Physicians may recommend a knee or hip replacement as a permanent fix for serious pain and immobility. But an invasive, complex surgery like a knee or hip replacement should only be performed after other treatments have been ruled out.

In some cases, Americans are choosing to unnecessarily undergo joint replacements. But there’s a hefty cost associated with elective knee and hip replacements, estimated at $8.3 billion per year.

New viewpoint research, published in the Journal of the American Medical Association (JAMA), shows patient education may be the key to opening the door to other options. Alternative treatment paths could offset the cost of joint replacements while limiting serious side effects that may require difficult, costly revisions.

About Joint Replacements in the U.S.

Hundreds of thousands of Americans undergo joint replacements each year. In 2014, the Agency for Healthcare Research and Quality estimated the annual number of knee replacements at 723,000 procedures. The annual number of hip replacements was 505,000 procedures.

This translates to an estimated 226 knee and 204 hip replacements per 100,000 people, which far exceeds the number of procedures performed in other high-income countries.

Some of these surgeries are “elective,” meaning they are optional rather than compulsory. An estimated one-third of hip and knee replacements may actually be unnecessary.

JAMA Study Measures Joint Replacement Costs

The study, authored by Vanessa Lam, Steven Teutsch and Jonathan Fielding from UCLA’s Center for Health Advancement, was featured in the Viewpoint section of the JAMA peer-reviewed medical journal. It was published on March 13, 2018.

The costs differ depending on the location of the surgery. Total surgery costs can range from $17,000 to $60,000. The lack of standardization in costs creating a very wide gap, with some hospitals actually overcharging patients.

They measured the cost of joint replacements at more than $20 billion, uncovering about $8.3 billion in unnecessary costs. Authors refer to this health care trend and cost as “potentially controllable.”

Joint Replacement Side Effects

A recent CNN article showed that joint replacements are actually increasing, especially in young men. Knee and hip replacements, however, may have poor outcomes.

People believe knee or hip replacements will result in an overall improved quality of life, but many are left with serious knee and hip replacement side effects.


Limited mobility

Device loosening

Difficulty walking

Flu-like symptoms

Hearing loss

Device failure

Joint Replacement Patient Education

The U.S. spends nearly 18 percent of its gross domestic product on health care. Research shows unnecessary joint replacements could be an opportunity to save funding for other health issues.

The Ambulatory Surgery Center Association said one-fourth to one-half of these joint replacements could take place in outpatient settings. Pursuing the procedure in an outpatient setting could save Medicare about $714 million annually.

Patients can also wait until the joint replacement is necessary, or consider other treatment options. Another potential solution could be to cap costs for joint replacement costs, which would save billions for taxpayers and insurance companies.

The authors argue that informing patients about treatment alternatives and being transparent about costs can lead to more informed decisions--and better long-term results.