Surgeon Mean Operative Times in Total Knee Arthroplasty in a Variety of Settings in a Health System

Khanuja, Harpal S.; Solano, Mitchell A.; Sterling, Robert S.; Oni, Julius K.; Chaudhry, Yash P.; Jones, Lynne C.

doi:10.1016/j.arth.2019.06.029

Cited by 15 publications

(14 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They did not comment on the differences in total OR time. 9 Similarly to our findings, their fastest total OR times were at their highest volume institution, which in their case was a community hospital. A major difference of their studied compared with our study is that they did not have an orthopaedic specialty hospital as their main academic center.…”

Section: Discussionsupporting

confidence: 85%

An Academic Orthopaedic Specialty Hospital Provides the Shortest Operative Times within a Single Health System for Primary and Revision Total Knee Arthroplasty

et al. 2020

View full text Add to dashboard Cite

The study aimed to optimize value-based health care practices in total joint arthroplasty (TJA), and we need to understand how the surgical setting can influence efficiency of care. While this has previously been investigated, the purpose of this study was to clarify if these findings are generalizable to an institution with an orthopaedic specialty hospital. A retrospective review was conducted of 6,913 patients who underwent primary or revision total knee arthroplasty (TKA) at one of four hospitals within a single, urban, and academic health system: a high volume academic (HVA) hospital, a low volume academic (LVA) hospital, a high volume community (HVC) hospital, or a low volume community (LVC) hospital. Patient demographics were collected in an arthroplasty database, as were operating room (OR) times and several specific time points during the surgery. The HVA (orthopaedic specialty) hospital had the shortest total primary TKA OR times and the LVC that had the longest times (156.69 vs. 174.68, p < 0.0001). The HVA hospital had the shortest total revision TKA OR times, and the LVC had the longest times (158.20 vs. 184.95, p < 0.0001). In our health system, the HVA orthoapedic specialty hospital had the shortest overall OR time, even when compared with the HVC hospital. This is in contradistinction to prior findings that HVC institutions had the shortest OR times in a health system that did not have an orthopaedic specialty hospital. This provides evidence that an orthopaedic specialty hospital can be a model for efficient care, even at an academic teaching institution.

show abstract

Section: Discussionsupporting

confidence: 85%

An Academic Orthopaedic Specialty Hospital Provides the Shortest Operative Times within a Single Health System for Primary and Revision Total Knee Arthroplasty

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In a recent study by Khanuja et al, the authors found that the community hospitals in their hospital system had significantly faster operating room time compared with tertiary academic hospitals. 15 Contrary to previous findings, their study did not find that surgeon volume had any impact on surgical time. [16][17][18] However, a main limitation of their study is that in their hospital system, the community hospital functioned as a pseudo-specialty hospital potentially increasing its efficiency in comparison to the academic hospitals.…”

contrasting

confidence: 76%

“…While a recent study has shown that a pseudo-specialized community hospital in a single health system had shorter operative times for total knee arthroplasty (TKA), we sought to determine if these findings were translatable to THA performed at our institution. 15 In the present study, we examined the differences in surgical times for primary and revision THA between four medical centers of varying operative volume. For primary THA, the HVA center had statistically lower total OR and incision times in comparison to all of the other sites included in this study, most notably the HVC and LVC sites.…”

Section: Discussionmentioning

confidence: 99%

“…For hospital systems without an orthopedic hospital, community hospitals may in fact be more efficient than the academic hospital such as seen in the study by Khanuja et al, where they function as a pseudo-specialty hospital. 15 Perhaps more important than the surgery location, the creation of specialized orthopedic teams who have familiarity with implants, equipment, and arthroplasty protocols allow for more efficient operative times.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A High-Volume, Academic Orthopedic Specialty Hospital Provides the Shortest Operative Times in Total Hip Arthroplasty

