Thinking about knee replacement surgery? Here’s what you should know first

For many Australians over 60, bad knees can slowly shrink life.

Walking the dog becomes difficult. Gardening hurts. Stairs feel like mountains. Even getting out of a chair can become an ordeal.

So it’s little wonder knee replacement surgery has become one of Australia’s most common operations, with tens of thousands performed every year.

And for many people, the results can be life-changing.

But experts say surgery shouldn’t always be the first step – and understanding the costs, recovery and alternatives is important before making a decision.

According to health insurer HCF⁠ , many Australians with knee osteoarthritis may benefit from trying evidence-based non-surgical treatments first, including exercise, weight management and physiotherapy.

Surgery isn’t always the only answer

Knee replacement surgery is usually recommended when pain becomes severe and starts interfering with everyday life.

That may include:

• pain keeping you awake at night
• difficulty walking or climbing stairs
• struggling to shower or dress independently
• giving up hobbies, exercise or social activities
• ongoing pain that doesn’t improve with medication or therapy

But surprisingly, many Australians aren’t first offered the treatments most strongly recommended by clinical guidelines.

Experts increasingly recommend starting with:

• strengthening exercises
• regular movement
• physiotherapy
• weight management
• pain management strategies

Orthopaedic surgeon Dr Samuel Duff says these approaches can help many people manage symptoms and potentially delay surgery.

What actually happens during knee replacement surgery?

A knee replacement involves removing damaged parts of the knee joint and replacing them with artificial components.

Some people need:

a partial knee replacement, where only one damaged section is replaced
or
a total knee replacement, where the entire joint surface is replaced

The aim is to reduce pain, improve movement and help people return to normal daily activities.

While outcomes are often very good, it’s still major surgery – and recovery can take time.

How much does knee replacement surgery cost?

The costs can vary dramatically depending on whether you go through the public or private system.

According to HCF:

• Public hospital surgery is generally covered by Medicare
• Private surgery with health insurance may still involve out-of-pocket costs
• Paying privately without insurance can cost more than $20,000
• Even insured patients can face additional expenses.

HCF says people with private cover who underwent knee replacement surgery in a private setting during 2023–24 typically paid about $1,000 in specialist out-of-pocket costs alone, excluding hospital excesses and other fees.

The wait time dilemma

One reason many Australians choose private surgery is to avoid public hospital waiting lists.

But that comes at a financial cost.

Recent figures show that in Australia’s public system:

• half of patients waited around 255 days for surgery
• almost one in four waited more than a year
• For people living with severe pain, that can feel like a very long time.

Recovery can take months – not weeks

Many people underestimate how long recovery takes after knee replacement surgery.

Dr Duff says full recovery can take up to nine months.

Rehabilitation usually includes:

• physiotherapy
• strengthening exercises
• walking programs
• home exercises
• mobility training
• Some patients recover at home, while others attend rehabilitation clinics or inpatient rehab programs.

The type of rehab recommended often depends on:

• age
• mobility
• overall health
• support available at home
• level of private health cover

How to reduce costs

Before committing to surgery, experts recommend carefully checking your private health cover.

One important detail: joint replacement and joint reconstruction are not the same thing.

Some insurance policies cover one but not the other.

HCF also recommends:

• checking for gap payments
• using participating hospitals and specialists
• researching rehabilitation costs
• understanding exactly what your cover includes before surgery

New tools helping Australians decide

Making the decision about surgery can feel overwhelming.

One option mentioned by HCF is the SMART Choice tool, developed through research funded by the HCF Research Foundation.

The tool asks users a series of questions and compares their likely outcomes with people who have already undergone knee replacement surgery, helping patients discuss options with their doctor more confidently.

What if you want to avoid surgery?

For many older Australians, surgery may eventually become necessary.

But experts say there are still several non-surgical options worth exploring first.

These include:

• strength training
• aerobic exercise
• weight loss
• knee taping
• walking aids
• medications
• physiotherapy

HCF also points to several programs designed to help eligible members manage osteoarthritis symptoms and potentially delay surgery.

The bottom line

Knee replacement surgery can absolutely transform lives.

For many Australians, it restores independence, movement and quality of life after years of pain.

But it’s also major surgery with significant costs, lengthy recovery and important decisions attached.

Experts say the best first step is having an honest conversation with your doctor about all available options – including the non-surgical treatments that may help you stay active and mobile for longer.