Knee and hip replacement abroad: the complete guide

A joint replacement is probably the most durable device you will ever be given: fifteen to twenty-five years. That is why, in orthopaedics, two questions weigh more than price: which implant am I getting, and who rehabilitates me afterwards.

Before surgery: is this the right time?

Joint replacement is indicated when pain limits daily life and conservative treatment has been exhausted: weight loss, supervised physiotherapy, prescribed analgesia and injections where appropriate. An X-ray showing advanced arthritis without disabling pain is not, on its own, an indication for a prosthesis.

This matters especially in medical travel, where the patient arrives already decided and the centre has an obvious financial incentive to confirm the indication. An independent second opinion at home, using the same images, costs little and prevents premature surgery.

The implant: brand, model and batch

Demand in writing the brand, model, reference, batch number and bearing surface of the implant, and keep the implant card the hospital must give you. Without that information, fifteen years from now a surgeon in your city will have to plan a revision blind.

Also ask whether the model appears in a national arthroplasty registry with published survival data. Implants with documented ten-year follow-up are a more conservative choice than a new model backed by aggressive marketing.

Robotics, navigation and how to read them

Robot-assisted surgery improves cutting precision and alignment. It is a useful tool, especially in the knee, but it does not turn a low-volume surgeon into an expert, nor does it replace planning. Paying for robotics is worthwhile if the team is experienced with it; it is not worthwhile if it is the main selling point.

The indicator that still correlates best with outcome is how many procedures that surgeon and that hospital perform per year.

Preventing the two complications that matter

• Periprosthetic infection: the most feared complication. Ask about the antibiotic prophylaxis protocol, pre-operative nasal decolonisation and the department's infection rate.

• Venous thrombosis: anticoagulant prophylaxis and early mobilisation are mandatory. This point governs your flight home.

Both are the reasons a joint replacement does not fit into a five-day trip.

Rehabilitation: 50 % of the result

A well-placed prosthesis with poor rehabilitation produces a mediocre result. The programme starts on the day of surgery or the day after and continues for six to twelve weeks.

Before travelling you must know who will rehabilitate you at home, how many sessions and under which protocol. Ask the centre for the rehabilitation plan in writing and in a language your physiotherapist understands. This cost is usually excluded from the package and typically adds 400 to 1,200 euros.

When it is safe to fly

Ten to fourteen days after a hip or knee replacement is reasonable, with prescribed anticoagulation, compression stockings, a seat with legroom and standing up to walk every hour. Long flights concentrate clot risk precisely in those first two weeks.

Plan the door-to-door journey too: stairs at home, toilet seat height, the shower, and whether you will need help in the first weeks.

Indicative prices

8,000 to 14,000 euros in central Europe, 10,000 to 18,000 in western Europe, 30,000 to 50,000 in the United States. Check whether the price includes the implant, hospital nights, anticoagulant prophylaxis, crutches or a walker, and the first physiotherapy sessions.

Red flags

• A surgical indication without any trial of conservative treatment.

• Refusal to give the implant brand and model.

• Hospital discharge in under 48 hours.

• A return flight before day ten.

• No written rehabilitation plan.

• No implant card at discharge.

Keep reading

• Hip osteoarthritis: total replacement

• Knee osteoarthritis: robotic prosthesis

• Flying after surgery: clot risk

• Postoperative recovery abroad