How to choose a soft tissue knee surgeon

So, choosing a surgeon is really difficult. It's surprised me over the years to realise that trusting a GPs choice is not always the best. I'm quite surprised at bad referral patterns from certain GPs, of course, many GPs get it right, but others I'm often surprised who they would choose, to send a patient to for soft tissue knee surgery and indeed for more complex revision surgery - which is much more demanding.

How do you know if you're in the right surgeon's hands?

Andy: I think its very hard for patients who don't have any medical contacts to find out. If they do have medical contacts, then doctors can ask around and usually come to the right conclusion. But I would say, as a principle, it's best to choose a super-specialist knee surgeon, in other words, someone who does nothing but knee surgery. In the UK that might mean they also do joint replacement, but there are a few surgeons who simply do soft tissue knee surgery.

What information should patients base surgeon selection on?

Also the surgeon should be able to provide data on their practice. I know, it seems shocking, but many surgeons don't keep records of numbers etc, but I think they should. And they should have no fear about giving patients that information and the patient should have no fear in asking.

If a surgeon takes offence to that question, then probably it's best not to see that surgeon, I would suggest.

What volume of a procedure performed annually indicates a true specialist?

Andy: In terms of raw numbers, it's very difficult to give a number of minimum cases that suggest expertise. This is because there are some surgeons who have a huge experience, but perhaps have cut down on the numbers and will get it right first time, even if they did only twenty a year.

Around a hundred is perhaps not a bad idea for one operation and I think if you have a surgeon doing a hundred plus cruciate ligaments a year, they're going to be competent and they should be able to do re-do surgery.

How would you choose a knee surgeon?

Andy: So, I think it's really hard, but I would say, if you've got any medical contacts, get them to make inquiries, but also I would choose a surgeon who has high volumes of soft tissue knee. I would not go to a generalist - if somebody also offers shoulder surgery, ankle surgery, hip surgery - guess what, they're jack of all trades and perhaps they're master of none. There are exceptions, I accept, but generally the super specialist is the way to go. And that's about as good as it gets.

Mr Andy Williams, Consultant Knee Surgeon and co-founder of Fortius Clinic in London champions research and data. He lectures internationally and is passionate about patients accessing latest best practice to achieve better results after surgery.