How to Choose a Knee Replacement Surgeon

Most people choosing a knee replacement surgeon are working from a GP referral, a friend’s recommendation, and a few websites that all say roughly the same thing. The marketing is not much help — every practice describes itself as experienced, patient-focused and using the latest techniques.

Here is what actually separates one surgeon from another, and what to ask.

Start with volume

Of everything you can find out about a surgeon, how often they perform the operation is the factor with the most consistent evidence behind it.

The research does not describe a threshold you cross into safety. It describes a relationship: higher-volume surgeons and higher-volume hospitals tend to have lower rates of complication and revision, and the steepest part of that curve sits at the lower end of the range. The difference between a surgeon doing a handful a year and one doing them routinely is more meaningful than the difference between two busy surgeons.

So ask. How many knee replacements do you do in a year?

It is a fair question and it should get a specific answer. Very few practice websites in Perth publish a number at all, which makes asking directly the only reliable way to find out.

For reference: Dr Clark performed 401 hip and knee replacements in 2025 and more than 900 since the start of 2024, around 60% of that work being knee replacement. Those figures come from his own surgical records.

Ask whether they do revision surgery

This one is less obvious, and more revealing than it looks.

Revision surgery — replacing a knee replacement that has loosened, worn, become infected or failed — is a distinct subspecialty. Not every arthroplasty surgeon does it.

Why it matters when you are only having a first replacement: a surgeon who regularly revises other people’s knee replacements has spent a lot of time looking at exactly how and why first replacements fail. That is a different and more useful education than only ever performing primaries. It also means that if something does go wrong years from now, the person who put the knee in can deal with it.

The follow-up question is worth asking too: if this needs revising in fifteen years, who does that?

Check they offer partial as well as total

A partial knee replacement resurfaces only the damaged compartment, preserving the ligaments and the parts of the joint that are still healthy. It suits arthritis confined to one compartment — roughly a quarter of knee replacement candidates, though estimates vary — and where it is appropriate it generally means a smaller operation and a faster recovery than a total replacement.

The catch is that not every surgeon performs them. Partials are technically less forgiving, and a surgeon who does not do them cannot offer you one. That does not make them a bad surgeon. It does mean that if your arthritis is confined to one compartment, you may be recommended a total replacement simply because that is what is on the menu.

So ask directly: do you do partial knee replacements, and is one an option for my knee?

Take robotics seriously, but keep it in proportion

Robotic assistance is the most heavily marketed thing in joint replacement, and the gap between what it demonstrably does and what it is implied to do is wide.

What is well established: it improves the accuracy of implant positioning and limb alignment, with fewer cases landing well outside the intended range.

What is not yet established: whether that accuracy makes implants last longer. Answering that takes 15 to 20 years of follow-up and the technology has not been in widespread use that long. The Australian Orthopaedic Association National Joint Replacement Registry is monitoring exactly this. The early signals are encouraging and they are early.

Useful questions: do you use robotic assistance, which system, and why that one? A surgeon who can explain the trade-offs of their own system — including what it does not do — is more reassuring than one who presents it as a guarantee.

Be wary of anyone telling you the robot makes the outcome better. It makes the placement more accurate. Those are different claims, and only one of them is currently supported.

Ask where they operate, and what that means for you

The hospital matters for reasons that have little to do with prestige.

• Does the hospital do a lot of joint replacements? Hospital volume shows the same relationship with outcome that surgeon volume does — it reflects the whole system around the operation, from theatre staff to ward physiotherapy.
• Is there an intensive care unit? Relevant if you have significant heart, lung or other medical conditions.
• How far is it from home? You will be going back for reviews, and possibly for physiotherapy.
• Are consulting rooms and hospital on the same campus? Not essential, but it removes friction at a point when you are not moving well.

Get the cost in writing, in full

Out-of-pocket cost in Australian private surgery is genuinely confusing, because it is not one bill. There is the surgeon’s fee, the anaesthetist’s fee, the assistant’s fee, the hospital, the prosthesis, and any imaging. Different portions are covered by Medicare and your health fund at different rates.

Ask for informed financial consent — a written estimate of your total out-of-pocket cost, covering every one of those components, before you commit. You are entitled to it.

Ask specifically whether the surgeon works on a no-gap basis, meaning fees are matched to what your insurer pays. And ask about the anaesthetist and assistant separately, because their fees are billed independently and are a common source of unexpected bills.

The cost of a knee replacement in Australia sets out the public, private and self-funded routes in full.

What to actually ask in the consultation

Write these down and take them in. Consultations move faster than you expect, and it is very common to leave having forgotten the one thing you meant to ask.

1. How many of these do you do a year?
2. Do you do partial knee replacements, and is one an option for me?
3. Do you do revision surgery?
4. What are the specific risks in my case — given my age, weight, and other conditions?
5. What is my total out-of-pocket cost, including the anaesthetist and assistant?
6. What does recovery actually look like, week by week?
7. What happens if something goes wrong — who do I call, and who sees me?
8. What happens if I wait? Is there a cost to delaying?

That last one matters. Knee replacement is almost always an elective operation, chosen when the pain and loss of function outweigh the surgery. A surgeon who is comfortable telling you it is not yet time is giving you better advice than one who books you in regardless.

Some things that should give you pause

• Pressure to decide quickly, or a booking made before you have asked anything
• An out-of-pocket figure that stays vague after you have asked for it directly
• Any guarantee of a specific outcome — nobody can offer that honestly
• Dismissiveness about a second opinion
• Technology presented as the reason to choose them, rather than as one part of how they work

And on second opinions

Getting a second opinion is normal, and it does not require leaving your current surgeon’s care. It is particularly worth doing if you have been told surgery is your only option, if you are being moved along faster than you are comfortable with, or if you are simply not sure.

A surgeon who reacts badly to the request has told you something useful.

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If you would like to discuss whether knee replacement is the right step for you, book a consultation or phone the rooms on (08) 6332 6365. Dr Clark consults at Murdoch and Mandurah. If you are earlier in the process, Understanding Knee Arthritis covers what happens before surgery is on the table at all.