Knee Replacement Surgery: A Race to the Bottom?

A total knee replacement is a very common operation and more than 700,000 of them are performed each year in the United States. With a mean cost of about $16,000 each, in 2011 we spent over eleven billion dollars paying for knee replacements. Projections are that, by 2030, we’ll be doing 3.5 million per year. The operation has great results and patients generally do well during and after their surgery. Anesthetic care has improved dramatically over time. Whereas initially patients who had a knee replaced would be given large doses of narcotic pain medicines (morphine) to deal with their pain, over time anesthesiologists figured out that treating pain in different ways at the same time was better. Patients began to receive spinals and epidurals in addition to or instead of general anesthetics and to be given non-narcotic medications in addition to their narcotics. In the present day we provide nerve blocks to dramatically reduce the pain after surgery for about a day to give them time to get over their primary anesthetic. Patients benefited from the lower narcotic doses by feeling less drugged, being at lower risk for respiratory arrest, and experiencing less nausea, urinary retention, constipation, and pruritus after surgery. These techniques evolved over time after prospective, randomized, controlled clinical trials demonstrated their superiority and safety. Furthermore, studies have shown that reducing narcotic-induced adverse effects saved money and shortened th...
Source: Waking Up Costs - Category: Anesthesiology Authors: Tags: Health Care Reform Source Type: blogs