Who Needs Knee Replacement Surgery?
Knee replacement is one of the most successful surgeries in modern medicine, with over 95% of patients experiencing significant pain relief and improved quality of life. But how do you know if you're a candidate?
✅ You May Be a Candidate If:
- • Severe knee pain that limits daily activities (walking, climbing stairs, getting in/out of car)
- • Pain at rest or during sleep, not just with activity
- • Stiffness preventing normal knee movement
- • X-rays show significant arthritis with bone-on-bone contact
- • Conservative treatments failed (medication, injections, physiotherapy for 3-6 months)
- • Age: Most commonly 55-75, but symptom severity matters more than age
- • Good overall health to undergo surgery
⏳ You May Want to Wait If:
- • Pain is tolerable with medication and activity modification
- • Haven't tried conservative treatments (physiotherapy, weight loss, injections)
- • Age under 50 and highly active (implant may need future revision)
- • Active infection elsewhere in body (must resolve first)
- • Severe health conditions making surgery risky (uncontrolled diabetes, heart disease)
- • Insufficient knee damage on X-rays
💬 What Surgeons in Singapore Look For
Singapore orthopaedic specialists use a combination of symptom severity, X-ray findings, and quality of life impact to determine candidacy. They typically recommend surgery when conservative treatments have been exhausted and pain significantly interferes with daily living. Many surgeons say: "You're ready when your knee prevents you from living the life you want to live."
How Much Does Knee Replacement Cost in Singapore?
Transparent pricing so you can plan ahead—no surprises.
| Hospital Type | Total Cost (SGD) | Typical Patient |
|---|---|---|
| Public (Subsidized) | $5,000 - $7,000 | Singapore Citizens, B2/C ward, 2-6 months wait |
| Public (Unsubsidized) | $20,000 - $30,000 | PRs, foreigners, or private ward choice |
| Private Hospital | $32,000 - $56,000 | Faster access (1-4 weeks), surgeon choice |
💡 Key Takeaway
Most Singaporeans with insurance pay $3,000-$10,000 out-of-pocket after MediSave and Integrated Shield Plans, regardless of total bill.
Complete Cost Breakdown: What You're Paying For
1. Surgeon Fees: $15,000 - $25,000
Covers the surgical procedure, pre/post-op consultations, and follow-up care for 3-6 months.
Factors: Experience level, reputation, surgical technique (traditional vs minimally invasive)
2. Hospital Stay: $8,000 - $20,000
3-5 day stay including ward, meals, nursing care, and operating theater use.
Ward type: B2 (~$300/day) vs B1 (~$600/day) vs Private ($2,000+/day)
3. Knee Implant: $5,000 - $15,000
Artificial knee joint (standard, high-flex, or custom 3D-printed).
Brands: Zimmer, Stryker, DePuy, Smith & Nephew
4. Anesthesia: $1,500 - $3,000
Anesthesiologist consultation, general/spinal anesthesia, and post-op pain management.
5. Pre-Op Tests: $800 - $1,500
Blood tests, ECG, chest X-ray, knee imaging (often not included in initial quote).
6. Post-Op Rehab: $1,000 - $3,000
15-20 physiotherapy sessions over 3-6 months (not always included in surgery cost).
