I'm concerned about my aging mother. She's 86 and needs a total knee replacement. She's on Medicare and doesn't have any other insurance. Will she get the care she needs?

Many patients getting a TKR are on Medicare. Most Medicare patients getting their first total knee replacement (TKR) are 65 years or older. Medicare is interested in reducing their costs through better outcomes after a TKR. This means fewer deaths and lower rates of infection, pneumonia, and blood clots.

One way to do this is to regionalize medical care. This means having patients go to a hospital in their area where all TKRs would be done by the same doctor(s). Research shows that patients managed at hospitals by doctors with high volumes of TKR have fewer problems.

Based on these studies you may want to help your mother find a surgeon who accepts Medicare patients and who performs many TKRs each year. Larger regional hospitals where TKRs are done routinely may be better than smaller hospitals.

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