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Knowing how to choose an orthopedic surgeon comes down to four facts you can verify and one thing you can only feel in the room. The four facts are board certification, fellowship training in the area of your problem, annual surgical volume, and the quality of the hospital or surgery center. The fifth is whether you felt heard.
I have spent more than 20 years doing hip replacement and knee replacement surgery in Middle Tennessee. Patients ask me this question constantly, and they usually ask it about other surgeons.
Here is the process I would use if I were the patient.
Why Does the Right Orthopedic Surgeon Matter So Much?
Joint replacement is one of the most reliable operations in medicine. Results are not identical across every operating room. Infection rates, dislocation rates, and revision rates vary between surgeons and between hospitals, which is the real reason the choice of orthopedic surgeon matters.
That variation matters, because a joint replacement is built to last decades. A well-positioned implant can serve you for 20 years or longer. Revision surgery to fix a poorly placed implant is harder, riskier, and less predictable than the first operation.
You get one clean shot at a first-time replacement. Spending two extra weeks choosing well is a reasonable trade.
What Credentials Should an Orthopedic Surgeon Have?
Start with credentials. They are public, they are verifiable, and checking them takes about ten minutes.
Board Certification Is the Floor, Not the Ceiling
Board certification means an orthopedic surgeon finished an accredited residency, passed written and oral exams, and submitted a case log for peer review. In the United States, that certification comes from the American Board of Orthopaedic Surgery or the American Osteopathic Board of Orthopedic Surgery.
Certification also has to be maintained, which is why the word “current” matters. You can check status on the certifying board’s website in under a minute. Look up disciplinary history on your state medical board site at the same time.
What certification does not tell you is what that surgeon actually does all week. That is the next question.
Fellowship Training Tells You Where the Focus Is
A fellowship is one or more extra years of training after residency in a single area: joint replacement, spine, hand, sports medicine, foot and ankle, or trauma. Most orthopedic surgeons trained in the last 15 years completed one.
Match the fellowship to your problem. If your knee needs a replacement, you want an adult reconstruction fellowship, not a general practice that covers everything from wrists to ankles.
I completed my fellowship at the Anderson Orthopaedic Research Institute, and I limit my practice to hip and knee replacement. That narrowing is not modesty. It is the whole point.
Why Surgical Volume Predicts Your Result
If you ask one question, ask about volume. The link between how often a surgeon performs an operation and how well patients do afterward is one of the most consistent findings in orthopedic research, and the American Academy of Orthopaedic Surgeons lists it as a factor patients should weigh.
Higher-volume surgeons have lower rates of infection, dislocation, readmission, and early revision. The same pattern holds for hospitals. Teams that do joint replacement all day build systems around it: dedicated operating rooms, set anesthesia protocols, and nurses who catch small problems early.
Experience is not the same as years in practice. A surgeon 25 years into a general practice may do fewer knee replacements each year than a focused orthopedic surgeon five years out of fellowship.
How Many Procedures Should an Orthopedic Surgeon Perform Each Year?
Published outcome data shows results improving as annual volume climbs. The steepest gains appear above about 50 hip or knee replacements per year. Past that point the curve keeps rising, just more slowly.
Ask for the number directly. Any surgeon who does a lot of these will tell you without pausing.
I perform more than 700 joint replacements per year. That number is simply the answer to a fair question.
If you get a vague answer, that itself is information.
8 Questions to Ask Before You Choose an Orthopedic Surgeon
Print these and bring them. Good surgeons welcome the list.
- How many of these procedures do you perform each year? You are looking for a specific number, not “a lot.”
- What is your fellowship training? Confirm it matches the joint you are having treated.
- Am I actually a candidate right now, and what happens if I wait? A surgeon willing to tell you it is too early has earned some trust.
- What are your infection, dislocation, and revision rates? Most focused surgeons track these and will share them.
- Which surgical approach do you recommend for me, and why that one? Listen for reasoning tied to your anatomy, not a sales pitch for a technique.
- Where will my surgery be performed, and could I go home the same day? The facility is part of the decision.
