Razi Berry

A recent article from Kaiser Permanente questions the number of knee surgery, and other joint replacements, that are done yearly. Rates of knee surgery have doubled between 1999 and 2008, and are projected to reach 3.5 million per year by 2030. Currently, just under a million are performed each year.

Rates of knee surgery doubled between 1999 and 2008

Though many individuals experience symptomatic relief from knee replacement surgery, many do not. And physicians are becoming increasingly concerned that the procedure is being overused and that its benefits are overstated.

As much as a third of individuals undergoing knee replacement continue to experience chronic pain

Research suggests that as much as a third of individuals undergoing knee replacement continue to experience chronic pain,1 and a study last year from the BMJ concluded that knee replacement largely shows “minimal effects on quality of life.”2 These less than ideal outcomes are even more prevalent in those who have less severe arthritis.

A third of people getting knee replacement surgery may not even be appropriate candidates

The article points out that a third of people getting knee replacement surgery may not even be appropriate candidates for the procedure because their symptoms aren’t bad enough to warrant an aggressive intervention.

“We do too many knee replacements,” said Dr. James Rickert, president of the Society for Patient Centered Orthopedics, which advocates for affordable health care. “People will argue about the exact amount. But hardly anyone would argue that we don’t do too many.”

Doctors’ willingness to operate on younger people likely accounts for the rise

Individuals are aging and getting heavier, which are factors in arthritic changes that could lead to needing joint replacement. However, these factors alone don’t account for such increases and it is thought that a doctor’s willingness to operate on younger people – in their 50’s and 60’s – likely accounts for the rise. This shift has occurred due to the increase in longevity of implant material.

Many who received implants at younger ages are requiring second “revision” surgeries

Even with the longer lasting implant material, many who have received implants at younger ages are requiring second “revision” surgeries to repair previous knee replacements. These second surgeries carry added burden as well as increased risk of complications. The bottom line is that younger patients are simply more likely to “outlive” the implant, requiring a second surgery. It is estimated that about 35 percent of men need a revision surgery if they are younger than 60 at the time of the first surgery; 20 percent for women.

Hospitals and surgery centers heavily market knee replacements

Yet, hospitals and surgery centers market knee replacements heavily, with ads that show patients running, bicycling, even playing basketball after the procedure, said Dr. Nicholas DiNubile, a Havertown, Pa., orthopedic surgeon specializing in sports medicine. While many people with artificial knees can return to moderate exercise — such as doubles tennis — it’s unrealistic to imagine them playing full-court basketball again, he said.

Kaiser adamant in stating: ‘alternative effective ways of treating arthritis outside of surgery exist’

The article by Kaiser was adamant in stating that there are other effective ways of treating arthritis aside from surgery. Even more severe forms of arthritis have been well documented to be relieved by non-surgical interventions.


  1. Riddle DL, Jiranek WA, Hayes CW. Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study. Arthritis Rheumatol. 2014;66(8):2134-43.
  2. Ferket BS, Feldman Z, Zhou J, Oei EH, Bierma-zeinstra SM, Mazumdar M. Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative. BMJ. 2017;356:j1131.

Razi Berry is the founder and publisher of  the journal Naturopathic Doctor News & Review  that has been in print since 2005 and the premier consumer-faced website of naturopathic medicine, NaturalPath.  She is the host of The Natural Cancer Prevention Summit and The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10 week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and Chronic Fatigue Syndrome and Fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. Follow Razi on Facebook at Razi Berry and join us at  Love is Medicine  to explore the convergence of love and health.

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