Orthopedic surgery is a medical specialty focused on the diagnosis and treatment of conditions affecting the musculoskeletal system, which includes the bones, joints, ligaments, tendons, muscles, and nerves. These interventions range from minor procedures to complex, reconstructive operations. Every year, millions of procedures are performed across the United States to restore mobility and alleviate pain, reflecting the high prevalence of joint and bone issues. To understand the landscape of this field, it is helpful to look at which procedures account for the highest volume of surgical activity annually.
The Procedure Holding the Top Spot
When looking at the sheer number of procedures, some simple, non-operative interventions, such as joint aspiration and injection, technically occur most frequently. However, when focusing on major, reconstructive operations that involve replacing joint surfaces, Total Knee Arthroplasty (TKA), or total knee replacement, is the most common procedure. Physicians perform this surgery to treat severe knee pain and disability, most often caused by advanced osteoarthritis. The annual volume of TKAs in the U.S. approaches 800,000, with projections indicating a substantial increase in demand over the next decade.
The procedure involves removing the damaged cartilage and bone from the thighbone (femur), shinbone (tibia), and sometimes the kneecap (patella). These surfaces are then resurfaced with prosthetic components, typically made of metal alloys and high-grade plastic. The primary goal of this intervention is to eliminate the bone-on-bone friction that causes chronic pain and to restore functional alignment of the joint. The typical patient demographic for TKA is individuals over the age of 55, although younger patients with conditions like rheumatoid arthritis or post-traumatic arthritis are also candidates.
Contextualizing High Surgical Frequency
The high volume of orthopedic procedures, especially joint replacements, is driven by several interconnected factors. The most significant factor is the rapid aging of the population, which increases the number of people living long enough to develop degenerative joint diseases. As people live longer, the cumulative wear and tear on major load-bearing joints, like the knee and hip, necessitates intervention. For example, nearly half of American adults will develop knee osteoarthritis in at least one knee during their lifetime.
The increasing prevalence of chronic conditions, such as obesity, also contributes substantially to the demand for joint surgery. Excess body weight places greater mechanical stress on the joints, accelerating the deterioration of cartilage and leading to more severe osteoarthritis. Furthermore, advancements in surgical technology and implant materials have made TKA and other procedures safer and more durable, expanding the pool of eligible patients. These technological improvements, coupled with a societal emphasis on maintaining an active lifestyle, have raised patient expectations for pain-free mobility, prompting more individuals to seek surgical solutions.
The Next Most Frequent Orthopedic Interventions
Beyond total knee replacement, several other orthopedic procedures are performed with high frequency, contributing significantly to musculoskeletal care. Total Hip Arthroplasty (THA), or total hip replacement, ranks just behind TKA in volume among major joint reconstruction surgeries. This procedure addresses debilitating hip pain, usually from osteoarthritis or avascular necrosis, by replacing the damaged ball-and-socket joint with prosthetic components. THA is highly effective at reducing pain and improving function, and its demand is also projected to grow substantially.
Another highly common category is arthroscopic surgery, a minimally invasive technique used across various joints, with the knee and shoulder being the most frequent sites. This procedure involves inserting a small camera and instruments through tiny incisions to diagnose and repair issues inside a joint. Knee arthroscopy is often performed to repair a torn meniscus or damaged ligaments like the anterior cruciate ligament (ACL), while shoulder arthroscopy is commonly used for rotator cuff repair or to treat shoulder instability. The minimally invasive nature of arthroscopy allows for smaller incisions and generally quicker recovery times compared to traditional open surgery.
Finally, the surgical treatment of fractures remains a consistently high-volume area within orthopedics, particularly extremity fracture repair. These operations involve fixing broken bones, often using plates, screws, rods, or pins to stabilize the fragments and ensure proper alignment for healing. Fracture repair volume is high due to the constant occurrence of traumatic injuries from sports, falls, and accidents across all age groups.