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Knee Joint Replacement Takes Center Stage

People needing both knees replaced can have both done at the same time (one-stage). Or they can enter the hospital two separate times (two-stage). The two-stage method has a much shorter wait between operations than ever before.

But what about the costs? Is it less expensive to do a one-stage or two-stage knee replacement for people who need both knees done? It makes sense that the one-stage method would have a shorter total hospital stay and lower costs.

A recent study from Stanford University School of Medicine looks at cost issues. They compared 91 one-stage patients with 32 two-stage patients. They looked at both the hospital costs and costs after discharge. All patients had both knees replaced.

The researchers found that hospital costs for a one-stage knee replacement are almost 25 percent less than for a two-stage operation. But the costs go up afterwards when the one-stage patients go to a rehab unit for up to nine days.

Most of the two-stage patients went directly home. Some had home health services, but this was much less costly than in-patient rehab services. The authors conclude that what happens after surgery is more important in comparing costs of one-stage to two-stage knee replacements. One-stage patients are more likely to need a longer stay in a rehab unit.

References: Alex Macario, MD, MBA, et al. Economics of One-Stage Versus Two-Stage Bilateral Total Knee Arthroplasties. In Clinical Orthopaedics and Related Research. September 2003. Vol. 414. Pp. 149-156.

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