1. Pre-Surgery

My Journey: Finding A Surgeon

The failure of my knees took away the option of continuing to ignore my condition. Over the next two months, I saw these professionals:

• My primary care doctor

• An orthopedic surgeon

• A physical therapist

• A sports medicine doctor

My primary care doctor suggested MRIs, which the physical therapist reviewed and pronounced among the worst he had ever seen. X-rays confirmed my status as a future TKR recipient. They showed my knees had suffered extensive damage from osteoarthritis, and degraded cartilage had left them bone on bone.

Once I decided to have TKRs, the next step was to find a surgeon I could trust. Since I was not qualified to evaluate a surgeon’s technical skill, I had to use other criteria to conduct this search. The first critical decision was that I did not want a “Ghost Surgeon.” This term refers to a surgeon who is only present for part of the operation, turning the procedure’s beginning and end over to an orthopedic resident /fellow. Delegating these responsibilities enables the surgeon to supervise more than one surgery at a time, allowing ghost surgeons to claim an extremely high number of surgeries per year. However, this number can be illusory, as the surgeon is not there for the entire operation.

At the same time, I did not want a doctor who performed very few surgeries (under 50) a year. I was advised to look for a doctor who did between 200 and 500 joint replacement surgeries annually.

The other criteria I used were subjective.
I wanted a surgeon who :

1. Would listen to my concerns about anesthesia and work with me to find a solution with which I was comfortable.

2. Had a history of successful TKRs

3. Would spend time with me post-surgery if I needed further care.

Again I turned to my PT, who had provided rehab for patients from several highly regarded surgeons in the area. Since my surgery was to take place in an academic medical center (a teaching hospital), I wanted a surgeon who would understand my request that the operation be performed by my doctor’s hands and not by someone with less experience. Perhaps that was selfish, but I felt I had the right to be selfish in this situation. With patient responsibility comes patient empowerment, and there is no place for embarrassment when making decisions about your own body. Finally, I turned to friends who had either had TKRs or were connected, in some way, to the medical community and asked for their opinions and advice.