title: Influence of sex on surgical time in primary total knee arthroplasty.
abstract: BACKGROUND
  Total knee arthroplasty (TKA) is widely recognized as an effective procedure for treatment of knee arthritis. However, there have been documented differences between men and women with respect to anatomic variability, timing of access to surgical care and surgical outcomes. We examined the influence of sex on the technical difficulty of TKA using a tourniquet and overall surgical time as a surrogate for complexity of exposure, soft-tissue balancing and implantation.
  
  
  METHODS
  We performed a retrospective database review of patients who underwent primary TKA over a 5-year period. Tourniquet time, wound closure time and surgical time from 54 consecutive men (58 knees) and 48 women (58 knees) who underwent primary cemented TKA were recorded.
  
  
  RESULTS
  The mean surgical time among men (108.2, standard deviation [SD] 17 min) was significantly longer than among women (96.8 [SD 14.8] min; p = 0.001). Similarly, the mean tourniquet time among men (75.9 [SD 11.7] min) was significantly longer than among women (65.9 [SD 11.8] min; p = 0.001).
  
  
  CONCLUSIONS
  Total knee arthroplasty in men requires more time than in women because of the complexity of exposure and to achieve the desired alignment of the components. Our data may allow a better resolution of surgery time planning, which could lead to better use of health system resources.
authors.affiliation: Mount Sinai Hospital, University of Toronto, Ont., Canada.
authors.forename: Yona
authors.initials: Y
authors.lastname: Kosashvili
authors.forename: Ian P
authors.initials: IP
authors.lastname: Mayne
authors.forename: Tom
authors.initials: T
authors.lastname: Trajkovski
authors.forename: Dror
authors.initials: D
authors.lastname: Lackstein
authors.forename: Oleg
authors.initials: O
authors.lastname: Safir
authors.forename: David
authors.initials: D
authors.lastname: Backstein
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome