What to expect from your first consultation with your knee surgeon

Author: Jessica Houlcroft, Nurse

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Considering any surgical solution to knee pain can make you feel both excited and anxious – you might be looking forward to the final result but also be experiencing apprehension about the process.  We hope this article eases some concerns about what to expect from your first consultation with your knee surgeon.

Pre appointment planning

Prior to confirmation of an appointment, plenty of work goes on behind the scenes to ensure that paperwork and pathology are in order.  A GP referral is required to see a specialist and usually, a GP will also refer a patient for imaging (x-rays +/- MRI) in order to confirm a diagnosis.  Most specialists can view this imaging online so will already have an idea of these results prior to your appointment.

Medical History

Upon attending an appointment, patients may be asked to complete a comprehensive medical history both in writing and also in consultation with a nurse such as myself prior to seeing the knee surgeon.  This will include an overview of your general health, previous surgeries and current medications as well as an outline of the knee pain being experienced.  This is an important step in deciding if elective knee surgery is a safe and sensible solution.

It is very useful in compiling this history for patients to bring with them a list of their medications and any other specialists involved in their care.

Hands on examination

After meeting the surgeon, patients will be asked to lie down on an examination couch where the surgeon will examine your knee or knees if your pain is bilateral (in both knees).  This may be a little uncomfortable but is an important element of your initial consultation in order for an assessment to be made about tenderness, swelling and range of motion.  An observation of how you walk may also take place at this time and it is a good idea to wear shorts or loose pants that can be pulled up so that your knees can be seen.

At the time of the physical assessment, the surgeon will likely also be paying attention to other areas of your body such as your feet, hips, spine as well as the integrity of your skin.  You will likely be asked questions at this time about your knee symptoms and whether you have difficulty standing and walking, how it feels when you negotiate stairs and whether the pain wakes you from your sleep at night.

Imaging review

Upon conclusion of a physical examination, the surgeon will review your imaging – either via hard copy films you have been given or through an online portal.  At this time, the surgeon will likely show you the structures within your knee, narrowing of joint spaces, bone spurs and loose bodies and this usually gives patients a visual confirmation of why they are experiencing pain.

Diagnosis

After an extensive history, physical examination and imaging review has taken place, the surgeon will put forward a diagnosis to account for your symptoms and provide potential solutions for your knee pain.  Treatment options will be suggested which will include non-operative pathways as well as surgical solutions.  Patients may already have some awareness of their pathology and the pathway they wish to take, in which case further discussion can take place at this time with respect to the nature of either non operative or operative care.

Opportunity to discuss and decide

An initial consultation with a surgeon should be an information gathering process on BOTH sides.  Patients considering knee surgery should be given further information regarding any treatment option and should feel free to ask the surgeon questions about their diagnosis and proposed treatment plan.  Further information is often provided in the form of written or online resources from external sources for patients to read or view in their own time.

It can be useful to have a friend or family member to accompany you to your initial consultation as they can help you to remember the information provided and also discuss the surgeon’s recommendations.

I hope that this gives you an idea of what your initial consultation with a knee surgeon involves and that you can now attend an appointment with purpose and power.