Costly Surgeries vs. At-Home Physical Therapy: A Path to Major Savings in Joint Care

By RaeAnn Grossman
Costly Surgeries vs. At-Home Physical Therapy: A Path to Major Savings in Joint Care

Executive Summary

The U.S. healthcare industry is witnessing a significant surge in joint replacement surgeries such as Total Knee Replacement (TKR) and Total Hip Replacement (THR). However, a substantial portion of these surgeries could be averted through a more proactive approach, such as at-home physical therapy. By diverting 1,000 potential surgeries to physical therapy per month, Luna Physical Therapy anticipates savings of at least $1.8 billion over five years, reducing hospital visits, and improving patient quality of life.

The Problem

TKR and THR surgeries, while necessary in certain cases, can range from $30,000 to $120,000 in cost, placing a considerable economic burden on the healthcare system and the patients. By 2030, the projected growth rates for THR and TKR surgeries are 171% and 189% respectively. Compounding the problem is the fact that 14.9% of patients visit the emergency department within 30 days of a total joint replacement surgery, 99% of whom could have been treated in a doctor’s office.

Proposed Solution

Conservative approaches such as at-home physical therapy offer a cost-effective and convenient alternative to surgery for many patients. It assists in managing joint pain, enhancing mobility, and can delay or eliminate the need for surgery, thus decreasing the overwhelming financial strain on the healthcare system and improving patient outcomes.

The cost of physical therapy is significantly lower than the cost of surgery. With our proposed shift of 1,000 surgeries per month to at-home physical therapy, we predict a substantial $1.8 billion reduction or more in healthcare costs over five years.

Evidence Supporting Physical Therapy Over Surgery

Approximately one-third of knee replacements in the U.S. are avoidable, as per a study in the "Arthritis & Rheumatology" journal.

A study in the New England Journal of Medicine discovered that patients with meniscal tears and osteoarthritis who received physical therapy had similar functional outcomes after six and twelve months as those who had undergone surgery.

According to another study in the New England Journal of Medicine, physical therapy combined with supervised exercises can decrease pain and improve physical functioning in patients with knee osteoarthritis.

Quality of Life Considerations and Convenience

At-home physical therapy provides patients with enhanced quality of life. It doesn’t require a significant recovery period, reduces the risk of complications, and can increase patients' physical functionality and self-reliance. Additionally, offering this service at home is especially convenient for patients, eliminating the need to travel for therapy, thus saving time, and ensuring adherence to care.


Given the financial savings, improvement in patient quality of life, convenience, and reduction in hospital visits, a shift toward using at-home physical therapy as a primary intervention for joint issues presents a compelling case.

Key References:

  • Total Joint Replacement: A Breakdown of Costs -
  • Forecasted growth in THR and TKR surgeries -
    Factors associated with emergency department presentation after total joint arthroplasty - CMAJ Open.
  • Determining the need for hip and knee arthroplasty - Arthritis & Rheumatology.
  • Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis - New England Journal of Medicine.
  • Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain - Journal of the American Physical Therapy Association.