title: Does speed matter? Revision rates and functional outcomes in TKA in relation to duration of surgery.
abstract: Longer operative times may be required in complex total knee arthroplasty (TKA), however little is known about outcomes in procedures performed rapidly. We analysed 58,009 primary TKAs from the New Zealand National Joint Registry. The mean surgical duration was 89 minutes, and 50% of procedures lasted between 60 and 89 minutes. There was no difference in adjusted revision rates for groups lasting between 40 and 120 minutes, however procedures lasting >120 minutes had significantly higher revision rates. There was a higher revision rate in TKAs lasting <40 minutes (0.71 vs 0.48 revisions per 100 component years) but this was not statistically significant (P = 0.1). For primary TKAs lasting less than 120 minutes, further shortening operative time did not improve outcome, and very rapid procedures (<40 minutes) may lead to an increased risk of revision.
authors.affiliation: Department of Orthopaedics, North Shore Hospital, Auckland, New Zealand.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Young
authors.affiliation: Department of Orthopaedics, North Shore Hospital, Auckland, New Zealand.
authors.forename: John
authors.initials: J
authors.lastname: Mutu-Grigg
authors.affiliation: University of Otago, Christchurch, New Zealand.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Frampton
authors.affiliation: Department of Orthopaedics, North Shore Hospital, Auckland, New Zealand.
authors.forename: John
authors.initials: J
authors.lastname: Cullen
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012042:Registries; D012086:Reoperation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: TKA; duration of surgery; total knee arthroplasty