Zak

Bernstein

Tang

et al. 2021

The Journal of Hip Surgery

View full text Add to dashboard Cite

Operative time is a potential modifiable target for reducing cost and optimizing efficiency in total hip arthroplasty (THA). Shorter operative times are associated with decreased costs and complications. One proposed solution for reducing operating room (OR) times is to preferentially perform THAs at a higher volume center. The purpose of this study is to investigate the impact of different hospital settings on mean operative time in THA. A retrospective analysis of 7,694 consecutive primary and revision THA cases across four different hospitals was conducted. The hospitals reviewed in this study include a high-volume academic (HVA) orthopedic hospital, a large tertiary, low-volume academic (LVA) center, a high-volume community (HVC) hospital, and a low-volume community (LVC) hospital. Operative times, patient baseline demographics, and procedure classification (inpatient vs. outpatient) were collected. For primary THA, the HVA hospital maintained the statistically lowest total OR times followed by the HVC hospital (155.96 vs. 167.27 minutes, p < 0.0001). The LVC and HVC centers had similar total OR times (175.48 vs. 167.27 minutes, p = 0.578). For revision THA, the LVC center had the shortest total OR time followed by the HVA, LVA, and HVC sites (194.85 vs. 224.69 vs. 244.07 vs. 279.54 minutes). However, there were a larger amount of revision cases performed at our HVA sites than our community hospitals (523 vs. 123 cases). Our HVA hospital specialized in orthopedic care experiences shorter primary THA OR times than community hospitals. These findings suggest that in addition to hospital volume, factors such as specialized staffing, standardized OR protocols, and additional resources affect operative times, making HVA centers better equipped to handle primary THA.

show abstract

“…Other studies found that surgeon experience has an impact on the operating time, without exact prediction of this difference. 23 Cases that are considered complex tKas are usually due to high Bmi or the presence of complex deformities. several studies have demonstrated a relationship between operating time and risk of perioperative complications due to high Bmi.…”

Section: Discussionmentioning

confidence: 99%

Predicting robotic-assisted total knee arthroplasty operating time

et al. 2022

View full text Add to dashboard Cite

Aims No predictive model has been published to forecast operating time for total knee arthroplasty (TKA). The aims of this study were to design and validate a predictive model to estimate operating time for robotic-assisted TKA based on demographic data, and evaluate the added predictive power of CT scan-based predictors and their impact on the accuracy of the predictive model. Methods A retrospective study was conducted on 1,061 TKAs performed from January 2016 to December 2019 with an image-based robotic-assisted system. Demographic data included age, sex, height, and weight. The femoral and tibial mechanical axis and the osteophyte volume were calculated from CT scans. These inputs were used to develop a predictive model aimed to predict operating time based on demographic data only, and demographic and 3D patient anatomy data. Results The key factors for predicting operating time were the surgeon and patient weight, followed by 12 anatomical parameters derived from CT scans. The predictive model based only on demographic data showed that 90% of predictions were within 15 minutes of actual operating time, with 73% within ten minutes. The predictive model including demographic data and CT scans showed that 94% of predictions were within 15 minutes of actual operating time and 88% within ten minutes. Conclusion The primary factors for predicting robotic-assisted TKA operating time were surgeon, patient weight, and osteophyte volume. This study demonstrates that incorporating 3D patient-specific data can improve operating time predictions models, which may lead to improved operating room planning and efficiency. Cite this article: Bone Jt Open 2022;3(5):383–389.

show abstract

Surgeon Mean Operative Times in Total Knee Arthroplasty in a Variety of Settings in a Health System

Cited by 15 publications

References 16 publications

An Academic Orthopaedic Specialty Hospital Provides the Shortest Operative Times within a Single Health System for Primary and Revision Total Knee Arthroplasty

An Academic Orthopaedic Specialty Hospital Provides the Shortest Operative Times within a Single Health System for Primary and Revision Total Knee Arthroplasty

A High-Volume, Academic Orthopedic Specialty Hospital Provides the Shortest Operative Times in Total Hip Arthroplasty

Predicting robotic-assisted total knee arthroplasty operating time

Contact Info

Product

Resources

About