Medical Capability Explainer
China’s Progress in Joint Replacement Surgery
What international patients should know about knee and hip replacement, robotic assistance, and recovery planning in China.
Updated
What the evidence shows
China has established knee and hip replacement services, published multicenter surgical studies, and approved domestically developed robotic technology. This gives international patients concrete evidence to consider when exploring treatment options. The most useful findings concern clinical experience, surgical positioning and organized recovery—not a promise that one country or technology will deliver the best result. Access to equipment, a hospital’s experience and suitability for an individual patient are separate questions. This guide explains what the evidence supports, where its limits matter, and what to clarify before requesting an assessment or arranging travel.
Why patients explore joint replacement abroad
Persistent joint pain can make walking, sleeping and ordinary daily activities difficult. Patients may explore other healthcare systems because of waiting lists, specialist access or uncertainty about treatment choices. OECD reporting documents substantial differences in elective hip replacement waiting times across countries. It does not establish how quickly a particular Chinese hospital can accept an international patient. [8]
Confidence should come from a clear diagnosis, a suitable operation and a team able to explain its results. Joint replacement aims to relieve pain and improve function; a single national ‘cure rate’ would conceal differences in procedures, patients and follow-up. Ask about outcomes in patients with needs similar to yours. [12]
Clinical experience, scale and affordability
A Chinese database study published in 2023 included 184,363 primary total knee replacements performed during 2013–2019. This is evidence of substantial clinical experience, not a count of all operations in a recent year. Hospital stay and charges varied with patient and hospital characteristics. [1]
A more recent official procurement report, dated May 2024, recorded over 1.1 million selected hip and knee implant sets used during two years of implementation. More than 6,000 hospitals joined the renewal procurement, with reported demand for 580,000 sets. These figures describe procurement and implant use, not a current annual surgical total. [11]
The same report found selected implant prices around 6% lower than in the first procurement round. This supports a specific affordability development within China’s system. It does not establish an international patient’s total bill, insurance eligibility or waiting time. Obtain a hospital-specific assessment and itemized estimate. [11]
Knee, hip and partial knee replacement
Total knee arthroplasty (TKA) resurfaces damaged joint surfaces with artificial components. Unicompartmental knee arthroplasty (UKA), or partial knee replacement, treats one compartment and may be considered when disease is limited to that area. Examination, imaging and the condition of the rest of the knee influence the choice. [12][13]
Total hip arthroplasty (THA) replaces damaged hip components with a prosthetic joint. A surgeon assesses symptoms, structural damage, previous treatment and general health before recommending an operation. These descriptions explain options; they cannot determine which procedure an individual needs. [14]
Revision surgery addresses an existing replacement that needs further surgery. Chinese research found revision knee procedures concentrated in higher-volume regions. Infection-related or repeatedly revised cases warrant particularly careful specialist and hospital selection, rather than a routine travel package. [10]
Robotic assistance: precision with perspective
Robotic systems can help surgeons translate a surgical plan into positioning and bone preparation. In July 2023, China’s NMPA announced approval of a knee replacement navigation positioning system using a six-degree-of-freedom robotic arm to assist adult total knee replacement. That approval concerns a specific device and intended use. [2]
A five-center Chinese trial randomized 134 patients and analyzed 127. The robotic group achieved better accuracy on some alignment measures, but operations took longer. At 90 days, the groups did not differ significantly in their KSS and WOMAC functional scores. More precise positioning does not automatically mean better long-term function or implant survival. [3]
A separate three-center hip replacement trial involving 145 participants found advantages in some radiographic measures. Its imaging findings should not be presented as proof of superior long-term recovery. [4] West China Hospital also reported domestic robot-assisted hip replacement in 2022—a concrete institutional example, not a guarantee of current access or a MedVoyage partnership. [7]
Recovery is part of the treatment
