Lean management in total knee arthroplasty: A model for efficiency and value-based care

With rising procedure volumes, cost pressures, and shorter hospital stays, the application of Lean management principles offer substantial promise for the pathway of total knee arthroplasty (TKA). This editorial outlines how Lean and Lean Six Sigma methodologies can be applied to TKA-covering pre-operative pathway standardisation, intra-operative workflow optimisation, implant and instrument logistics, and post-operative care. Evidence shows that process redesign can reduce length of stay, time in the operating room, cancellations, and wasted resources. Key success factors, barriers, future directions and limitations are highlighted, with particular relevance for high-volume arthroplasty centres and revision scenarios. The concept is positioned as a model for clinical innovation in arthroplasty services, aligning with the ambitions of value-based care.