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Changes in Trends of Shoulder and Knee Arthroscopy Because of the COVID-19 Pandemic

J Am Acad Orthop Surg Glob Res Rev. 2026 Feb 11;10(2). doi: 10.5435/JAAOSGlobal-D-25-00178. eCollection 2026 Feb 1.

ABSTRACT

PURPOSE: The purpose of this study was to analyze national trends in knee and shoulder arthroscopy to identify seasonal and annual variability using the Healthcare Cost and Utilization Project-Nationwide Ambulatory Surgery Sample (HCUP-NASS) dataset.

METHODS: Estimated national rates of ambulatory knee and shoulder arthroscopy were analyzed using HCUP-NASS data from 2016 to 2021. Time trend plots were generated to identify potential seasonal trends in these procedures.

RESULTS: There was a decreasing trend in the number of procedures (shoulder arthroscopy, rotator cuff repair [RCR], knee arthroscopy, meniscal repair [MR]/meniscectomy, and anterior cruciate ligament reconstruction [ACLR]) done from 2016 to 2021. There were an estimated 264,987 (95% confidence interval [CI] = 251,205 to 276,770) patients who underwent shoulder arthroscopy and 381,125 (95% CI = 362,555 to 399,696) patients who underwent knee arthroscopy in 2021, as compared with 345,892 (95% CI = 326,224 to 365,559) patients who underwent shoulder arthroscopy and 521,912 (95% CI = 496,905 to 546,919) patients who underwent knee arthroscopy in 2016. Male patients showed markedly higher rates of shoulder arthroscopy, RCR, knee arthroscopy, MR, and ACLR procedures as compared with female patients, whereas female patients showed markedly higher rates of knee arthroscopy done without MR and ACLR. Shoulder and knee arthroscopy rates peaked in the 55 to 75-year-old age group. In addition, both procedures were most frequently done in December and had the lowest utilization in the month of July.

CONCLUSION: There was a nonlinear decrease in the estimates of shoulder arthroscopy, RCR, MR/meniscectomy, knee arthroscopy, and anterior cruciate ligament reconstruction procedures from 2016 to 2021, with peaks in 2016 and 2019, and a low point in 2020. There are notable variations in rates of knee and shoulder arthroscopy procedures by age and sex.

CLINICAL RELEVANCE: Recent data on commonly done ambulatory orthopaedic arthroscopies are important for policy makers and for understanding utilization trends.

PMID:41678780 | DOI:10.5435/JAAOSGlobal-D-25-00178

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