Choosing an orthopaedic surgeon in Adelaide — what to look for

The decision matters more than most people realise

For most patients, hip or knee surgery is the biggest medical decision they will make in their lives. The outcome — how the joint functions, how quickly recovery proceeds, how long the implant lasts — is significantly influenced by the surgeon performing the procedure. Choosing well is worth the effort.

The challenge is that most patients have no framework for comparing surgeons. They know to look for someone trustworthy, experienced, and recommended by their GP. But what does that actually mean in practice? This article outlines what to look for, what to ask, and how the referral process works in Adelaide.

Qualifications — what the letters mean

In Australia, orthopaedic surgeons who have completed specialist training hold the Fellowship of the Royal Australasian College of Surgeons (FRACS) in orthopaedic surgery. This requires five years of accredited surgical training after basic medical and surgical qualifications. It is the minimum credential for a practising orthopaedic surgeon in Australia.

Many surgeons also hold the Fellowship of the Australian Orthopaedic Association (FAOrthA), which reflects AOA membership and commitment to the professional standards of the specialty. Both credentials are worth looking for.

Beyond the basic fellowship, many surgeons undertake subspecialty fellowship training after completing their FRACS — typically a one-year position in a specific area of orthopaedics, either in Australia or overseas. This additional training in a focused area makes a meaningful difference in the complexity and quality of cases a surgeon is equipped to manage.

Subspecialty focus

Orthopaedics covers a wide range of conditions and body parts — from spine and shoulder to foot and ankle, as well as hip, knee, and sports injuries. A surgeon with a dedicated focus in hip and knee surgery will generally have greater experience with those procedures than a generalist covering the full range.

If you need a hip or knee operation, look for a surgeon whose practice is centred on that area. The volume of procedures a surgeon performs in a specific area matters — both for technical skill and for pattern recognition in the less straightforward cases.

Surgical technique and technology

Not all hip and knee replacements are performed the same way. Two areas of significant variation are the surgical approach and the use of robotic assistance.

For hip replacement, the most common approach is the posterior approach, which involves detaching the short external rotator muscles and requires hip precautions during recovery. The direct anterior approach (DAA), by contrast, works between muscle planes without detaching them — patients generally recover faster and have no posterior restrictions. Not every surgeon performs the DAA; it requires specific training and is associated with a steeper learning curve.

Robotic-assisted surgery — most commonly using the Stryker MAKO system for hip and knee replacement — uses a CT-based 3D plan to guide implant positioning with greater accuracy than freehand surgery. The clinical benefit is more precise implant placement, which is associated with better function and longer implant longevity. Again, not all surgeons use robotic assistance; those who do have typically undertaken specific training.

Questions worth asking at a first consultation:

• Which surgical approach do you use, and why?
• Do you use robotic assistance? If so, which system?
• How many of these procedures do you perform each year?
• What are the specific risks in my case?

Hospital access and facilities

The hospital where surgery takes place matters for two reasons: the quality of the anaesthetic, nursing, and allied health team around the surgeon, and access to specific technology. The MAKO robotic system, for example, is only available at hospitals that have invested in the equipment and trained their theatre staff to use it.

In Adelaide, joint replacement surgery is typically performed at private hospitals. The major facilities for hip and knee surgery include Eastwood Private Hospital, Calvary Adelaide, St Andrew's Hospital, and the Wakefield Hospital. Access to your surgeon at a specific hospital depends on their hospital credentialling — not every surgeon operates at every hospital.

Will you always see the same surgeon?

In larger group practices, it is not uncommon for a patient to see one surgeon at their initial consultation and a different surgeon at follow-up appointments. Some patients are comfortable with this; others find it unsettling, particularly if questions arise during recovery.

It is reasonable to ask directly: will Dr X be performing my surgery, and will I see Dr X at my follow-up appointments? A clear answer on this point before agreeing to proceed is worthwhile.

How to get a referral in Adelaide

To see an orthopaedic surgeon in Adelaide, a GP referral is required for Medicare rebate purposes. Your GP can refer you to a specific surgeon by name, or to a practice. If you have a preference, it is worth stating it.

When seeking a referral, it helps to have a recent X-ray of the affected joint. Your GP can arrange this, and most orthopaedic surgeons will ask for one before the consultation. If your GP has already tried conservative treatment — physiotherapy, anti-inflammatories, weight management — documenting this is also useful context for the surgical consultation.

Wait times for an initial consultation vary between surgeons and practices. If your pain is significantly affecting your quality of life, it is worth asking your GP to flag this on the referral.

What to expect at your first consultation

The first consultation with an orthopaedic surgeon is an assessment — not a commitment to surgery. The surgeon will review your imaging, examine the joint, and discuss your symptoms and functional limitations. They will then outline the options available to you, which may include continuing conservative management, an injection, or surgery.

You are not obliged to proceed with anything at the first appointment. A good consultation gives you the information you need to make a decision that is right for you, on your timeline.

The consultation is about making sure the patient has enough information to make a good decision — not about getting them to the operating theatre as quickly as possible.