A second opinion on the hip or knee replacement you’ve been offered
You’ve been given a plan. Before you commit to a major elective operation, it’s reasonable to have someone else look at your imaging and tell you what they’d actually do — including whether they’d operate at all. Available as a video visit, a written opinion, or an in-person consultation.
A straight answer, including “not yet”
Getting a second opinion before joint replacement is normal, and any surgeon confident in their plan expects it. You don’t need a referral, you don’t need permission, and you don’t need to tell the first surgeon.
What I want you to know up front is that this isn’t a sales consultation. A meaningful share of the second opinions I give end with me recommending against the operation someone has been offered — or recommending a smaller one, or a different sequence, or waiting. I recommend staging bilateral replacements rather than doing both at once. I tell patients regularly that their X-ray looks worse than their life does, and that surgery can wait.
If the honest answer is that the plan you were given is the right one, I’ll tell you that too, and you’ll go into your operation more confident than you came in.
The situations that bring people here
These are the reasons patients most often ask me to look at a plan somebody else made. If yours isn’t on the list, it still counts.
You’ve been told you need a replacement and you’re not sure you’re ready
An X-ray showing bone-on-bone arthritis does not automatically mean it’s time to operate. The question I care about is what the joint is costing you day to day — and whether the things that don’t involve surgery have genuinely been exhausted.
Bone-on-bone knee: do I need surgery?You’ve been told you’re too young
This is one of the most common reasons patients come to me for a second read. There is rarely an age that is “too young.” The decision is driven by pain, function, and health — not a birthday — and being told to wait a decade in significant pain deserves a second look.
Am I too young for a replacement?Both joints are arthritic and you don’t know whether to do them together
You may have been offered both hips or both knees in a single operation. It can be done — but for nearly every patient I recommend staging them about four to six weeks apart, because doing both at once means higher blood loss, higher transfusion risk, and no good leg to lean on while you recover.
Double hip replacement: why I stage itYou have a surgery date and second thoughts about the approach
Approach, implant choice, and whether the quadriceps is protected all shape how the first six weeks feel. If you’ve been offered an approach you don’t fully understand, it’s reasonable to have it explained by someone who isn’t the one scheduled to do it.
Jiffy Knee, subvastus, and what muscle-sparing really meansYou were offered a total and wonder about a partial
Not every arthritic knee needs the whole joint replaced. When arthritis is confined to one compartment and the ligaments are intact, a partial can mean a faster recovery and a more natural-feeling knee. It’s worth knowing which one you actually are.
Partial knee replacementYou have a painful or failed replacement
A replacement that still hurts, feels unstable, or never felt right deserves a real workup rather than reassurance. Revision is a different operation with a different set of questions, and getting the diagnosis right matters more than getting to the OR quickly.
Revision hip replacementYou’ve been told to wait it out and you can’t function
Being managed with repeat injections while your world gets smaller is not a plan. If you’ve stopped doing the things that make your life yours, that belongs in the decision — and it often isn’t what gets asked about.
Cortisone injections before joint replacementYou simply want a second set of eyes before you commit
This is a major, elective operation. Wanting one more opinion before you schedule it isn’t distrust — it’s diligence, and every good surgeon expects it. You don’t need a reason beyond that.
Three ways to do this
You don’t have to travel to get a second opinion. Most of what makes a second opinion useful — reading your films, understanding your history, and talking through what I’d actually do — works well without you leaving home.
A virtual consultation, wherever you are
A scheduled visit over secure, HIPAA-compliant video — no travel required. We review your imaging together and I walk you through what I see, what I’d recommend, and why. Our team confirms scheduling and benefits when you reach out.
A written second opinion, no visit required
No travel and no scheduled visit. You send your imaging and records; I review them and send back a written opinion covering what I see, whether I agree with the operation you’ve been offered, and what I would do instead — something you can sit with, and bring back to your own surgeon.
An office visit in D.C. or Germantown
For patients in the Washington region — or anyone who would rather be seen in person — I can examine the joint directly, which is the fullest version of this visit when it’s practical.
Send your records
Imaging and notes go in ahead of time so the visit is spent on your questions, not on paperwork.
We review and talk
I look at your films before we meet, then walk you through what I see and what I would do.
