgeries.