Primary hip and knee replacement has moved toward shorter stays and recovery at home. Revision surgery hasn’t kept pace, according to the American Joint Replacement Registry’s 2026 annual report, released Nov. 5 by the American Academy of Orthopaedic Surgeons.
The report covers more than 5.2 million hip and knee procedures performed from 2012 through 2025.
Infection has become a larger part of revision work. It accounted for 26.6% of hip revisions in 2025, up from 11.8% in 2012, and has held at about 26% since 2022. The registry said the trend may reflect changes in which sites report data and improvements in data quality, rather than a true rise in infections after hip replacement.
Revision patients also haven’t shifted home the way primary patients have. About 92% of elective primary hip replacement patients were discharged home in 2025, compared with 66% of revision hip patients. That share has stayed at about two-thirds for most of the study period. Discharge to a skilled nursing facility after hip revision fell from 28.9% in 2012 to 23.6% in 2025.
Repeat revisions remain a risk, especially for younger seniors. Among Medicare patients who had a knee revision, cumulative re-revision at 12 years was 14.39% for patients ages 65 to 74, 11.39% for ages 75 to 84 and 8.53% for those 85 and older. Infection was the most common diagnosis in knee re-revisions, recorded in 41.2% of 27,244 procedures.
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