Report Overview
The U.S. orthopedic ambulatory surgery center market size was valued at USD 10.1 billion in 2022 and is expected to expand at a compound annual growth rate (CAGR) of 4.61% from 2023 to 2030. The growth can be attributed to the lower cost of orthopedic surgeries in ambulatory surgery centers (ASCs) and rising investment in orthopedic ASCs. As per research conducted by the Rothman Orthopaedic Institute based in Philadelphia, and Hospital for Special Surgery based in New York, treatment in ASCs costs around 40% less compared to hospital-based outpatient departments. The number of outpatient orthopedic surgical procedures undertaken at ambulatory surgery centers (ASCs) has significantly increased in the past few years. The growing demand can be attributed to the lower cost of treatment at these centers for orthopedic surgeries. According to the study published in PubMed in March 2022, among 990,980 outpatient orthopedic surgeries performed from 2013 to 2018, the ASCs utilization rate increased from 31% to 34% for all the orthopedic procedures with a CAGR of 3.3% for lumbar microdiscectomy, 1.4% for anterior cruciate ligament, 1.8% for knee arthroscopy, 1.4% of carpal tunnel release, 1.2% for the repair of the arthroscopic rotator cuff, and 0.5% for the repair of the bunion.
Medical device vendors such as orthopedic & spine companies and DME manufacturers are suppliers of orthopedic ASCs. With the growing preference and patient shift to ASCs, medical device manufacturers are launching various platforms & programs to transition their pricing and offers in line with customers. Hence, many companies are entering into the supplier business to offer services to orthopedic ASCs. For instance, in 2020, Stryker launched an ASC-focused business segment with around 13,990 products and around 22 product categories that specifically meet the demand for outpatient orthopedic surgery centers.
The number of ASCs is rapidly growing with the continuous shift of cases from Hospital-based Outpatient Departments (HOPDs) to ASCs. This growth can be attributed to several factors including the increased movement of cases from HOPDs to ASCs owing to better patient outcomes, higher patient safety, cost-effectiveness, and profitability. The shift is majorly observed in orthopedic surgeries including knee replacements and elective hip surgeries. According to a research article, more than 50% of joint replacement surgeries would be performed in ASCs by 2030. Hence, the number of ASCs offering orthopedic services is increasing in the U.S.
The COVID-19 pandemic led to the halt of nonurgent orthopedic procedures at ASCs. In March 2021, CMS, CDC, the American College of Surgeons, and the Ambulatory Surgery Center Association issued guidelines to postpone elective surgeries to reduce exposure to the virus. Moreover, the pandemic led to staff burnout and attrition, which has created a shortage of staff in the U.S. As per the 2021 OR Manager Salary/Career Survey, around 49% of ASCs reported open positions for registered nurses, which is double in number compared to 2020.
Procedure Insights
Based on procedure, the U.S. orthopedic ASC market has been segmented into ACL reconstruction, knee replacement, hip replacement, shoulder replacement, arthroscopy, foot & ankle, fracture repair, and others. The fracture repair segment accounted for the largest market share of 37.1% in 2022. This can be attributed to the growing cases of fractures in the U.S. and the low cost of treatment for fracture repairs in Ambulatory Surgery Centers (ASCs) compared to Hospital-based Outpatient Departments (HOPDs). Hence, fracture repair is shifting from hospital settings to orthopedic ASCs. As per the article published in ScienceDirect in 2019, around 6.3 million fractures occur in the U.S. and are treated each year.
Moreover, ankle fractures are the most common injuries in the U.S., accounting for around 10% of the total fractures annually in the country. As per the article published in the Sage journal in October 2022, the outpatient ankle fracture repair performed at ASCs cost around USD 12,315 compared to USD 35,944 in HOPDs and around USD 96,697 in hospital inpatient settings.
The knee replacement segment is expected to witness the fastest growth during the forecast period, owing to the migration of knee replacement patients from inpatient hospital settings to cost-effective ASCs & HOPDs. Other factors driving this segment are the changing reimbursement scenario for knee replacement surgeries in the U.S., focusing more on orthopedic ASCs.
The CMS payment updates shifted joint replacements toward ASC and outpatient settings, and studies demonstrated that the procedure can be performed safely in ASCs. There are more than 500 ASCs in the U.S. that perform total joint replacements, and there are 50 ASC facilities in California. With 42 ASC-equipped institutions, Florida is in 2nd place, followed by Maryland and Texas, each of which has 32 facilities capable of performing total joint replacements.
Key Companies & Market Share Insights
The U.S. orthopedic ambulatory surgery center industry is moderately fragmented and key players are adopting several strategies, including the launch of new centers and raising funds from investors, to strengthen their position in the market. For instance, in May 2022, Academy Orthopedics L.L.C. opened a new facility in northern New Jersey. Some prominent players in the U.S. orthopedic ambulatory surgery center market include:
Spectrum Orthopedics
Academy Orthopedics L.L.C.
Upstate Orthopedics Ambulatory Surgery Center
Washington Orthopedic Center
Southern California Orthopedic Institute
ProOrtho
Texas Health Orthopedic Surgery Center
Columbia Orthopedic Surgery Center
Chatham Orthopedic Surgery Center
The Orthopedic Surgery Center Of Arizona
HealthPartners
Specialty Orthopedics