By the late 2020s New Zealand will have more than 1 million people aged over 65. It is predicted that will lead to 84 percent more hip replacements - and for knee replacements, a 183 percent increase.
A University of Otago report, published in the New Zealand Medical Journal today, said the country would need about 80 more orthopaedic surgeons by 2026 to cope.
Head researcher Gary Hooper said that was just the beginning.
"When you increase the surgeons you will need to increase the infrastructure," he said.
He said peoples' weight played a part in the increase in surgeries as well.
"Obesity is directly proportional to osteoarthritis of the knee and we're seeing a significant increase in knee replacements performed in New Zealand."
The Association of Salaried Medical Specialists' executive director, Ian Powell, said there was already a shortage of surgeons in every speciality.
He believed filling the 80 surgeon gap would be tough.
"You just don't get orthopaedic surgeons overnight," he said.
"What it requires is longer term planning. Planning in terms of not just training more... but also keeping them in the country... and being more effective in recruiting internationally as well."
The New Zealand Orthopaedic Association did not think there was a problem yet.
President-elect, Brett Krause, said the number of orthopaedic surgeons had gone from 195 in 2010 to 234 last year.
But he agreed down the line there would be a serious problem with under resourcing.
"It can't just be a matter of increasing the number of orthopaedic surgeons, although obviously that will be a part of it," he said.
"It needs a co-ordinated approach and it needs better planning for the future because it is undoubtedly going to be a problem."