Cost of knee replacement
When selecting what implants to have available in their hospital, decision makers need to concentrate on cost-related factors. This includes, for example, focussing on the up-front cost of an implant and associated equipment, length of stay (it is more cost-effective for patients to go home as soon as possible), and likelihood of readmission or repeat surgery (each repeat treatment is costs more than the first surgery). Choosing when to treat patients can also be influenced by cost effectiveness considerations. Lifetime treatment for younger and more active patients is likely to cost more. Many patients have to wait until their disease is worse before they can have surgery. When they finally get their replacement, they are more likely to be satisfied with moderate function, will usually be less active and being older are less likely to seek repeat surgery in 10+ years.
In the UK, a knee implant can cost anywhere from £600-£3,000. Equivalent prices will vary around the world but also have a range. The price of an individual design will depend on how new it is, what materials and technologies it offers, and on any deals the hospital is able to negotiate with the manufacturer. Surgery itself can cost from average £6,500 for a straightforward knee replacement in an efficient specialist orthopaedic hospital to over £16,000 for complicated revision surgery. The NHS tariffs for knee replacement do not always cover the cost to the hospital so emphasising their need to focus on lower cost.
The price of a knee replacement in private hospital will vary between hospitals. Prices are influenced by factors including the perceived quality of care before, during and after the operation, and overall patient experience provided by the hospital. In the UK, straightforward knee replacement surgery in a private hospital is usually priced £10,000-£13,000.
In terms of how well knee replacement designs work, the factors that you are likely to think most important are not necessarily what hospital decision-makers are focused on. As can reasonably be expected, state-funded hospitals are focussed on a quality of care that means patients can return home with an acceptable relief from pain, be independent and able to live well enough that they will not require further treatment.
Privately funded hospitals usually use the same designs as state-funded hospitals because they are what the surgeons are familiar with. But because they compete for business with other hospitals and wish to attract patients, some are more focussed on better outcomes and more patient satisfaction. Surgeons also usually have more influence in what they use in their private practices and are keen to achieve high patient satisfaction. To do this they may have more freedom to choose newer and potentially better performing technologies.
Fortunately in recent years, acceptable norms are changing. Patients expect more and modern technologies can provide meaningful differences to them. Newer designs may be more stable, feel more normal, and allow patients to be more active. Some patients even report that they are able to forget about their knee during daily and recreational activities. The devices that do this are not always the lowest priced devices or ones provided by the biggest manufacturers that can offer attractive price bundles to hospitals. And although working against increasing cost pressures, performance and satisfaction factors are gaining in importance in both state and privately funded hospitals.
It is worth doing your research and seeking consultation with a surgeon you feel you can trust to ensure you have access to the best options.
Different options exist for funding a knee replacement, including state-funded treatment, medical insurance or direct payment for the treatment. It is worth considering what your requirements are. Does your local state-funded hospital provide the implant that you want? Are you able to select a different state-funded hospital or is it worth seeking private treatment? If you are considering private treatment, it is worth asking your surgeon if the device you want is covered by your insurer. It may be worth considering the value to you of getting the best treatment and whether it is worth paying up front to get your choice.