@jenatsky

I agree but don't assume that because a surgeon works out of a teaching hospital, he is terrific. There are duds in those positions.

My view is that the overall level of medical knowledge and delivery is greater at facilities like the Mayo Clinic and Cleveland Clinic and at teaching hospital groups like Harvard (Mass General, Brigham and Women's, etc.) but the very best individual for a particular procedure might be outside of one of those groups.

I would research neurosurgeons. My neurologist, top rated in the city, wanted me to get an opinion from a neurosurgeon on my stenosis and the surgeon we wanted to see was temporarily not taking my insurance. So he sent me to another surgeon who reviewed my MRIs and declared that if he did surgery, he would have to start with the stenosis in my neck and it was so bad in there that he could not go in minimally invasively.

I didn't trust his skill. The surgeon my neurologist wanted me to see finally was able to schedule an appointment with me. We put off any analysis until my knee situation was resolved but he said he could go in from the front minimally invasively if surgery were needed (he has written a primer for surgeons on doing minimally invasive spinal surgery). I trust this surgeon and I trust that he will not recommend surgery unless he is convinced that it is the best and only solution.

The first neurosurgeon was highly rated; the second, my current neurosurgeon, is top rated. Starting at a teaching hospital, if there is one in your area, is a terrific starting point. But then research the heck out of the results and check locally to see if there is some great surgeon out there for your particular operation.

For example, there is a surgeon in Los Angeles that is considered the best for elbows, shoulders, etc.: Neal Elattrache. Professional athletes flock to him. he is a single practitioner.

So my advice is research, research, research and then research some more. One more example. My brother, in a small city in the middle of the country, was getting a knee replaced at the same time as me. He is a busy Professor and he stopped once he found the best rated knee surgeon that city (someone with a bit of a positive reputation for doing knees but a conservative surgeon). I am retired and had time to do a lot more research and found a surgeon who met all of my requirements:

newest approach (sub or mid vastus)
no tourinquet
if my ACL is strong, do a BCR procedure
fix my severe misalignment (valgus) with one of the newer tools (kinetic, inverse kinetic, functional, etc.)
Has successfully performed ) many (at least a hundred) such procedures
Great mind
Great hands

Fortunately I found someone who met all of these requirements and is in my city. Once I identified a possible I research the heck out of her and the procedure. For example, I found a video of my surgeon doing exactly this procedure, back in 2020 at an Orthopedic Innovations Conference.

We had our operations within five days of each other. The only pain I had/have is some pain around the incision site that mostly goes away after about twenty feet of walking. I never took a pain pill. My brother is on opiods and is in constant pain. His doctor did use a tourinquet, did cut the tendon, etc. Two years down the road we will probably be the same. But the process of getting there can be a lot more painful if one doesn't fully do one's research.