- If I have a complication, who takes care of it? The best surgeons answer this in one sentence: I do.
- How do I reach your team after hours? Access after surgery matters as much as skill during it.
Question seven is the one I would not skip. Smooth operations do not test a surgeon; complications do. You want an orthopedic surgeon who owns the whole course of care instead of handing it off.
How Do You Judge the Hospital or Surgery Center?
Your surgeon’s facility becomes your facility. Ask about three things.
- Infection rate. High-performing joint programs run below one percent. This number should be tracked and available.
- Discharge pattern. Most healthy patients now go home the same day or the next morning instead of to a rehab facility. A program built for that has the protocols and staffing to match.
- Distance. You will return for follow-up visits and physical therapy. A drive that feels fine once feels long on week three.
Ask whether your orthopedic surgeon operates at a hospital, a surgery center, or both. Patients with heart or lung conditions are usually safer in a hospital. Healthy patients often recover faster in a dedicated surgery center.
Are Online Reviews a Reliable Way to Choose an Orthopedic Surgeon?
Reviews are useful for a narrow set of questions and nearly useless for the rest.
Reviews tell you about scheduling, wait times, staff friendliness, and whether the surgeon explains things clearly. They cannot tell you about implant position or ten-year survival. A patient three weeks out of surgery is rating pain, not the result.
Two filters help. Read reviews from patients who came back for a second procedure, since those people had time to judge the first one. Then weigh the pattern across many reviews over any single dramatic story.
Better sources exist. Physical therapists see patients after surgery from every surgeon in town, and they know whose patients move well. Primary care physicians hear the follow-up. Ask both.
What Should Happen at Your First Consultation?
A good first visit follows a pattern. Your X-rays should be pulled up and explained to you, not summarized from another room. You should also hear about nonsurgical options first, including injections and physical therapy, even when surgery is the likely answer.
You should leave knowing your diagnosis, your realistic options, and the expected recovery timeline. If you leave with a surgery date but no clear picture of why, slow down.
I tell patients the same thing every week: a second opinion never offends a confident surgeon. A sound recommendation survives review by another orthopedic surgeon.
Choosing an Orthopedic Surgeon in Franklin and Middle Tennessee
Patients across Franklin, Nashville, Brentwood, Murfreesboro, Spring Hill, and Nolensville have several good options nearby. Use that. Interview more than one orthopedic surgeon if your gut tells you to.
My practice at the Bone and Joint Institute of Tennessee is limited to hip and knee replacement. That includes anterior approach hip replacement, subvastus knee replacement, and robotic-assisted joint replacement. More answers to common questions are on our patient FAQ page.
If you want a surgical opinion or a second opinion from a fellowship-trained orthopedic surgeon, my team can arrange it.
Bone and Joint Institute of Tennessee
3000 Edward Curd Lane, Franklin, TN 37067
(615) 791-2630
Schedule an appointment with Dr. Calendine
Medical disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your individual condition. Individual results vary based on personal health circumstances.
References
- Ravi B, Jenkinson R, Austin PC, et al. Relation between surgeon volume and risk of complications after total hip arthroplasty: propensity score matched cohort study. BMJ. 2014;348:g3284. bmj.com
- Wilson S, Marx RG, Pan TJ, Lyman S. Meaningful thresholds for the volume-outcome relationship in total knee arthroplasty. J Bone Joint Surg Am. 2016;98(20):1683-1690. PubMed
- Kugler CM, Goossen K, Rombey T, et al. Hospital volume and outcome relationship in total knee arthroplasty: a systematic review and dose response meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;30(8):2862-2877. Springer
- Horst PK, Choo K, Bharucha N, Vail TP. Graduates of orthopaedic residency training are increasingly subspecialized: a review of the American Board of Orthopaedic Surgery Part II database. J Bone Joint Surg Am. 2015;97(10):869-875. PubMed
- American Academy of Orthopaedic Surgeons. Finding the Right Orthopaedic Surgeon. OrthoInfo. orthoinfo.org
- American Board of Orthopaedic Surgery. Verify a physician’s certification status. abos.org
