Health Insurance for Knee Replacement Surgery

What is the General Cost of Knee Surgery?

Understanding Knee Surgery Expenses

Knee surgery is a standard orthopaedic procedure often required to address injuries, degenerative conditions like osteoarthritis, or congenital deformities. Rising life expectancy and an ageing population in India have resulted in a notable increase in the number of people having knee operations, especially knee replacements.

However, with the rapid increase in medical costs in recent years, the expenses associated with knee surgery remain the top concern among patients. This guide aims to provide clear, comprehensive and research-backed insights into the costs, influencing factors, and other crucial aspects.

Keep reading!

What are the Types of Knee Surgery Available in India?

Before discussing costs, it's essential to understand the types of knee surgeries:

Total Knee Replacement (TKR): Replacement of the entire knee joint with a prosthesis.
Partial Knee Replacement (PKR): Only the damaged part of the knee is replaced.
Arthroscopic Knee Surgery: A minimally invasive technique used for ligament repairs, meniscus tears, or cartilage cleanup.
Knee Osteotomy: Realignment of the knee joint to relieve pressure on the affected part.
Knee Ligament Surgery (ACL/PCL Reconstruction): Common in younger, athletic patients.
Revision Knee Surgery: Done when a previous implant fails or causes complications.

What is the Average Cost of Knee Surgery in India?

The cost of knee surgery in India varies depending on the type of surgery, hospital location, type of implant, and surgeon's experience. Here is a general breakdown:

Knee Surgery Type	Average Cost
Total Knee Replacement (TKR)	₹1,50,000 – ₹4,50,000 per knee
Partial Knee Replacement	₹1,20,000 – ₹2,50,000 per knee
Arthroscopic Knee Surgery	₹70,000 – ₹2,00,000
ACL/PCL Reconstruction	₹1,00,000 – ₹2,50,000
Revision Knee Surgery	₹2,50,000 – ₹6,00,000

Note: These costs vary between government hospitals (AIIMS, PGIMER), private multispecialty hospitals (Apollo, Fortis, Manipal), and tier-2 or tier-3 city hospitals.

What Factors Affect the Cost of Knee Surgery in India?

Several elements influence the overall cost of knee surgery:

1. Type of Surgery

TKR is more expensive than arthroscopy or ACL repair due to the implant and hospital stay.

2. Hospital Category

Government hospitals provide subsidized or free treatment.
Corporate hospitals charge more due to amenities and experienced surgical teams.

3. City of Treatment

Metro cities like Mumbai, Delhi, and Bangalore are more expensive when it comes to treatment.
Tier-2 cities such as Jaipur, Coimbatore, and Nagpur offer quality care at lower costs.

4. Implant Quality

Indian-manufactured implants are less expensive (₹25,000–₹60,000).
Imported implants (Zimmer, Stryker, Johnson & Johnson) can cost ₹1,00,000 or more.

5. Surgeon's Expertise

A highly experienced orthopaedic surgeon may charge higher consultation and surgical fees.

6. Duration of Hospital Stay

Typically 5–7 days for TKR. ICU usage or complications can increase the stay and cost.

7. Pre & Post-operative Care

Pre-surgery diagnostics, physiotherapy, and medications contribute significantly to total expenditure.

Are There Any Government Schemes to Reduce the Cost of Knee Surgery?

Yes, the Government of India has implemented several schemes to reduce surgery costs for underprivileged and middle-class populations:

1. Ayushman Bharat (PM-JAY)

Offers free TKR under empanelled hospitals.
Coverage of up to ₹5 lakhs per family per year.
Available to economically weaker sections based on SECC 2011 data.

2. CGHS & ECHS

Government employees and ex-servicemen can access subsidized or free surgeries in empanelled hospitals.

3. Price Capping by NPPA (National Pharmaceutical Pricing Authority)

Knee implant costs are regulated under government guidelines.
High Flex implants are capped at ₹62,770, and other standard implants at ₹54,720.

What is the Typical Recovery and Follow-Up Cost Post-Knee Surgery?

Recovery after knee surgery is a critical part of the treatment journey. It includes:

Procedures	Average Costs
Physiotherapy (15–30 sessions)	₹8,000 – ₹25,000
Follow-up Consultations	₹500 – ₹2,000 per session
Medications & Supplements	₹2,000 – ₹5,000/month
Assistive Devices (walker)	₹1,000 – ₹5,000 (one-time)

How Can Patients Reduce the Overall Cost of Knee Surgery?

To reduce the overall costs of knee surgery, patients can do the following:

1. Choose the Right Hospital

Teaching hospitals or trust-run institutions offer high-quality surgery at moderate prices.

2. Compare Implant Brands

Evaluate cost-performance balance. Indian implants have improved significantly in recent years.

3. Utilize Health Insurance

Review your health insurer’s cashless network for hospitals.
Opt for a plan with minimal co-payment clauses.

4. Plan in Advance

Get diagnostics and second opinions covered by Outpatient Department (OPD) benefits.
Opt for family floater policies to distribute the cost burden.

Is Knee Surgery Worth the Investment in Terms of Quality of Life?

Yes, several Indian studies show that patients undergoing knee replacement report:

80–90% reduction in pain.
Significant improvement in mobility and independence.
Enhanced mental well-being and social engagement.
The capacity to walk daily and occasionally, even participate in sports activities.

Knee replacement surgery in India can incur high costs due to several factors. Thus, it is essential to have a comprehensive health insurance plan that covers surgery costs, pre- and post-hospitalization expenses, diagnostic tests, and other associated costs.

Star Health offers a range of health insurance policies that cover knee surgery costs, allowing you to manage treatment expenses without incurring additional financial burden.

Check out our policies today!

Also Read:

→ How to Treat Injuries to Knee Ligaments

→ What are the Non-Surgical Options for Treating Knee Pain

→ What are the Common Ways to Treat Knee Pain

→ How Does PRP Treat Knee Pain Effectively

→ What are the Best Home Remedies for Relieving Knee Pain