MediSave & Insurance Coverage: Reduce Your Costs
💰 MediSave Withdrawal Limits
- • Surgical expenses: Up to $3,000
- • Hospital stay: $450-$600/day (B1 or B2/C ward) for max 30 days
- • Typical claim: ~$4,500-$5,500 total
- • Family MediSave: Can use spouse's, children's, or parents' accounts
🛡️ Integrated Shield Plans (Private Insurance)
If you have an Integrated Shield Plan (AXA, Prudential, Great Eastern, etc.), private hospital costs are largely covered:
Example: $45,000 private hospital bill
- • Deductible (you pay): $3,500
- • Insurance covers: Remaining $41,500 (if panel surgeon)
- • Your out-of-pocket: $3,500
Without Rider: Add 10% co-payment (~$4,150), total out-of-pocket $7,650
💡 Pro Tips to Minimize Costs
- • Choose a panel surgeon: Save $5,000-$15,000 (insurance covers more)
- • Public hospital for non-urgent cases: Excellent care at fraction of cost if you can wait 3-6 months
- • Standard implants: Work excellently for most patients, high-end implants may not provide better outcomes
- • Polyclinic physio: Post-op rehabilitation at $20-30/session vs. $80-150 private
Types of Knee Replacement Surgery
What's replaced: End of femur (thigh bone), top of tibia (shin bone), and sometimes underside of patella (kneecap)
Best for: Arthritis affecting entire knee, severe damage to multiple compartments
Implant lifespan: 15-25 years (85-90% still functioning at 20 years)
Cost: $32,000-$56,000 (private), $5,000-$7,000 (subsidized)
Success rate: 90-95% patient satisfaction, significant pain reduction in 85-90% of cases
What's replaced: Only damaged compartment (usually medial/inner side)
Best for: Arthritis in only one area, intact ligaments, younger more active patients
Benefits: Faster recovery (4-8 weeks), more natural feel, preserves healthy bone/cartilage, smaller incision
Cost: $19,000-$32,000 (private), $4,000-$6,000 (subsidized)
Recovery advantage: Most patients walk same day, return to activities 50% faster than total replacement
Surgical Techniques & Technology
Traditional Approach
Standard technique, proven track record, surgeon uses instruments and experience to align implant. No extra cost.
Minimally Invasive
Smaller incision (8-12cm vs 15-20cm), less muscle disruption, faster recovery, less post-op pain. Add $2,000-$5,000.
Robotic-Assisted (Mako, ROSA)
Greater precision in bone cuts and implant positioning, personalized to your anatomy. May improve long-term outcomes. Add $5,000-$10,000.
The Procedure: What Happens During Surgery
Understanding the surgery can help reduce anxiety and prepare you mentally. Here's what to expect:
Anesthesia (Pre-Surgery)
You'll receive either general anesthesia (completely asleep) or spinal anesthesia (awake but numb from waist down). Your anesthesiologist will discuss options. Many surgeons also inject long-acting nerve blocks for post-op pain control.
Incision & Access (15 min)
Surgeon makes an incision (8-20cm depending on technique) over the front of your knee to access the joint. Muscles are carefully moved aside, not cut.
Removing Damaged Tissue (30-45 min)
Damaged cartilage and bone are precisely removed from the end of the femur and top of the tibia using specialized cutting guides. In TKR, undersurface of kneecap may also be resurfaced.
Implant Placement (30-45 min)
The metal components are attached to the bone (cemented or press-fit). A medical-grade plastic spacer is inserted between the components to allow smooth gliding. Surgeon tests range of motion and stability.
Closing (15-20 min)
The incision is closed in layers with sutures or staples. A drain may be placed to remove excess fluid. Sterile dressing applied.
Total surgery time: 1.5-2.5 hours. You'll spend 1-2 hours in recovery room before returning to your ward. Modern techniques have made knee replacement a same-day or 1-night stay procedure in some cases, though 3-5 days is still standard in Singapore.
Success Rates & Long-Term Outcomes
Knee replacement is one of the most successful surgeries in orthopaedics. Here's what the data shows:
📊 Patient Satisfaction
- 95%of patients report significant pain reduction
- 90%satisfied or very satisfied with results at 5 years
- 85%say they would do it again
- 80%no longer need pain medication for knee
⏱️ Implant Longevity
- 90%of implants still functioning at 10 years
- 85%of implants still functioning at 20 years
- 15-25years typical implant lifespan
- <10%require revision surgery in first 10 years
✅ What You Can Expect After Surgery
Improved Mobility:
- • Walk without pain or limping
- • Climb stairs normally
- • Get in/out of cars easily
- • Stand for longer periods
Enhanced Quality of Life:
- • Sleep through the night (no pain waking you)
- • Return to hobbies (golf, gardening, travel)
- • Improved mental health and mood
- • Greater independence
⚠️ Realistic Expectations
While outcomes are excellent, it's important to have realistic expectations. Your new knee will not feel exactly like your natural knee before arthritis—it will feel different, but much better than the painful arthritic knee you had. Some activities (kneeling, squatting deeply) may remain uncomfortable. High-impact sports are discouraged to preserve implant longevity.
Risks & Complications: What You Should Know
Knee replacement is very safe, but like all surgeries, it carries risks. Your surgeon will discuss these in detail during consultation.
