For orthopedic surgery, additional opinions may revise the course of treatment
Adam Chopp was a freshman, playing football for Olivet College in Michigan, when he tore his left hip labrum during a game. He thought the surgery would fix the problem quickly, but after four surgeries in the area, he still had pain and limited function.
About a year ago, her condition worsened again. “I’m very stubborn,” says Chopp, now 30. “I usually say, ‘Oh, I’m just going to push back.’ I can take the pain. But I walk with a limp. I can’t squat. I can not run. There are all these little movements that hurt me so much, and it wears out you mentally and physically.
He found himself facing surgery – again. But this time there was a difference. Chopp sought a second opinion from a new doctor. And this doctor identified the root cause of his injury and repeated pain: an underlying condition – the capital femoral epiphysis slipped. If Chopp had been correctly diagnosed initially, he might have been able to have had the right surgery the first time around, rather than multiple surgeries later.
This second opinion, from Henry Finn, MD, medical director of the Chicago Center for Orthopedics & Robotic-Assisted Surgery, made all the difference for Chopp, who underwent a total hip replacement on his left hip with Finn in January 2021.
Although many orthopedic cases do not require multiple revision surgeries, misdiagnosis is a common problem in medicine. A second opinion can make a big difference, providing individuals with a revised diagnosis.
For example, only 12% of patients who visited the Mayo Clinic over a two-year period retained its baseline diagnosis after seeking a second opinion, according to a 2017 study in the Clinical practice assessment journal. About 66% of patients received a refined diagnosis, and 21% walked away with a completely different diagnosis than when they were referred.
Importance of another look
Benjamin Domb, MD, founder and medical director of the American Hip Institute & Orthopedic Specialists (AHI) in Des Plaines, sees some patients requiring arthroscopic hip surgery who were initially misdiagnosed. These patients can suffer for months before seeking a second – or third or fourth – opinion from the AHI.
“With the Internet and the availability of information, patients are doing more research than they’ve ever done before,” says Domb. “They are looking for a higher degree of specialization than in the past.
When people seek a second opinion, they’re looking for an accurate diagnosis, new treatment options, and good communication with their doctor, says Finn. “[Patients] want to feel a connection with their doctor when they have a very serious health problem.
When faced with surgery for an injury or orthopedic condition, a second opinion can help people gather the information they need to feel comfortable with the surgical approach or to explore new options. .
People are generally afraid of spine surgery, and some are looking for less invasive surgical treatments, says Kern Singh, MD, co-director of the Minimally Invasive Spine Institute at Rush University Medical Center.
Most of his patients come to him for a second or third opinion, he says. Other doctors said for them, they need open surgery and hospitalization rather than the minimally invasive outpatient procedures in which he specializes.
Balancing differing opinions
To seek a second opinion, people may start by seeking recommendations from family members, friends, and other doctors.
When meeting with an orthopedic surgeon for a second opinion consultation, people should bring previous medical records – such as surgical reports, documentation of any previous advice or imaging such as CT and MRI – to provide the doctor with a complete picture of his condition.
“We want all of this information to be gathered before the visit, so that when we see it, we can give it a full analysis and create a game plan to move forward,” says Domb.
Singh believes that every patient should feel confident in the decision to go ahead with orthopedic surgery amid different opinions. “They should always do what is comfortable for them, so it’s a no-pressure situation,” he says.
Singh posts videos patient stories on social media. “Patients really relate to other patients who report their surgical results,” he says. “A lot of patients come to me and say, ‘I’ve seen these videos of the same operation I’m going to have, and I’m really happy to be here.'”
Despite having had four previous surgeries, Chopp is confident in his new diagnosis. He looks to the future with hope: “My quality of life is going to be much better than it is now.