The Questions to Ask Before Joint Replacement
Most patients leave the consultation having asked about pain and recovery. The questions that actually protect you are about volume, complication data, implant specifics, and what happens when something goes wrong.
You are about to let someone open your body, remove part of a joint, and bolt engineered components to your skeleton. It is a well-studied, generally safe procedure that improves millions of lives every year. It is also major surgery with real risks, a recovery that will consume weeks to months, and an implant that will be inside you for the rest of your life or until it needs replacing.
The difference between a well-considered decision and a rushed one usually comes down to seven or eight questions that most patients do not think to ask. Here they are, organized by what they tell you, with the reasoning behind each one.
About the surgeon
| Question | Why it matters | What a good answer looks like |
|---|---|---|
| How many of this specific procedure do you perform per year? | Volume-outcome relationships in joint replacement are well documented. Higher volume correlates with lower complication rates. | 50+ per year for knee/hip. 20+ for shoulder. 10+ for ankle. Specific to YOUR joint and procedure type. |
| What is your complication rate for this procedure? | A surgeon who tracks their own data practices differently from one who does not. The answer matters less than the fact that they have one. | A specific number, not a deflection. Infection rate under 2%, dislocation rate under 2% for hip, revision rate under 3% at 5 years. |
| Are you fellowship-trained in this joint? | Fellowship training indicates advanced specialization beyond residency. Particularly important for shoulder and ankle. | Yes, with the specific fellowship named. For ankle: foot and ankle fellowship. For shoulder: sports medicine or shoulder/elbow. |
About the implant
| Question | Why it matters | What a good answer looks like |
|---|---|---|
| What manufacturer and model will you use? | You want this in writing for your medical records and for any future surgeon who works on your joint. | A specific name: "Stryker Triathlon," "Zimmer Biomet Persona," "DePuy Attune." Not "we use the best available." |
| What bearing surface is used? | Highly cross-linked polyethylene is the current standard. Conventional polyethylene wears faster. | "Highly cross-linked polyethylene" or "Vitamin E infused HXLPE." If conventional PE, ask why. |
| What is this implant's record in a national joint registry? | Registry data is the most unbiased long-term performance review available. | A reference to AOANJRR, UK NJR, or SKAR data. If the implant is too new for registry data, that is worth knowing. |
About the plan
| Question | Why it matters | What a good answer looks like |
|---|---|---|
| What approach will you use and why? | For hip: anterior vs posterior. For shoulder: anatomic vs reverse. The answer should reference YOUR anatomy, not a blanket preference. | A rationale tied to your imaging, your cuff status (shoulder), your body habitus, or your activity goals. |
| What happens if something goes wrong after I leave? | Critical for medical travel patients. Complications can occur days or weeks after surgery. | A specific protocol: who to call, how to reach the surgical team, whether they coordinate with your home physician, and who handles a revision if needed. |
| What is the total, all-inclusive cost? | The number one source of billing surprise is comparing incomplete quotes. "Surgical fee" is not the same as "total cost." | A written, itemized breakdown: surgeon, implant, facility, anesthesia, post-op care, physical therapy, and DME. If any of those are excluded, you are not comparing apples to apples. |
The meta-question
All of these specific questions serve one deeper purpose: they reveal how the surgeon practices. A surgeon who answers seven or eight pointed questions without getting defensive, who volunteers their complication data without being pushed, and who names the implant and its registry record without hesitation is telling you something about their transparency, their self-awareness, and their commitment to informed consent.
A surgeon who deflects volume questions, gets irritated by complication rate questions, cannot name the specific implant model, or tells you to "just trust the process" is also telling you something. Both signals are worth listening to.
Bring this list on paper. You will forget things in the consultation room. Write the questions down, bring a notebook or a recording app (with permission), and bring someone who can listen while you are processing. The consultation is a two-way interview, and you are making a hiring decision about the person who will operate on your body.
For medical travel patients: additional questions
If you are considering joint replacement abroad, these questions are specific to the travel context and should be asked in addition to everything above.
Is the hospital JCI-accredited? Verify this yourself through the JCI directory. Accreditation applies to the hospital, not the surgeon.
Can I verify the surgeon's license? In Colombia, use ReTHUS. Ask for the surgeon's full name and cedula number.
How long should I stay before flying home? The answer depends on the joint. Hip: 7 to 10 days minimum. Knee: 10 to 14 days. Ankle: 14 to 21 days. Shoulder: 7 to 10 days. Get this in writing before you book flights.
Will you provide a written rehab protocol I can give my home physical therapist? Critical for continuity of care across borders. The protocol should specify exercises, restrictions, and milestones by week.
What is the revision policy if something goes wrong within the first year? Some international programs include revision coverage in the original fee. Others do not. Get it in writing.
Common questions
How many questions should I ask my surgeon?
Quality matters more than quantity. Five to eight well-chosen questions will tell you more about your surgeon and your procedure than a 30-question list. Focus on volume, complication rate, implant specifics, and what happens if something goes wrong. A surgeon who answers these plainly and without defensiveness is telling you something important about how they practice.
Should I get a second opinion before joint replacement?
Yes, especially for shoulder (anatomic vs reverse is a consequential choice), ankle (replacement vs fusion is a genuine fork), and any case where you are young, have unusual anatomy, or have been told you are not a candidate. A second opinion is not an insult to your first surgeon; it is due diligence on a decision you will live with for decades.
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