Question 1

What should I bring to my first consultation?

Accepted Answer

Bring every scan you have — X-rays, MRI or CT films and the written reports, ideally the actual images rather than only the report. Bring a list of the medicines you take, including anything for blood pressure, diabetes or blood thinning. If you have had previous surgery on the joint, bring the operation notes if you have them. And bring shorts or loose trousers, because the joint needs to be examined properly.

Question 2

Do I need an MRI before I come?

Accepted Answer

No. Please do not go and arrange one privately before being seen. Examination determines which scan is actually useful, and the wrong scan is both a waste of your money and occasionally misleading. If you already have one, bring it.

Question 3

How long does a consultation take?

Accepted Answer

Plan for twenty to thirty minutes for a new problem. That includes taking your history, examining the joint, going through your imaging on the screen, and agreeing a plan. If you are coming for a second opinion about surgery, allow a little longer.

Question 4

Can I bring a family member?

Accepted Answer

Please do. Most people absorb about half of what is said in a consultation, particularly when they are anxious or in pain. A second person hears the other half, and thinks of the questions you will wish you had asked.

Question 5

What questions should I ask?

Accepted Answer

The five that matter most: what exactly is wrong, what happens if I do nothing, what are the non-surgical options, what is the realistic result at three months and at a year, and what are the risks. If you leave without clear answers to those, the consultation is not finished.

Question 6

How do I know if I really need surgery?

Accepted Answer

For most orthopaedic problems, surgery is one option among several rather than the only one. The question is not whether your scan is abnormal — plenty of abnormal scans belong to people with no symptoms. It is whether the problem is limiting your life, whether non-surgical treatment has had a fair trial, and whether an operation reliably improves your specific situation. If those three do not all point the same way, waiting is usually reasonable.

Question 7

Should I get a second opinion?

Accepted Answer

If you have been advised surgery and you feel uncertain, yes — and no reasonable surgeon will be offended. A second opinion either confirms the plan, which lets you proceed with confidence, or it does not, which is exactly the information you needed. There is a dedicated second opinion service here for precisely this.

Question 8

What if I decide not to have the operation?

Accepted Answer

You will get a proper non-surgical plan instead, not a shrug. Very few orthopaedic operations are urgent, and choosing not to proceed is a legitimate decision. What you should not do is leave with no plan at all.

Question 9

Is it always better to operate sooner?

Accepted Answer

Not usually. Most joint problems give you time to think, and results are often better when swelling has settled and movement has been restored first. There are exceptions — a locked knee, a large acute rotator cuff tear in an active person, a fracture — and you will be told clearly if you are one of them.

Question 10

How do I know whether the surgeon does enough of these?

Accepted Answer

Ask. It is a reasonable question and you should not feel awkward asking it. Ask how many of your specific procedure they perform, and what their approach is when things do not go to plan. A surgeon who is uncomfortable being asked is telling you something.

Question 11

What does surgery cost?

Accepted Answer

It depends on the procedure, the hospital, the implant where one is used, and your insurance cover. You will be given a clear written estimate before you commit to anything, covering the surgeon's fee, the hospital and theatre charges, the anaesthetist, implants and the expected length of stay. If anything is likely to be additional, you will be told what and why.

Question 12

Do you accept insurance?

Accepted Answer

Most major health insurance and cashless schemes are accepted, subject to your policy's terms and pre-authorisation. Bring your policy details to your consultation and the paperwork can be started early — pre-authorisation is the step that most often delays a planned operation.

Question 13

How long will I be off work?

Accepted Answer

It depends far more on your job than on the operation. Desk work is usually one to three weeks. Work involving standing and walking, six to eight weeks. Heavy physical work, ladders or uneven ground, around three months. You will be given a realistic figure for your actual job, and a letter for your employer if you need one.

Question 14

When can I drive again?

Accepted Answer

When you can perform an emergency stop without hesitating, and when you are off strong painkillers. In practice that is one to two weeks after minor knee arthroscopy, four to six weeks after most major knee and hip surgery, and around six weeks after shoulder surgery on the driving side. Check your own insurance policy as well, since some have specific clauses.

Question 15

Can I have a video consultation?

Accepted Answer

For a second opinion where you already have imaging and reports, yes — it works well, and it saves people travelling long distances. For a new problem, an in-person examination is necessary. A hip cannot be examined over a video call, and the examination is often more informative than the scan.

Question 16

Why does physiotherapy matter so much?

Accepted Answer

Because for most of these operations, the surgery creates the opportunity and the rehabilitation determines the result. A perfectly reconstructed ligament in a knee that was not rehabilitated will disappoint. A repaired rotator cuff loaded too early comes apart. Surgery is roughly a third of the job.

Question 17

Will I get a written plan?

Accepted Answer

Yes. You will leave with a dated, written rehabilitation programme setting out what to do each week, what you should be able to do before progressing, and when you will be reviewed. 'Rest and see how it goes' is not a plan.

Question 18

How much pain should I expect?

Accepted Answer

Real but manageable, and worst in the first three to five days. Modern practice uses several medicines together — often including a nerve block for shoulder and knee surgery — rather than relying on one strong drug. If your pain is not controlled at home, that is something to report rather than endure.

Question 19

When do the stitches come out?

Accepted Answer

Usually around ten to fourteen days, at your first wound review. Some closures are absorbable and need nothing done. Keep the dressing dry until you are told otherwise.

Question 20

What should make me call?

Accepted Answer

Increasing rather than settling pain after the first few days; a wound that becomes red, hot, or starts discharging; a fever; calf pain or swelling; sudden breathlessness or chest pain. The last two need emergency assessment immediately, not a phone call.

Question 21

Do I need physiotherapy at the hospital, or can I do it locally?

Accepted Answer

Locally is fine and often more practical, provided your physiotherapist is working to the written programme you were given. What causes problems is a well-meaning programme that progresses faster than the healing tissue allows.

Questions patients ask

Before you come in

Deciding about surgery

Practical matters

Recovery and rehabilitation

Ask directly. It costs nothing to ask.

Bring your scans. Get a straight answer.