Surgical Decision-Making

Choosing to undergo surgery is a significant decision, and it's one we approach thoughtfully and collaboratively. Surgery is never the first step—it’s considered when nonoperative treatments have not provided adequate relief or when structural damage clearly requires repair or reconstruction.

Our goal is to help you understand your options, weigh the risks and benefits, and make an informed decision based on your goals, lifestyle, and the best available evidence.

When Is Surgery Considered?

Surgery may be recommended when:

• Nonoperative treatments (e.g., physical therapy, medications, injections) have been exhausted

• There is clear structural damage such as:

  • Full-thickness tendon tears

  • Joint instability

  • Mechanical symptoms (e.g., catching, locking)

  • Advanced arthritis with bone-on-bone contact

• Your pain or dysfunction is interfering with your ability to work, play sports, or enjoy daily activities

Key Factors in Surgical Decision-Making

1. Severity of the Condition

   • MRI, X-rays, and physical exam findings help assess the extent of injury or degeneration.

   • Some conditions (e.g., ACL tears, rotator cuff tears with retraction) may worsen over time if not addressed surgically.

2. Response to Conservative Care

   • If symptoms persist despite dedicated nonoperative treatment, surgery may be the next logical step.

3. Functional Goals and Lifestyle

   • A young, active patient may pursue surgery to return to high-level sport.

   • An older patient with lower demands may opt for continued conservative care if functional needs are being met.

4. Timing and Recovery

   • The timing of surgery can impact outcomes. For example:

     • Early repair of certain tendon tears leads to better healing

     • Delaying surgery in cases of joint instability or cartilage loss can result in further joint damage

5. Medical Risk and Readiness

   • Surgical decisions take into account your overall health, other medical conditions, and ability to safely undergo anesthesia and rehabilitation.

Shared Decision-Making Approach

Every patient’s case is unique, and we believe in a shared decision-making model where:

• We provide clear, evidence-based information about your condition and all treatment options

• You share your goals, concerns, and preferences

• Together, we choose a plan that balances optimal outcomes with what matters most to you

Surgical Planning

When surgery is indicated, we will:

• Review the procedure in detail, including what it involves, expected outcomes, risks, and the recovery process

• Answer all your questions and ensure you're comfortable with the plan

• Coordinate preoperative testing, physical therapy planning, and follow-up appointments to support a smooth experience

Conclusion

Surgical decision-making is a collaborative and personalized process. It’s not about rushing to the operating room—it’s about finding the right treatment at the right time for the right patient. Our role is to help guide you through this process with honesty, clarity, and a focus on what will truly improve your quality of life.

If you're considering surgery or want a second opinion, we’re here to listen, answer your questions, and help you move forward with confidence.