Knee Replacements Explained

Imagine you’ve been in a car accident and shattered your knee. Or, that you’ve woken up one morning to find your knee joints stiff and uncooperative. Imagine then, struggling with the most mundane tasks daily like lifting the carpet to give it a shake or bending over to tie your shoelaces.

Usually, your doctor will prescribe physiotherapy, medication, and even cortisone injections. If these prescriptions still don’t help, the subject of a total knee replacement surgery may come up.

The thought of taking out a part of your body and replacing it with a foreign object can be disconcerting. While it may leave you feeling like you’re about to become the next bed-ridden Terminator, don’t fret. Here are a few fun facts to put you at ease if you’re considering having total knee replacement surgery.

A Brief History

We have come a long way since the first knee replacement or arthroplasty in the 1950’s. The first prosthesis (artificial body part) named the Waldius hinge joint, was deemed a failure. This is possibly because its parts were being assembled from acrylic, cobalt, and chrome.

Since then, medical research has enabled orthopaedic surgeons to replace an arthritic or damaged joint with a successful prosthesis. The artificial joints are normally made from metal, strong plastic or ceramic. The femoral stem component is made from titanium or cobalt mixed metal.

Have you been trying to get your head around how an artificial knee replacement works? It is a highly polished metal that moves against an extremely hard-wearing plastic spacer to allow for easy manoeuvring. The lubricant for the bearing comes from your bodily fluids and your ability to move the joint comes from your muscles.

When should I start thinking about total knee replacement surgery?

The most common reasons for knee replacement are acute osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. These debilities can cause severe pain, mobility problems, and joint deformities.

Osteoarthritis and similar cartilage-damaging medical conditions commonly occur in the weight-bearing joints. These are usually because of injuries and repetitive impact from sport, but can also have hereditary contributions.

These conditions interfere with everyday living and cause a considerable amount of pain when walking, sitting, and even when lying down or resting.

Anyone can have knee replacement surgery but surgeons consider those under the age of 55 to be young for the procedure. Recent findings are showing that a younger demographic is now in need of the operation, because of the rising obesity rates at ages as young as 45.

Evidence states that every pound you put on places an additional 3 pounds of pressure to your knees, causing the cartilage to break down even quicker.

If you have exhausted all of the less invasive treatments, and still suffer from the condition, don’t lose hope. This might be a good time to consider knee replacement surgery to return you to your pain-free, everyday life. Total knee arthroplasty takes about 2 hours for the total procedure and 4 to 6 weeks to get back into your regular routine.

Knee Replacement Waiting Periods

According to the Australian Institute of Health and Welfare in 2013, about 1.8 million Australians were suffering from osteoarthritis alone. We are speaking about 8% of the entire population. In the same year, 1.6 billion dollars (about 2.2%) was spent on hospitalisation for the condition.

Now, according to a report released in February this year, Australia is at risk of facing an “unsustainable joint replacement burden” by 2030. This will have significant implications on the healthcare budget. The demand for orthopaedic surgery is due in part to the rising obesity rates and the large population of older people.

Medicare will pay for most medically necessary surgeries, but the increasing need for the operation means that waiting periods will extend considerably.  From 2017-18, 874,000 patients were placed on the public waiting list for elective surgery.

Current waiting periods already stand from anywhere between 40 to 200 days. 2017-18 statistics show that orthopaedic surgery had the longest waiting periods, with NSW, ACT, and Tasmania recording the highest wait times- around 350-360 days.

Now imagine having no idea when you are going to be able to tend your garden bed again or play footy with the kids because you’ve been put on an already massively burdened waiting list. Even more concerning is your condition affecting your ability to go to work.

So, you have the option to wait in notable discomfort for the public health care system to fit you in or have the advantage of getting your aching joint issues sorted right away through private health insurance. 

Knee Replacement Costs

While Medicare will fully cover you as a public patient, they will also put 75% of the scheduled Medicare Benefit Schedule fee towards your stay as a private patient if you have private health insurance and your health fund will put up the remaining 25% (up to the MBS fee).

If you don’t have private health insurance and want to have your operation in a private hospital, this will cost you anywhere from $18,000 to $30,000 depending on your choice of surgeon.

A hospital policy that covers you for knee replacements will allow you to be treated as a private patient in a private hospital. This means you will be able to choose your own surgeon, choose your hospital and crucially, avoid those public waiting lists.

Joint replacements will be found on gold tier plans, but can also be found on some Silver Plus covers like this policy from nib.

If you’re already with gold cover or a policy that covers you for joint replacements, and have already served your health fund waiting periods, you can go in for surgery as soon as your doc gives the green light.

If you’re new to cover, or are upgrading to have knee replacements covered, then the wait periods will be:

  • 12 months for a pre-existing condition
  • and 2 months for a new condition

How do I schedule knee replacement surgery?

Once your doctor has deemed your operation medically necessary, you will need to get in contact with your health fund, if you have one, about your upcoming procedure.

You will also need to discuss with your doctor about dates and costs upfront because there may be unseen out-of-pocket expenses you may incur if your doctor decides not to participate in your fund’s gap scheme.

What is a gap scheme?

So private health insurance works like this: Medicare and your health fund both pay a proportion toward your treatment according to the Medicare Benefit Schedule. The MBS is a schedule of fees set by the Australian Government for medical services. Each service, test, and procedure has its own set cost. For example, total knee replacement on the MBS is set at $1,338.90.

