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. © 2014 Elsevier Inc.