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Home/Large Joints and Extremities/$40, 000 in Economic Benefits From Knee Replacement Surgery
Large Joints and Extremities

$40, 000 in Economic Benefits From Knee Replacement Surgery

September 3, 2013 2 min read Premium comments

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$40, 000 in Economic Benefits From Knee Replacement Surgery
Source: Wikimedia Commons and David Stanley
Secondary

Despite its cost of more than $20, 000, knee replacement surgery more than pays for itself for most patients.

That is the conclusion of a study conducted by John R. Tongue, M.D., a researcher for the American Academy of Orthopaedic Surgeons (AAOS). Amir Khan, staff writer for Everyday Health wrote that the study estimated the economic benefits of the surgery to be up to $40, 000. Patients who undergo knee replacement surgery miss fewer work days, experience a better quality of life and, in many cases, are able to pursue their careers until later in life. Most of the pay-off, Khan wrote, came from increased productivity.

“We know that when a knee replacement is done on patients at the appropriate time, it adds tremendous value to their lives, ” Tongue said in a statement, quoted by Khan. “It gets them back to work and back to their families. It improves their quality of life and allows them to be productive and active again. But until now, that value has been hard to quantify. This study allows patients to see the big picture of the effect on their daily lives and in the long term.”

Barry Waldman, M.D., a clinical instructor of orthopedic surgery at the Johns Hopkins School of Medicine in Baltimore, said those patients whose osteoarthritis seriously limits their mobility should no longer look on knee replacement as an elective procedure. He said while that they used to tell patients to put off surgery until they couldn’t walk, that is no longer the case. “Now we advise patients to think about surgery when there’s something major they can’t do any more, like go to work, ” he said.

Ambivalence about the surgery remains. Kahn quoted William Macaulay, Jr., M.D., Director, Center for Hip & Knee Replacement in New York City, who said that patients need to be aware that knee replacement surgery is not a panacea. “One must realize that total knee replacement, as good as it is, does not restore completely normal knee function, ” he said. “It can make a very arthritic and painful knee much better, but not 100 percent.” Preventing osteoarthritis and the need for knee surgery in the first place could save even more money. Kahn quoted Daryl Osbahr, M.D., an orthopedic surgeon at MedStar Union Memorial Hospital in Baltimore, as saying. “And that begins by losing weight.”

The number of candidates for knee replacement surgery is expected to rise from 600, 000 to more than 3 million per year by 2030, according to the study. If those patients actually receive the treatment, Kahn wrote, millions of dollars could be saved in lost productivity.

The study findings may help provide a better way for assessing the value of what has become an increasingly common surgery. Khan noted that, with the baby boomer generation reaching the age where this surgery can become necessary, better understanding the risks and benefits can help doctors and patients with balky knees make the best decision possible.

React:

Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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