1 Mai 2026
Author: Dr. Alexandru Grecu — Senior Orthopedic and Trauma Surgeon
Medically reviewed by Dr. Alexandru Florian Grecu, Senior Orthopedic Surgeon · Published: 1 mai 2026 · Updated: 2 mai 2026
This article is written from what might seem like a strange perspective: I'm an orthopedic surgeon, telling you how to vet me (or anyone else). The reason is simple — a well-informed patient is a better patient. Your decision about who operates on you matters just as much for the outcome as the surgery itself.
Knee or hip replacement surgery is one of the most effective orthopedic procedures — but the outcome depends significantly on the surgeon. International studies show that complication rates differ substantially between surgeons who perform over 50 replacements per year and those who perform under 25. This doesn't mean the former is "good" and the latter is "bad" — but it does mean that volume matters.
Beyond volume, other factors matter: surgical technique, implant selection, the anesthesia and physical therapy team, the hospital where the procedure takes place, and communication — whether the surgeon explains the decision clearly and honestly.
What to look for: a senior consultant or specialist surgeon with a focus on arthroplasty (joint replacements) or knee arthroscopy; a volume of at least 30–50 replacements per year for your specific joint (knee or hip separately); years of experience — a minimum of 5–10 years post-residency for complex surgery.
How to find out: ask directly, "How many knee (or hip) replacements do you perform per year?"; check the doctor's profile on the hospital website; the doctor's personal website — the biography should specify their training and volume; LinkedIn.
Watch out for: "generalist" doctors who do a bit of everything; doctors claiming "1,000+ replacements" without context (in how many years? what type?). Vague, impressive-sounding numbers can hide a lack of real specialization.
What to look for: a diploma as a senior consultant in orthopedics and traumatology (the highest post-residency level in Romania); fellowships abroad or at elite centers; membership in professional associations (SOROT, ESSKA, EFORT); presenting at scientific conferences; indexed scientific publications.
How to find out: The doctor's CV should be public or available upon request; the "About" page of their personal website; Google Scholar for publications; websites of professional associations.
The absence of international memberships doesn't mean incompetence. But their presence is an additional positive signal.
Your surgery isn't performed by the surgeon alone. It's a team effort. For the hospital, what matters is: a modern operating room (laminar air flow system); a dedicated orthopedic surgical unit (reduces cross-contamination); 24/7 ICU availability; a high volume of orthopedic procedures; international accreditations (Joint Commission, ISO 9001) — a bonus, not mandatory; an integrated physical therapy team — recovery starts in the hospital.
In Oltenia: MedLife Private Hospital Craiova (private, recently inaugurated multidisciplinary operating unit); Craiova County Emergency Clinical Hospital (CAS); Craiova Military Hospital (CAS).
In Bucharest: Ortopedicum, Regina Maria, MedLife Băneasa, Memorial (private); Foișor Hospital, Sf. Pantelimon Hospital (CAS).
For the patient, this is the least transparent dimension. But it's very important.
What to ask: "What implant do you recommend and why?"; "Who is the manufacturer? Country of origin? How many years has it been on the market?"; "Do you have 10–15 year durability data for this implant?"
Reputable international manufacturers (in alphabetical order): Aesculap (Germany), DePuy Synthes (Johnson & Johnson, USA), Smith & Nephew (UK), Stryker (USA), Zimmer Biomet (USA).
This doesn't mean other manufacturers are bad — there are also lesser-known European products that perform well. But manufacturers with 30–50 years of history and millions of implants placed have solid durability data.
About the National Endoprosthesis Program: implants covered by the Romanian public insurance (CAS) come from validated suppliers. The quality is regulated; they are not "inferior". The difference between a standard CAS implant and a premium private one is usually at a "cosmetic" level (surface coating, ceramic-on-ceramic friction couple) — not at the level of "fundamental strength".
This is perhaps the most important criterion, and the most subjective.
Good signs: the doctor explains your anatomy and condition in terms you can understand; shows you the X-ray and explains what it shows; lists non-surgical alternatives before proposing surgery; discusses risks explicitly, not just benefits; asks about your lifestyle, expectations, and fears; gives you time for questions; tells you honestly if your case is beyond their specialization and refers you to someone else; allows you time to make a decision.
Red flags: the doctor proposes surgery without having exhausted conservative alternatives; mentions no risks, only advantages; guarantees results (serious medicine doesn't offer guarantees); makes you feel that "only they can do this"; schedules surgery in 1–2 weeks without complete investigations; refuses to answer questions; discourages you from seeking a second opinion; insists on the private route when CAS would be clearly appropriate for you.
Here is a list of concrete questions for the consultation. Take them with you.
What exactly is my condition? What is its stage? Can I see the X-ray/MRI and have you explain what it shows? How advanced is my case — on a scale of 1 to 10?
