An orthopedic evaluation for total knee replacement surgery is a multi-stage process that includes speaking with a healthcare professional, physical examinations, and several tests.

Total knee replacement (TKR) surgery may have several benefits if you’re living with knee osteoarthritis, including:

  • relieving symptoms, such as joint pain and stiffness
  • increasing knee function, mobility, and strength
  • improving your quality of life

If you’re considering TKR, the first thing you will need is a medical evaluation to help determine whether surgery is the best treatment option for you.

Keep reading to learn more about an orthopedic evaluation for TKR and questions to ask the doctor.

The first part of your orthopedic evaluation will involve answering a detailed questionnaire that covers your:

  • medical history
  • physical and mobility limitations
  • symptoms, such as pain levels and their impact on your day-to-day activities

This information will help the doctor provide a proper diagnosis for your knee problems and determine the best treatment approach.

Physical ability

Questionnaires may vary by doctor and clinic, but they typically focus on whether you’re able to:

  • get in and out of a car
  • bathe
  • walk without a limp
  • walk up and down stairs
  • sleep at night without pain
  • move without your knee feeling as if it’s going to “give way” at any given moment

Some questions will also look at whether any activities make knee pain worse and if you assistive devices.

Medical history

The questionnaire will ask you about your overall health, which may include:

It’s important to mention any health conditions you may have and medication you may be taking during the evaluation. Some conditions and medications may impact the treatment choices your doctor suggests.

For example, you may have a greater risk of developing a blood clot after TKR if you have experienced a blood clot before or you have hypercoagulability (thick blood).

During the physical examination, a doctor will measure your knee’s range of motion using an instrument that resembles a protractor. They will:

  • extend your leg in front to determine the maximum extension angle
  • flex it behind you to determine the maximum flexion angle

Together, these distances make up your knee’s range of motion and flexibility.

They will also check your muscle strength, mobility, and knee position, as well as the stability of your knee ligaments. For example, they will look to see if your knees are pointing outward or inward.

They will assess these while you are:

  • sitting
  • standing
  • taking steps
  • walking
  • bending
  • performing other basic activities

Sometimes, a doctor will order several tests to check for signs of infections, such as:

The following imaging tests could help a doctor get a better look at the inside of your joint:

  • X-ray: A knee x-ray provides information about the damage to your bone, cartilage, and joint.
  • MRI: A knee MRI may provide more information about the soft tissues and tendons around your knee.
  • CT scan: A knee CT scan may be needed before surgery if you’re going to get a robotic knee replacement. It provides information about the muscles, ligaments, tissues, and bones in your knee.

If you’ve had previous imagining tests, bring these with you to help the doctor measure any changes in your knee.

After you complete the questionnaire, physical examination, and any tests, a doctor will discuss your treatment options.

If your evaluation shows severe damage and other treatments are unlikely to help, they may recommend TKR surgery.

If TKR isn’t the best option for you, they may recommend alternatives to TKR.

The evaluation is a long and thorough process. You will have plenty of chances to ask questions and raise concerns.

Here are some questions you may like to ask:

Alternatives

  • What are the alternatives to surgery?
  • What are the pros and cons of each alternative?

Learn more about treatment options to help delay TKR surgery.

Surgery

  • Will you perform traditional surgery or use a newer method?
  • How large will the incision be and where will it be located?

Learn more about the step-by-step process of TKR.

Outlook

  • How much will knee replacement reduce my pain?
  • How much more mobile will I be?
  • What other benefits am I likely to see?
  • How will my knee function in the future if I don’t have surgery?
  • What problems are likely to occur?
  • What activities will I be able to resume after surgery?
  • Which activities will no longer be possible?

Learn more about the recovery timeline and what happens after TKR surgery.

Surgeon expertise and safety

  • Are you board certified and have you served a fellowship? What was your specialty?
  • How many knee replacements do you do a year? What outcomes have you experienced?
  • Have you had to do revision surgery? If so, how often and what are the typical reasons?
  • What steps do you and your staff take to ensure the best possible outcome?

Hospital stay

  • How long should I expect to be in the hospital?
  • Are you available after surgery to answer questions and address concerns?
  • At which hospital or clinic will you perform the surgery?
  • Is knee replacement a common surgery at this hospital?

Learn more about what to expect after TKR surgery.

Risks and complications

  • What risks are associated with this procedure?
  • What type of anesthesia will you use, and what are the risks?
  • Do I have any health conditions that would make my surgery more complicated or risky?
  • What are the most common postsurgery complications?

Learn more about the possible complications and clinical outcomes and statistics of TKR.

The implant

  • Why are you choosing the prosthetic device you’re recommending?
  • What are the pros and cons of other devices?
  • How can I learn more about the implant you’re selecting?
  • How long will this device last?
  • Have there been any previous problems with this particular device or company?

Rehabilitation

  • What is the typical recovery process like?
  • What should I expect and how long will it take?
  • What does the typical rehabilitation involve?
  • What extra help should I plan for after leaving the hospital?

Cost

  • How much will this procedure cost?
  • Will my insurance cover it?
  • Will there be any extra or hidden costs?

Learn more about the costs of TKR surgery.

What are the three diagnostic tests of an orthopedic evaluation?

There are no three specific tests used during an orthopedic evaluation. Depending on your condition, some diagnostic tests may include physical examinations, questionnaires, blood and urine tests, and imaging tests like X-rays, among others.

What does an orthopedic screening consist of?

An orthopedic screen typically consists of a questionnaire, physical examination, imaging tests, and consultation.

TKR is effective at relieving pain, restoring flexibility, and helping you live an active life.

Surgery can be complex, and recovery can take time. That’s why an in-depth evaluation process is essential.

Remember to ask the doctor many questions during the evaluation, as this will help determine if TKR surgery is the right treatment for you.