“…Centralization of complex orthopaedic elective services within the UK was piloted in 2015, 14 with more recent studies from the British Association for Surgery of the Knee (BASK) providing an exploratory analysis and hypothetical models of case redistribution in a network reconfiguration. 15 Despite these early steps, or perhaps, in part, because of some of the methods employed, this arthroplasty network is yet to come to fruition. Evidence of the need for change is strong; there has been exponential growth in waiting lists without resolution, 9 and there is potential for improvement in patient outcomes, collaborative research opportunities, and dissemination of best practice.…”