The Importance of a Second Opinion

Knee surgery is a life-changing event. It can give you years of mobility back or just let you spend most of your day pain-free. Anything that important deserves a careful amount of consideration and due diligence. The more serious your potential surgery (e.g., partial or total knee replacement), the more time you should spend researching and getting comfortable with a decision. And if you really want to cover all your bases or there’s any uncertainty pre-surgery, highly consider getting a second opinion. A lot of people shy away from them to not offend their doctor or just to avoid the aggravation. In reality, it can be an extremely useful way to confirm your physician’s original diagnosis (peace of mind) and, in some cases, take you down a better path. Here are some of the best reasons to get a second opinion.

Confusion between partial and total replacement

In medicine, things are rarely black and white. After your doctor has taken a full complement of diagnostic tests (MRIs, CAT Scans, X-rays, etc), he’ll typically get a summary report back from the radiologist. From there, he’ll make the final determination between partial and total knee replacement and recommend it to you. As discussed here, partial is an option if the injury is contained to a specific area of the knee. However, the limits of that area vary from doctor to doctor.

From experience, one may give the edge to a partial replacement (especially if they’re more aggressive in your projected mobility afterwards). More traditional doctors are likely to give a “tie” to total replacement. Getting at least two qualified opinions will make your decision that much easier.

Uncertainty in the type of knee implant

Whether you get total of partial replacement, your physician will be choosing a specific type of implant for you. There are a myriad of implant shapes, sizes and types. From gender-specific models to new alloys, knee implants are big business for their manufacturers. You can be sure they’re constantly vying for your doctor’s time and attention. There’s certainly nothing wrong with a doctor’s preference for particular model or manufacturer, but that can/will influence the rate with which he uses it for his patients. For that reason alone, it’s extremely helpful to meet with another surgeon and take note of the specific type of implant he recommends (write down the manufacturer and model number). Don’t be afraid to bring up the implant type your primary physician recommended and ask about their relative (dis)advantages.

Activity limitations and post-operative care

This one’s highly overlooked. After surgery, your doctor will give you a general list of activities you can do once fully healed and some that you can’t (if one of yours isn’t covered, be sure to ask him/her). If your doctor is on the conservative side, they might tell you to give up your racquetball or flag football altogether. Of course, it’s YOUR knee and your life, so you have the ultimate say, but most patients do follow their doctor’s orders and adjust their free-time accordingly. I have friends who’ve run marathons after TKR and another that gave up tennis after just PKR. Again, there aren’t any hard and fast rules, so it’s always helpful to get advice from another expert before you jump back in…it could save you years of regret.

Conclusion

Your doctor won’t take personal offense to a second opinion (and in most cases, will never find out). Most insurances also cover them as part of their core plan, so why not take advantage of it? When you do schedule one, just make sure you come prepared. Have a copy of ALL your scans and the exact diagnosis, implants, etc. your primary doctor has in mind. Be sure to ask plenty of questions (create a list beforehand) and once it’s over, you should be that much closer to making a quality, informed decision.