Abstract
A long surgical procedure length has been well associated with worse clinical outcomes, also in an economic climate where in the theatre, time is money, surgical procedures are done very rapidly. Few studies have documented the clinical outcomes of procedure speed.
Using the New Zealand Registry we reviewed the operation time of 41,560 primary knee joint replacements. These were split into groups of time slots for the surgery from less than 40 minutes, 40–59, 60–89, 90–119, 120–179 and greater than 180mins. This was referenced to the oxford knee scores obtained and the revision rate.
For operations done in less than 40 or greater than 180 minutes, the oxford knee score was lower by 5 years. The revision rate was also increased in these same groups.
Operations done in greater than 180 minutes are generally the more complex non-osteoarthrtic and tumour cases and have a higher revision rate reflecting their complexity. Procedures done less than 40 minutes are more straight forward, but there is a relationship shown between this speed and revision rate and poorer outcome. The cause is likely multifactorial, but begs the question, does speed kill?
