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Dr. Bart Ferket’s study of knee replacements begins with a few eye-popping facts. Since 2000, the annual rate of that surgery has more than doubled in the United States. More than 640,000 are now performed each year, at a cost of more than $10 billion.

But in some cases, Ferket found, the patients receiving them had relatively mild symptoms, and derived limited physical benefits. Published in BMJ, his study concluded that surgeries on such patients were “economically unjustifiable.”


“If a procedure is expensive and it’s used a lot, you would think the evidence would be very solid,” said Ferket, a professor of population health at the Icahn School of Medicine at Mount Sinai  “That’s not the case for knee replacements.”

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  • As an orthopedic surgeon specializing in total joint replacement, I agree with their findings. I see patients in the office all the time who were told they “need” a knee replacement yet when I tell them it’s okay to live it, many are extremely happy to know they don’t “need” to have surgery. I think there are many surgeons who don’t enough time with the patient to know how much the arthritis really affects their day to day life. Instead they hear the patient has pain in their knee and see arthritis in the X-ray. Or worse yet, the patient has minimal findings on X-ray but has an MRI report that states there is arthritis or had a knee scope that shows focal areas of cartilage loss. Bottom line, it’s okay to tell patients it’s okay to live with arthritis. Satisfaction rates would be much higher if surgeons were more careful with patient selection.

  • Before knee replacements, people suffered unbearable pain and inability to walk. The only solution was a wheelchair or surgical house cleaning or tibial osteotomy. Surgical results were rarely of benefit. Then in the 70’s, we began doing knee replacements at first only in older people b/c we did not know how long they would last. I am now retired but the physician who oversees my patients tells me that 20 years after the fact these patients continue to do remarkably well. In my opinion, TK and TH are two of the greatest accomplishments in medicine.
    Certainly the indications, inability to walk short distances b/c of pain, must be correct then the benefit is definitely worth the cost.
    Further, inactivity most likely causes other illneses which would have cost money had the joint replacement not been performed

  • The increase can be seen in India too One pressure from patients to do things at earliest without going to routine exercise and precautions and most importantly Dr are trying to earn more money more name than their peers saying that they have performed so much surgery that too difficult ones And implant companies luring Drs

  • Hi my name is Irene!! I had 3, knee replacements the left knee first one failed. The doctor was supposed to replace when he put in , I still have loose hardware and he skipped the State . In 2007! What do you suggest?

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