What non-surgical alternatives do I have? Have I tried them all? If I postpone the surgery for a year, what is likely to happen? Are there any conservative treatments I haven't tried yet?
How often do you perform this surgery? How many per year? What technique do you use, and why? What implant do you recommend, and why? What are the risks specific to my case? What complications have you had in the last 12 months with similar operations?
How long will I need care at home? Who will supervise my recovery? Which physical therapist? Will we talk again before the surgery? With whom?
How much does it cost privately? What's included? Can I have the surgery covered by CAS? What is the waiting time? Which option do you recommend for my case, and why?
Will you be the one operating on me? Or someone from your team? Will you be the one following up with me post-operatively? At what intervals? Can I speak with a patient who recently had the same surgery?
The last question is very powerful. Many doctors shy away from it — their response tells you something.
For any major elective surgery, a second opinion is sound practice. It's not a sign of distrust — it's due diligence.
What makes a good second opinion: another orthopedic surgeon, institutionally separate from the first; with a similar specialization (knee or hip replacement); who reviews the same imaging studies; who gives you their independent verdict.
What to compare between the two opinions: Is the diagnosis the same? Is the surgical indication the same? The recommended technique — the same or different? The risks presented — similar? The attitude — empathetic or pressuring?
If the two opinions differ significantly: get a third. It's rare, but it happens.
Personal note: I will never be offended if you tell me you want a second opinion. On the contrary — it's a sign you're taking the decision seriously. And sometimes, if your case is better suited for a colleague with a specific sub-specialty, I will direct you myself.
The surgery is just the beginning. The recovery is a marathon. Here's what matters:
What to check before surgery: Who will provide physical therapy after discharge? Do you have a good physical therapist near your home? Who will change the dressings? Who will conduct the post-operative check-ups? A treatment plan for complications — what do you do if you develop a fever, intense pain, or difficulty walking? Who can see you urgently? Family support — who will be with you for the first 2–4 weeks?
What to ask at the consultation: "Do you perform the post-operative check-ups yourself, or does someone else?" "Can I call you if something comes up?" "Do you have a recommended physical therapist in my area?" "How often will you ask me to come for a check-up?"
Good sign: the doctor/clinic provides a clear cost estimate before the surgery, detailing all components: pre-op consultation; hospitalization (with estimated number of days); operating room fees; anesthesia; the implant (with type specified); consumables; dressings; in-hospital recovery (is physical therapy included?); included post-operative check-ups.
Red flag: "This is a rough estimate; we'll see the final cost later." This opens the door to hidden costs.
With the CAS route, the costs are zero. Just verify if there are any hidden extra costs (private room, certain medications).
The decision about who operates on you is about balancing medical authority and human connection. The world's top expert who treats you like a number is not necessarily the best choice. But neither is the friendliest doctor who lacks the necessary surgical volume.
Here is a summary of the criteria in order of importance (in my experience): (1) volume and specialization; (2) communication; (3) the team and hospital; (4) honesty about alternatives and risks; (5) accepts a second opinion; (6) availability and accessibility; (7) transparent cost; (8) the implant used; (9) training and certifications.
No surgeon will tick all the boxes with a 10/10 score. Look for one who checks most of them and has an acceptable score on the others.
Remember: the best choice is the one you make with good information and without pressure.
If you have chronic pain and are considering surgery but are unsure who to turn to, the first consultation commits you to nothing. Bring your X-rays, and together we can evaluate your case, discuss alternatives, and I'll answer all your questions.
If, after the consultation, you decide it would be better to have surgery with someone else — I will help you find the right surgeon for your case. It's not about me; it's about you.
Appointments: 0251 960 (MedLife) or 0787 210 391
Consultations: CAS or private (360 RON). Monday–Friday, 08:00–18:00.
Felson DT et al. — Weight loss reduces the risk of symptomatic knee osteoarthritis in women. Ann Intern Med. 1992;116(7):535-9.
For the rule 'losing 5 kg can reduce knee pain by 20-30%'.
Messier SP et al. — Effects of intensive diet and exercise on knee joint loads in adults with knee osteoarthritis. JAMA. 2013;310(11):1226-1235.
For the rule '1 kg of body weight = approximately 4 kg of pressure per knee with each step'.
Bourne RB et al. — Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468(1):57-63.
For the >90% satisfaction rate after knee replacement.
Swedish Hip Arthroplasty Register — Annual Report 2022.
For the long-term success rate of hip replacement.
Allen KD, Golightly YM — Epidemiology of osteoarthritis: state of the evidence. Curr Opin Rheumatol. 2015;27(3):276-83.
For the prevalence of knee osteoarthritis and risk factors (3-4 times more common in women).