Enhanced Recovery After Surgery (ERAS) coordinates several aspects of perioperative care. A Chinese multicenter trial of 320 primary knee replacement patients, conducted in 2021–2023 and published in 2025, reported average total hospital stays of 5.92 days with its ERAS pathway and 8.17 days with usual care. These are study averages, not promised discharge dates. [5]
A 2026 retrospective Chinese study associated activity within 24 hours with some improved outcomes. Observational findings cannot prove causation; after matching, the hip group’s hospital-stay difference was not statistically significant. The clinical team should determine appropriate activity for each patient. [6]
Before travel, establish who will guide rehabilitation, monitor the wound, provide follow-up and respond to complications at home. Leaving hospital, completing rehabilitation and being fit to fly are different milestones. Keep the discharge summary, implant information and follow-up instructions available for the receiving clinician. [9]
Published safety outcomes: what the data show
A study published in 2023 analyzed 146,877 knee arthroplasty cases recorded in China's Hospital Quality Monitoring System during 2013–2019. After propensity score matching, the urban and rural groups each contained 36,482 patients. The following results describe those matched groups, not a current national rate or an individual international patient's predicted risk. [15]
| Reported outcome | Urban group (36,482 patients) | Rural group (36,482 patients) |
|---|---|---|
| In-hospital mortality | 5 (0.01%) | 12 (0.03%) |
| Pulmonary embolism | 58 (0.16%) | 60 (0.16%) |
| Deep vein thrombosis | 562 (1.54%) | 731 (2.00%) |
| Wound infection | 87 (0.24%) | 76 (0.21%) |
| Periprosthetic joint infection within 90 days | 52 (0.14%) | 38 (0.10%) |
| Red blood cell transfusion | 2,225 (6.10%) | 3,008 (8.25%) |
In-hospital mortality is not the same as death during surgery. These figures do not establish a cure rate, long-term implant survival or superiority over another country. Transfusion is a care requirement rather than, by itself, evidence of an error. Outcomes can overlap and percentages should not be added. Database reporting and follow-up can miss events; discuss the treating hospital's results and your own risk factors with the clinical team. [15]
Recovery experience also matters. The Chinese ERAS trial described above reported postoperative nausea and vomiting in 2.6% of its ERAS group versus 24.7% of its control group. This is a specific outcome from that trial, not the rate of all adverse events or a guarantee for every hospital. [5]
What international patients should evaluate
Ask the hospital which surgeon and team would review your case, what alternatives remain, which implant is proposed and how complications are managed. Discuss relevant experience and outcome information rather than relying on equipment names. Confirm language support, admission requirements and arrangements for a companion directly with the institution. [9]
People considering planned surgery or a second opinion can begin by organizing records. Existing infection, poorly controlled medical conditions, complex previous operations or difficulty arranging follow-up may change the plan. These require clinical assessment, not a website eligibility score. Urgent symptoms should be assessed locally rather than waiting for international travel. [9][14]
Costs, timing and travel
Request a written estimate distinguishing hospital care, the implant, rehabilitation, interpretation, accommodation and transport. Clarify what happens financially if the plan changes or complications extend your stay. Historical domestic hospital charges and procurement prices are not international treatment packages. Scheduling and the anticipated stay must be confirmed for your case. [1][11]
Surgery and prolonged air travel can both increase blood-clot risk. Discuss the return journey and prevention plan with the treating team; there is no universal flight date offered here. Arrange continuity of care before departure, including a clinician at home and access to records in a usable language. [9]
How MedVoyage China can help
MedVoyage China provides patient-side information and practical coordination: organizing non-clinical case information, communicating with institutions, coordinating requests and appointments, and supporting interpretation and travel arrangements. It can help you clarify the questions to take to a hospital. Licensed professionals remain responsible for diagnosis, treatment recommendations and surgical suitability.
Begin with your main question and the records already available. Confirm the appropriate private submission channel before sharing detailed medical information. Institutional acceptance, clinical costs and outcomes are not guaranteed. A coordinated next step should help you understand your options before making a travel decision.
