- M.B.B.S.
- M.S. Orthopaedics
- Fellow in Knee and Hip Replacement, Mumbai
- Fellow In Knee and Hip Surgery, Germany
- Fellow in Knee and Hip Surgery, NHS, Singapore
- Fellowship in Complex and revesion knee and Hip replacement, London, Lancaster, UK
Knee replacement is a major decision. You’re choosing a surgery that will affect how you walk, sit, sleep, and live for the next 15-25 years. Yet most patients arrive at the surgeon’s office without knowing what to ask, accept the first plan presented, and only realise in retrospect what they wished they’d known.
This is the list of questions every patient should be asking and the answers you should expect from a surgeon worth choosing.
How many knee replacements do you personally perform each year?
Why it matters: This is the single strongest predictor of surgical outcome in published research. Surgeons performing 75+ knee replacements per year have demonstrably better outcomes — lower complication rates, faster recovery times, better long-term function — than those performing 25-30 per year. Volume matters because joint replacement is a technical skill that requires constant practice.
What to listen for: An honest specific number (“about 200-250 per year”) is what you want. Vague answers (“we do a lot”) suggest lower volume.
Red flag: A surgeon who performs primarily other procedures (sports medicine, fracture surgery, spine surgery) and does knee replacement occasionally. Volume matters within sub-specialty, not just total operations.
What's your complication rate, and how do you handle complications when they happen?
Why it matters: All surgery has complications. The difference between excellent and average surgeons isn’t whether complications occur — it’s whether they’re transparent about rates and whether they have systems to manage them when they happen.
What to listen for: Honest numbers (e.g., “Infection rate around 0.5%, blood clot rate around 1%, manipulation under anaesthesia needed in about 3%”). A clear protocol for managing each complication. Willingness to discuss specific past cases without revealing patient identity.
Red flag: “We don’t have complications” or evasive answers. Complications happen to every surgeon; how they’re handled separates competent practitioners from problematic ones.
Which implant will you use for my surgery, and why?
Why it matters: Implant choice should be specific to your case — your age, anatomy, activity level, weight, and lifestyle. A surgeon who uses the same implant for every patient isn’t customising care to you.
What to listen for: A specific brand and model recommendation with clinical reasoning. (“For your age and activity level, I recommend a high-flexion design from [brand] because…”). An explanation of alternatives and their trade-offs.
Red flag: “We use the best implant” without specifics, or aggressive promotion of premium implants without medical justification.
What approach and technique will you use? Will it be robotic, navigation, or conventional?
Why it matters: Different cases benefit from different technical approaches. The surgeon should be able to explain why their chosen approach fits your specific anatomy.
What to listen for: Specific reasoning tied to your case. (“Your deformity is mild and your anatomy is straightforward, so conventional surgery will give equivalent results to robotic — saving you the technology premium” or “Your previous knee surgery has altered the anatomy, so robotic assistance specifically helps in your case.”)
Red flag: A surgeon who insists on the most expensive technology for every patient regardless of clinical fit, or who dismisses newer technology without thoughtful reasoning.
What approach and technique will you use? Will it be robotic, navigation, or conventional?
Why it matters: Different cases benefit from different technical approaches. The surgeon should be able to explain why their chosen approach fits your specific anatomy.
What to listen for: Specific reasoning tied to your case. (“Your deformity is mild and your anatomy is straightforward, so conventional surgery will give equivalent results to robotic — saving you the technology premium” or “Your previous knee surgery has altered the anatomy, so robotic assistance specifically helps in your case.”)
Red flag: A surgeon who insists on the most expensive technology for every patient regardless of clinical fit, or who dismisses newer technology without thoughtful reasoning.
What's the total cost, and what does it include? What might cost extra?
Why it matters: Joint replacement is one of those purchases where the “package price” sometimes excludes things that materially affect the final bill. Pre-op investigations, specific medications, room category upgrades, post-discharge physiotherapy — these can add ₹20,000-₹50,000 if not clarified upfront.
What to listen for: A written, line-itemised quotation. Clear explanation of what’s covered in the package and what may be charged separately. Honest discussion of payment options — cash, insurance, Ayushman.
Red flag: Reluctance to provide written costing. Pressure tactics (“if you book today we’ll waive the…”). Surprise charges that appear during the admission process.
What does my recovery realistically look like? When will I be back to my normal activities?
Why it matters: Most patients underestimate the first two weeks and overestimate how slow the next two months will be. Honest expectation-setting prevents disappointment and improves compliance with physiotherapy.
What to listen for: Specific milestones tied to weeks (“walking with stick by week 2-3, driving by week 5-6, back to office work by week 6-8, full recovery by month 4-6”). Acknowledgment that the first 10 days are hard. Clear physiotherapy plan with named providers.
Red flag: Overly optimistic timelines (“back to normal in 2 weeks”) or vague answers. Recovery is well-studied; surgeons should be able to give specifics.
What happens after surgery? Who handles my care, and how do I reach you if there's a problem?
Why it matters: Surgery is one day. Recovery is months. The accessibility of the surgeon and team during recovery affects outcomes — patients who can quickly raise concerns (“my knee is more swollen today, is this normal?”) get faster reassurance or intervention than those who feel cut off after discharge.
What to listen for: A clear contact pathway — phone, WhatsApp, or both. Clarity on follow-up schedule (typically 2 weeks, 6 weeks, 3 months, 1 year). Willingness to be available, not just delegated to junior staff.
Red flag: A surgeon who hands over post-op care entirely to others. Lack of clear contact information. Stories from other patients of difficulty reaching the surgeon during recovery.
What You Shouldn't Need to Ask But Should Verify
A few things that should be in place at any quality joint replacement practice:
- Hospital accreditation (NABH, JCI, or equivalent)
- Dedicated joint replacement OT with laminar flow ventilation
- Specific infection control protocols for joint replacement
- Pre-op anaesthesia consultation with a senior anaesthesiologist
- Pain management protocol that includes regional blocks, multimodal medications
- Physiotherapy starting on day of surgery — not delayed to day 2 or 3
- Written informed consent discussion that covers benefits, risks, and alternatives clearly
FAQ
Two to three opinions are reasonable for a major surgery. Listen for consistency in diagnosis and approach. Significant disagreement between surgeons is itself useful information.
No. Quality surgeons expect and welcome this question. It’s a routine part of informed consent in modern medicine.
Generally no. Joint replacement is one surgery where you want the best outcome, not the cheapest. The cost difference between an average and excellent surgeon is small compared to the cost of revision if the surgery fails.
A trusted GP’s referral is valuable — but verify the referred surgeon’s credentials and volume independently. Some referrals are based on long-standing professional relationships rather than current surgical excellence.
Of course. You’re hiring a surgeon, not marrying one. If you don’t feel confident in the surgeon you’ve consulted, get another opinion. Switching costs nothing; surgical regret costs everything.
Concerned about your knee pain?
Dr. Utsav offers initial telephonic consultations to assess whether your symptoms need an in-person evaluation. No pressure, no rushed sales pitch — just clear assessment of where you stand.
Call: +91 7447799000
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