What does this research mean for the field?

Total knee arthroplasty procedures in the United States are undergoing a dramatic shift toward outpatient delivery, with ambulatory surgery center volumes projected to exceed 2.1 million cases annually by 2040. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To model national volume trends for total knee arthroplasty across inpatient and outpatient care settings and forecast procedure growth through 2040.

September 14, 2026Journal of the American Academy of Orthopaedic Surgeons

Forecasting US Total Knee Arthroplasty Volumes to 2040: The Shift to Ambulatory Surgery Centers Has Just Begun

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Authors

PMPaul G. Mastrokostas LMLeonidas E. Mastrokostas DSDivya Sheth

Discussion

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Overview

Retrospective database study finds total knee arthroplasties shifting predominantly to ambulatory centers in US adults, indicating outpatient procedures will dominate volume by 2040.

Key Points

To model national volume trends for total knee arthroplasty across inpatient and outpatient care settings and forecast procedure growth through 2040.
Retrospective analysis of procedural data from the National Inpatient Sample and Nationwide Ambulatory Surgery Sample from 2016 to 2022.
Stratified procedures into inpatient overnight stay (length of stay ≥1 day), inpatient same-day discharge, and ambulatory surgical center (ASC) outpatient settings.
Modeled trends using survey-weighted regression and projected volumes through 2040 using negative binomial and autoregressive integrated moving average (ARIMA) modeling, while evaluating regional costs and payer shifts.
Between 2016 and 2022, inpatient TKA with stays ≥1 day declined by 85.0% and same-day inpatient discharge dropped by 46.7%, while ASC TKA procedures increased by 413.6% from 104,971 to 539,175 cases.
Forecasting models project annual ASC TKA volume will exceed 2.1 million procedures by 2040, led regionally by the South at an estimated 881,000 annual cases.
Medicare's proportion of ASC TKA cases rose from 42.5% in 2016 to 59.2% in 2022, with 2022 ASC charges ranging from $50,200 in the Midwest to $74,123 in the West.

Cite This Study

Mastrokostas et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b2e10926e14a848b17eb https://doi.org/10.5435/jaaos-d-26-00047

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September 14, 2026Journal of the American Academy of Orthopaedic Surgeons

Forecasting US Total Knee Arthroplasty Volumes to 2040: The Shift to Ambulatory Surgery Centers Has Just Begun

View Full Paper

Ask AI

Bookmark

Authors

PMPaul G. Mastrokostas LMLeonidas E. Mastrokostas DSDivya Sheth

Discussion

Member takes

Overview

Retrospective database study finds total knee arthroplasties shifting predominantly to ambulatory centers in US adults, indicating outpatient procedures will dominate volume by 2040.

Key Points

To model national volume trends for total knee arthroplasty across inpatient and outpatient care settings and forecast procedure growth through 2040.
Retrospective analysis of procedural data from the National Inpatient Sample and Nationwide Ambulatory Surgery Sample from 2016 to 2022.
Stratified procedures into inpatient overnight stay (length of stay ≥1 day), inpatient same-day discharge, and ambulatory surgical center (ASC) outpatient settings.
Modeled trends using survey-weighted regression and projected volumes through 2040 using negative binomial and autoregressive integrated moving average (ARIMA) modeling, while evaluating regional costs and payer shifts.
Between 2016 and 2022, inpatient TKA with stays ≥1 day declined by 85.0% and same-day inpatient discharge dropped by 46.7%, while ASC TKA procedures increased by 413.6% from 104,971 to 539,175 cases.
Forecasting models project annual ASC TKA volume will exceed 2.1 million procedures by 2040, led regionally by the South at an estimated 881,000 annual cases.
Medicare's proportion of ASC TKA cases rose from 42.5% in 2016 to 59.2% in 2022, with 2022 ASC charges ranging from $50,200 in the Midwest to $74,123 in the West.

Cite This Study

Mastrokostas et al. (2026) studied this question.

synapsesocial.com/papers/6aa7b2e10926e14a848b17eb https://doi.org/10.5435/jaaos-d-26-00047

View Full Paper

Ask AI

Bookmark