Infection (1-2% risk)
Infection near the implant is rare but serious. Prevented through: antibiotic prophylaxis, sterile surgical technique, skin preparation. Treated with antibiotics; severe cases may require implant removal and two-stage revision.
Blood Clots / DVT (2-3% risk)
Deep vein thrombosis (clot in leg) or pulmonary embolism (clot to lungs). Prevented through: blood thinners, compression stockings, early mobilization. Risk is low with modern prophylaxis protocols.
Stiffness (<5% risk)
Some patients develop excessive scar tissue limiting knee bend. Prevented through: aggressive physiotherapy, early mobilization. Treated with: manipulation under anesthesia if needed.
Implant Loosening (1-2% in first 10 years)
Implant may loosen from bone over time due to wear or improper fixation. May require revision surgery. Modern implants and surgical techniques have significantly reduced this risk.
Nerve or Blood Vessel Injury (Rare <1%)
Structures around the knee can be damaged during surgery. Experienced surgeons take great care to protect these. Usually temporary if occurs.
💡 Minimizing Your Risk
Work with your surgical team to reduce complications:
- • Control chronic conditions (diabetes, blood pressure) before surgery
- • Stop smoking at least 4 weeks before (doubles infection risk)
- • Lose weight if overweight (reduces stress on implant, lowers infection risk)
- • Follow post-op instructions carefully (wound care, antibiotics, blood thinners)
- • Attend all physiotherapy sessions (prevents stiffness)
Recovery Timeline: Week by Week
Every patient recovers at their own pace, but here's a typical timeline for knee replacement in Singapore:
Walking with Assistance
Physical therapist helps you stand and take first steps. Pain managed with medication.
Hospital Discharge
Walking with walker or crutches. Go home with pain medication and rehabilitation plan.
Regaining Mobility
Begin outpatient physiotherapy 2-3x/week. Gradual reduction in pain medication. Walking improves daily.
Return to Normal Activities
Most daily activities resumed. Able to drive (if right knee, after 4-6 weeks). Continue physiotherapy.
Full Recovery
Return to work (desk jobs). Resume light exercise (walking, swimming, cycling). Near-complete recovery.
💪 Long-term outlook: Modern knee implants last 15-25 years. 85-90% of patients report significant pain relief and improved quality of life. Many wish they'd done it sooner.
Life After Knee Replacement: What to Expect Long-Term
Most patients report their new knee dramatically improves quality of life. Here's what your new normal looks like:
✅ Activities You CAN Do
Daily Living
- • Walking (unlimited distances)
- • Climbing stairs normally
- • Driving (after 4-6 weeks)
- • Traveling, flying
- • Gardening, household chores
Exercise & Recreation
- • Swimming, water aerobics
- • Cycling (stationary or outdoors)
- • Golf
- • Doubles tennis
- • Tai chi, yoga (modified poses)
- • Hiking on even terrain
- • Dancing (ballroom, social)
⚠️ Activities to Avoid or Limit
High-Impact Activities
- • Running/jogging (especially long distance)
- • Singles tennis
- • Basketball, football, contact sports
- • High-impact aerobics
- • Jumping, lunging exercises
Challenging Positions
- • Deep squatting (may be uncomfortable)
- • Kneeling (use knee pads if needed)
- • Prolonged sitting cross-legged
These activities put excessive stress on the implant and may shorten its lifespan. Discuss any specific activities with your surgeon.
💼 Returning to Work
Desk jobs: 4-6 weeks (may work from home earlier)
Light labor (teaching, retail): 8-12 weeks
Moderate labor (delivery, warehouse): 3-4 months
Heavy labor (construction, nursing): 4-6 months or job modification needed
🛡️ Protecting Your New Knee: Lifelong Care Tips
- • Tell dentists and doctors you have a knee replacement (may need antibiotics before dental work)
- • Maintain healthy weight to reduce stress on implant
- • Stay active with low-impact exercise to maintain muscle strength
- • Watch for warning signs: increased pain, swelling, warmth, fever (call surgeon immediately)
- • Attend follow-up appointments: Usually at 6 weeks, 3 months, 1 year, then annually
- • X-rays every 2-3 years to monitor implant condition
Frequently Asked Questions About Knee Replacement
Get answers to the most common questions from patients considering knee replacement surgery in Singapore.