You decide
Go back to your surgeon with better questions, wait, or schedule with us. No pressure either way.
What to send ahead
A second opinion is only as good as what it’s based on. Recent weight-bearing X-rays are the single most valuable thing you can send — an MRI is rarely the study that decides a replacement.
- Recent X-rays of the affected joint — weight-bearing views if you have them
- MRI or CT report, if one has been done
- Notes or the surgical plan from the surgeon you’ve already seen
- A list of what you’ve already tried: injections, physical therapy, medications, bracing
- Records from any prior surgery on the same joint, including operative reports and implant details
Don’t have all of it? Send what you have. Our team can help you request the rest from the office that took them.
What I’ll actually tell you
- A direct read on whether the arthritis in your imaging matches the severity of your symptoms
- Whether I agree with the operation you’ve been offered — and if not, what I would do instead
- What I would expect your recovery to look like, honestly, including the parts patients find hardest
- What remains reasonable to try before surgery, if anything does
- A clear answer on timing — whether this is a now decision, a this-year decision, or a not-yet
You are under no obligation to have surgery with me, and plenty of patients don’t. Taking what you learn back to the surgeon you already trust is a perfectly good outcome.
Coverage
A second surgical opinion for an elective operation is usually covered by insurance, including Medicare, and some plans actively encourage one before approving a joint replacement.
Give us a call and our team will confirm your benefits and get you scheduled.
For more on the plans accepted at our offices, see the insurance page. If you’re weighing traveling for surgery, the travel-for-surgery pathway covers how out-of-town care is coordinated.
Start here
Tell us where you are and what you’ve been told. Our team will follow up to schedule your visit, walk you through sending your imaging, and confirm your benefits — and if you already have a surgery date, say so and we’ll prioritize it. You do not need to live nearby, and you do not need a referral.
Questions patients ask before booking
Is it rude to get a second opinion on joint replacement surgery?
No. Joint replacement is a major elective operation, and a surgeon who is confident in the plan will not be bothered by you confirming it. Most surgeons — myself included — would want a second opinion in your position. You do not need to tell your first surgeon, and you do not need a referral to get one.
Will you just tell me I need surgery?
No, and a fair number of second opinions end with me saying the opposite. I recommend staging bilateral replacements rather than doing both at once, and I regularly tell patients that their arthritis is not yet severe enough — or their symptoms not yet limiting enough — to justify an operation. If the honest answer is not yet, that is the answer you will get.
Can you do a second opinion by video if I live in another state?
You do not need to travel to get one. Second opinions are available as a secure video visit or as a written opinion based on your imaging and records, with no scheduled visit at all. Call the office or send the form and our team will confirm which option fits your situation and get you scheduled.
What do I need to send before the consultation?
Recent X-rays of the joint are the single most important item — weight-bearing views if you have them. Beyond that: any MRI or CT report, the notes or surgical plan from the surgeon you have already seen, a list of what you have already tried, and operative reports plus implant details if you have had prior surgery on that joint.
Does insurance cover a second opinion?
Usually, yes. Most plans, including Medicare, cover a second surgical opinion for an elective operation, and some plans specifically encourage one before approving joint replacement. Call the office and our team will confirm your benefits before your visit.
If I decide to have surgery with you, do I have to travel to Washington?
Yes — surgery happens at our facilities in the Washington, D.C. area. Many out-of-town patients use a single-trip pathway, with the consultation and follow-up handled virtually where permitted and one in-person trip for surgery itself. Many patients are able to fly or drive home within about five days.
What if I already have a surgery date scheduled?
Tell us that when you reach out and we will prioritize getting you seen before it. Second thoughts before a scheduled operation are common and worth resolving one way or the other — either you go into it confident, or you find out something that changes the plan.
What patients say after seeing Dr. Harb
“A really smooth operation — I was discharged the same day and basically able to walk easily within a day.”
“I walked into the surgical center in great pain and walked out with a new knee and a renewed person.”
“My full knee replacement is a big success — six months after surgery I’m hiking and kayaking again.”
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Get a second read before you commit to surgery
Schedule a consultation with Dr. Harb to discuss your hip or knee and build a plan to get you back to the activities you love.