Questions & answers
Is knee replacement available in China?
Yes. Chinese hospitals perform knee replacement, and published research includes a large database study of primary procedures. Availability alone does not establish which hospital is appropriate for you. Ask a qualified orthopedic team to review your diagnosis, previous treatments and general health before deciding whether surgery is warranted. [1][12]
Does China have robotic-assisted joint replacement?
Yes. China has approved a domestic knee replacement navigation positioning system, and Chinese teams have studied robotic-assisted knee and hip replacement. Availability depends on the hospital and procedure. Ask which system would be used, the team’s experience with it, and why it is relevant to your proposed operation. [2][3][4]
Is robotic surgery always better than conventional surgery?
No universal advantage is established by the studies discussed here. A Chinese knee trial found improvements in some alignment measures but longer operating time and no significant difference in two functional scores at 90 days. Discuss potential benefits, limitations and additional costs with the surgeon rather than choosing on technology alone. [3]
Can international patients explore treatment in China?
International patients can ask hospitals to assess their needs, but admission, records requirements, language support and scheduling must be confirmed individually. Clinical suitability and travel readiness also require professional review. Arrange a realistic rehabilitation and home follow-up plan before committing to treatment, with clear responsibilities if complications occur. [9]
How much does treatment cost, and how long will I need to stay?
Both depend on the proposed procedure, hospital, implant, health conditions and recovery plan. Request an itemized estimate and a provisional timeline after medical review. Procurement prices are not complete treatment prices, and hospital discharge does not mean full recovery or clearance for a long flight. Avoid booking an inflexible return journey. [9][11]
What should I prepare before requesting an initial evaluation?
Gather your diagnosis, imaging and reports, medication and allergy information, and previous operation records. Summarize symptoms, daily limitations and the question you want answered. Ask the receiving institution what formats and translations it needs. Share detailed records only through an agreed private channel, and retain copies for subsequent care. [9]
Explore your next step
Sources
- Chinese Medical Journal · 2023Length of stay and inpatient charges of total knee arthroplasty in China: analysis of a national database
- NMPA · 2023Knee Replacement Surgical Navigation Positioning System Approved for Marketing
- Chinese Journal of Reparative and Reconstructive Surgery · 2023A multicenter randomized controlled trial of domestic robot-assisted and conventional total knee arthroplasty
- Journal of Orthopaedic Surgery and Research · 2024Radiographic evaluation of robot-assisted versus manual total hip arthroplasty: a multicenter randomized controlled trial
- European Journal of Medical Research · 2025Reducing the length of hospital stay for patients undergoing primary total knee arthroplasty by application of enhanced recovery after surgery (ERAS) pathway: a multicenter, prospective, randomized controlled trial
- Frontiers in Medicine · 2026Early ambulation within 24 h after joint arthroplasty: a retrospective cohort study
- West China Hospital · 2022 · ChineseHospital report: Professor Zhou Zongke’s team performs domestic robot-assisted total hip replacement
- OECD · 2025Health at a Glance 2025 — Waiting times
- CDC Yellow Book · 2026 editionMedical Tourism
- Journal of Arthroplasty · 2023Burden and Characteristics of Revision Total Knee Arthroplasty in China: A National Study Based on Hospitalized Cases
- National Healthcare Security Administration · 21 May 2024 · ChineseArtificial-joint procurement renewal: prices remain stable or decline
- AAOS OrthoInfo · accessed 30 September 2026Total Knee Replacement
- AAOS OrthoInfo · accessed 30 September 2026Unicompartmental (Partial) Knee Replacement
- AAOS OrthoInfo · accessed 30 September 2026Total Hip Replacement
- International Journal of Surgery · 2023Rural-urban differences in characteristics, postoperative outcomes, and costs for patients undergoing knee arthroplasty: a national retrospective propensity score matched cohort study — Table 3, primary propensity-matched analysis; DOI: 10.1097/JS9.0000000000000494