Thanks. She actually has not been complaining much about her back in some weeks. She has this set of exercises she does every day, and I think with the steroid injection, it is helping. By the way, I sent out emails to a number of reference names I got from various "medical tourism" sites, and I have received answers from several people now who had their knees replaced in either Costa Rica or Mexico. I decided to forget about India. By the time you figure in the air fares it's just as cheap to go to Central America and it's a whole lot closer to home. Got this one this morning: "It has now been two years since my knee replacement in Puerto Vallarta, Mexico. I am now 52 years old and have had a wonderful experience without pain. Here is some information for you. My doctor was Dr. Max Grieg. He is a German doctor who lives in Puerto Vallarta. He speaks fluent German, Spanish and English and is a terrific guy. Google his name and you should get his website. My cost two years ago was roughly $12,600.00 (US$). This included the surgery, 3 day hospital stay, prosthesis (Zimmer), 6 days of rehab and medications. Since I was unable to fly back to the states right away, I made it a little two week vacation and had a terrific experience. This does not include flight and hotel. My advice to you is to have a company like MedToGo set up the whole thing for you. They not only have qualified doctors like Dr Grieg in Puerto Vallarta in their network but also several other doctors and cities in Mexico that you may be interested in. Talk to Bobby Page at the company. He handles everything and is a great guy. Their website is www.medtogo.com. I hope it works out for you. Thanks for writing. Mark Sawko" I know most of the people here have med insurance that covers all this in their home country, but I thought I would mention my investigations into this for those who have insurance problems. Costa Rica, around $ 10.5K. Mexico, around $ 12.5K. Thats real good stuff to know if you are paying for it yourself.