Why Patients Should Get a Second Opinion Before Any Knee Surgery

Athletes with ACL tears and patients with knee osteoarthritis (OA) often accept the treatment recommended by the first physician they see. This is a big mistake. “If your knee surgery doesn’t work out, you can’t go back and try it again,” says K. Donald Shelbourne, MD, orthopedic surgeon and founder of Shelbourne Knee Center.

Evaluate Treatments and Surgeons

Neither an ACL tear nor knee OA is an emergency. Patients should take the time to evaluate their treatment options and orthopedic surgeons.

Educating patients about options and surgical outcomes is a key part of the process at Shelbourne Knee Center. “Patients should be well informed and understand their options before making a decision about knee surgery,” says Rodney Benner, MD, an orthopedic surgeon at Shelbourne Knee Center. Both Dr. Shelbourne and Dr. Benner encourage their patients to ask questions and to seek a second opinion before agreeing to surgery.

The best outcomes occur when the orthopedic surgeons are knee experts who see a high volume of patients, like Dr. Shelbourne and Dr. Benner. Shelbourne Knee Center’s specialized pre-op and post-op rehab program also helps optimize surgical outcomes.2

Second Opinions for ACL Tears

Choosing the wrong orthopedic surgeon for ACL reconstruction can make return to sport more difficult—or impossible. Nationally, only about 50% of athletes who have ACL reconstruction have two normal knees after rehab and are able to return to sport at the same level.

At Shelbourne Knee Center, 85–90% of athletes return to sport at the same level within a year.1

Athletes and their parents should ask orthopedic surgeons for data about:

  • Number of ACL reconstructions performed
  • Rate of return to sport at the same level
  • Choice of graft
  • Rehab process

Dr. Shelbourne has performed more than 7,000 ACL reconstructions. In most procedures, he uses a contralateral patellar tendon graft, which provides a predictable return to normal strength in both knees.

Read more about second opinions for ACL reconstruction.

Second Opinions for Knee OA

In patients with knee OA, the right physical therapy often makes total knee arthroplasty (TKA) unnecessary. For 76% of patients in Shelbourne Knee Center’s research-based Knee Rehabilitation Program for OA, physical therapy relieved pain and stiffness in 4–6 weeks3.

Of the 24% of patients who went on to have TKA3, the pre-op improvements made during physical therapy facilitated a better surgical outcome and a faster, easier recovery.

Dr. Benner recommends that patients try physical therapy for 4-6 weeks to see how they feel. While most orthopedic surgeons will recommend pre-op physical therapy, few have systems in place to provide effective physical therapy.

Lack of experience in TKA is another reason to seek a second opinion. Dr. Benner completed a fellowship in knee surgery, adult reconstruction and sports medicine at The Insall Scott Kelly Institute. He has performed 900 TKAs since joining Shelbourne Knee Center in 2012 and consistently uses what he considers to be the best implant.

Patients should ask orthopedic surgeons for data about:

  • Number of TKAs performed
  • Choice of implant
  • Pre- and post-op physical therapy protocols
  • Time to return to daily activity after surgery

Read more about second opinions for total knee arthroplasty.

Second Opinions after Knee Surgery

Patients often come to Shelbourne Knee Center for a second opinion after a failed ACL reconstruction or TKA. “We can make a bad outcome better, but we can never make the outcome as good as if the surgery had been done right the first time,” says Dr. Shelbourne. He and Dr. Benner both have extensive experience in revision surgery.

For TKA, Dr. Benner finds that the implant is often fine but the patient is under-rehabilitated. Appropriate physical therapy enables these patients to maximize their range of motion, strength and function.

For more information about second opinions or to refer a patient for a second opinion, call 888-FIX-KNEE.


References

  1. Unpublished data, 2018.
  2. Shelbourne DK. Thirty-five Years of ACL Reconstruction, presentation at Andrews University, February 2018.
  3. Shelbourne DK. Thirty-five Years of ACL Reconstruction, presentation at Andrews University, February 2018.