Joint replacement second opinion
Up to 20% of patients have persistent pain or functional problems after joint replacement surgery. Most are told it's normal. Often it isn't. Fellowship-trained arthroplasty specialists review your complete case and give you a straight answer.
Joint replacement is one of the most successful procedures in medicine — when it's performed for the right reasons, at the right time, by the right surgeon. The problem is that recommendation rates vary dramatically by geography, by surgeon, and by practice. A fellowship-trained arthroplasty specialist can tell you whether the timing is right, whether you've exhausted appropriate non-operative alternatives, and whether the surgeon recommending the procedure has the volume and subspecialty experience your specific case requires.
Total knee replacements performed in the US annually — making it one of the most common elective surgeries
Of second opinions result in a changed recommendation — a different approach, different timing, or different surgeon
Variation in joint replacement rates between high- and low-utilization regions — same patients, very different surgical rates
The conditions below are among the most common reasons patients seek expert second opinions after joint replacement. If you recognize your situation in any of these, a fellowship specialist review is one of the most valuable steps you can take.
Persistent pain after total knee replacement is more common than most patients — or their surgeons — acknowledge. Studies consistently show that 15-20% of patients are dissatisfied with their TKA outcome. Pain that does not improve progressively, pain that was never relieved, or new-onset pain after a period of recovery all warrant evaluation.
Common causes our specialists evaluate:
A structured expert review determines which of these is most likely in your specific case, and whether further diagnostic workup or intervention is appropriate.
Hip replacement generally has better patient-reported outcomes than knee replacement, but a meaningful subset of patients experience persistent groin pain, thigh pain, or new-onset pain that their surgeon attributes to "normal variation." These symptoms are often not normal.
Conditions our specialists assess:
Many of these conditions have specific diagnostic and treatment pathways that a general orthopedist may not recognize or pursue.
Periprosthetic joint infection (PJI) is one of the most serious complications of joint replacement and one of the most commonly missed — particularly in the first weeks after surgery when symptoms overlap with normal post-operative inflammation.
What you need to know:
Treatment depends entirely on timing and organism identification. Options include DAIR (debridement, antibiotics, implant retention), one-stage revision, or two-stage revision with antibiotic spacer. A fellowship arthroplasty specialist can assess whether the right diagnosis is being pursued and whether the proposed treatment is appropriate for your specific case.
A fracture around a joint replacement — whether it occurred during the original surgery or as the result of a fall or injury afterward — is a complex problem requiring subspecialty expertise. The management decision involves assessing the stability of the implant, the quality of the surrounding bone, and the patient's overall health.
Treatment pathway questions a specialist addresses:
Periprosthetic fractures around knee replacements are classified by the Rorabeck/Lewis and Su systems; around hip replacements by the Vancouver classification. Understanding which classification applies to your fracture directly determines treatment. This is a decision that should involve a fellowship-trained arthroplasty surgeon.
Knee replacement stiffness — formally called arthrofibrosis when severe — is one of the most undertreated complications in joint replacement. Patients are routinely told to keep doing physical therapy when they have already passed the window where PT will make a meaningful difference.
What the evidence shows:
If your surgeon continues to tell you that more time and physical therapy will resolve your stiffness, and you are beyond 3 months post-operatively with significant limitation, an expert second opinion is warranted.
Hip replacement stiffness is less common but occurs — particularly with anterior approach techniques and heterotopic ossification (bone forming in the soft tissues). This can be painful, limit motion, and require treatment.
Many patients who have had joint replacement find that they walk differently than expected — a limp that wasn't there before, difficulty with stairs, instability, or the feeling that the joint "isn't right." These functional concerns are often dismissed but they represent real, evaluable, and frequently correctable problems.
Conditions our specialists evaluate:
These problems have specific diagnostic evaluations and, in many cases, specific treatments. The first step is identifying the exact cause — which a fellowship arthroplasty specialist is best positioned to do.
Every joint replacement case reviewed through ExpertMD is evaluated by a fellowship-trained arthroplasty surgeon — a specialist who completed additional training specifically in hip and knee replacement after residency, and who has been in active practice for 15 or more years. These are the surgeons who train residents and fellows at academic medical centers, who have published peer-reviewed research on joint replacement outcomes, and who other orthopedic surgeons refer their most complex cases to. When your case is reviewed, you will know exactly who reviewed it and what their specific credentials are.
Fellowship-trained arthroplasty specialists review your imaging, operative notes, and records. Written report in 4 business days. Educational and informational — available anywhere in the world.