Your doctor can, however, choose to charge more than the set cost. So, let’s say your doc charges $2,500 for your operation. The difference of $1161.10 will come out of your pocket. That difference is ‘The Gap’.

If your doctor agrees to participate in your health fund’s gap scheme, like this one from Australian Unity, you won’t be paying any out-of-pockets, or at least a significantly reduced amount, because your fund will pay a higher benefit towards your medical costs.

Going To Hospital

So I’ve discussed costs with my specialist, what now?

So now that you are aware of any potential costs, you can begin the journey on acquiring your shiny new joint. In the weeks leading up to your procedure, your surgical team will be preparing you for your operation. You will need to get a general check-up from your GP and your surgeon will most probably request for some blood and medical tests like coagulation screening and a cardiogram.

This would be a good time to jot down any queries or concerns you have for your doctor. It is always advisable to do some physical therapy beforehand.  This will aid your recovery rate and help you understand what to do post-op.

Also, consider how your home life will be affected. Make any necessary preparations so you don’t have to worry about holding down the fort while you’re in recovery. If you live alone or don’t have family and friends nearby, health insurance can help with your worries about convalescing alone. Some health fund policies offer provision for intensive physiotherapy in the comfort of your own home. nib’s Rehab at Home will help you get back to your old self as soon as possible.

Don’t forget that you won’t be as steady on your feet. Investing in some handy gadgets like a long-handled shoehorn and aids like additional bathroom rails will come in handy when you’re recuperating.

All set on the home front, can I call my Uber now?

Whoa there, tiger, just a couple of last-minute ends to tie up. You’ll be swanning around the ward in your hospital gown in no time.

Be aware that most surgical procedures require you to remove any body piercings, nail polish, and make-up for hygiene purposes.

For anyone going into hospital, here’s a general list of things to pack with you when you’re going in for surgery:

  • Nightdress or PJ’s
  • Clean undies
  • Day clothes
  • Slippers
  • Washcloth or hand towel
  • Toiletries- toothbrush, toothpaste, deodorant, soap
  • Comb or hairbrush
  • Some cash for snacks
  • Usual medication
  • Book or magazine
  • Glasses or contact lenses
  • Address book
  • Phone charger and phone (if permissible)

You will most likely be asked to fast from midnight the night before your procedure. Be sure to have a good, nutritious meal before that. Now go to sleep, feed the cat and call your Uber.

I’m in hospital, send help

Nerves are totally normal when you’re anticipating surgery. Happily, you won’t feel anything for much longer because your surgical team will put you to sleep. They will do this with general anaesthesia. They might alternatively numb your legs by spinal or epidural anaesthesia. Before you slide into la-la land, your surgeon will run you through a step by step explanation of what’s about to happen to your body.

During theatre, your surgeon will bend the problematic knee and make an incision of about 25 centimetres. Next, he will move your knee cap and take out the cartilage and bone. He will then attach the prosthesis to your femur and shinbone and knee cap with bone cement. Finally, your surgeon will bend your new knee and see if the prosthesis made a successful fit. Nurses will monitor you for a couple of hours and here begins your road to recovery.

In the days following your operation, medical staff will monitor you for blood clots, nerve damage or infection. The physio will ask you to start making small movements with your feet. Blood clots are one of the common risks associated with knee surgery. If this happens, your doctor will prescribe blood thinners or a compression boot.

You won’t be in bed for too long. Your health professionals will encourage you to start walking one day after your surgery.  Walking with crutches or an aid will help with healing and circulation. A few more days of this and your physio will be going through exercises with you to test out your new knee. Hospital staff will keep tabs on your pain levels and administer medication where necessary.

I’m home now, can I do the Melbourne Shuffle?

Success rates for total knee replacement surgery are quite high- over 90% of positive results. Even so, you may want to hold off on dancing the Irish jig for a short bit.

You will need to take extra care around your incision area to avoid infection. Remember to be extra careful around kids and enthusiastic pets in the first few weeks. Before doing any strenuous activity like exercise you have to check in with your doctor first.

It will take about 4-6 weeks to get back into your normal routine. To fully appreciate the benefits of your new knee will take around 6 months to a year. That’s about the same amount of time you would have possibly still been waiting on the public waiting list.

Knee prosthesis lasts for about 10-15 years if well cared for. If you are privately insured, you will be able to have regular check-ups with your preferred doctor and hospital whenever the need arises. The major activity that you will need to refrain from is anything involving jumping. Aside from this, bike riding, stair climbing, and light hiking can all resume normalcy. Joint replacement surgery is not as daunting as it sounds. A new knee will enable you to live a fuller, more enjoyable life.

Where Can I Compare Knee Replacement Cover?

Choosing a private health insurer can be frustrating, as there are over 40 health funds across Australia. Health Deal is a free service that assists you to choose a hospital policy or compare your current cover without the overload of complex information.

Our agents are experts in the field of private health insurance. We understand that most people do not have the time to research multiple private health insurance policies across Australia. So we do it for you.

Health Deal partners with 6 health funds to ensure that you get the best value for your money. We have been assisting Australian families with increasing their benefits and lowering their premiums since June 2015, and currently hold the highest rating on Trust Pilot.

If you are looking to get private health cover for your knee replacement surgery, don’t spend hours surfing the net looking at every single hospital policy. It only  takes 10 minutes out of your day to get in touch with a Health Deal agent today to walk your way into a brand new you

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