HSS Study Challenges Surgeon Volume Paradigm in Knee Replacement Infections

Event summary

  • HSS study analyzed 33,747 total knee arthroplasty (TKA) procedures from 2018–2024, finding no significant infection rate differences across surgeon volume groups.
  • Infection rates ranged from 0.1% to 0.3% across low-, high-, and ultra-high-volume surgeons, all below national averages.
  • Study presented at AAOS 2026 Annual Meeting challenges conventional wisdom linking surgeon volume to infection outcomes.
  • HSS attributes low rates to institutional factors like robust infection prevention programs and state-of-the-art facilities.

The big picture

The study underscores the growing importance of institutional systems in orthopedic outcomes, challenging the historical focus on individual surgeon experience. As TKA volumes continue rising, this could reshape credentialing standards and payer contracting strategies. HSS's model—combining high procedural volume with rigorous infection control—may become a benchmark for specialty hospitals.

What we're watching

Institutional vs. Individual Factors
Whether HSS's findings will prompt other high-volume centers to re-evaluate their surgeon volume policies.
Regulatory Impact
How NHSN and similar bodies may adjust infection prevention guidelines based on institutional performance data.
Market Differentiation
The pace at which orthopedic centers emphasize institutional infrastructure in marketing and quality metrics.