Related Experiment Video
Updated: Jun 29, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Patient, hospital, and procedure characteristics influencing total hip and knee arthroplasty procedure duration
Kevin Ong1, Edmund Lau, Michael Manley
1Exponent, Inc, Philadelphia, Pennsylvania, USA.
Insights
Procedure duration for total hip arthroplasty (THA) and total knee arthroplasty (TKA) decreased over time. Higher hospital and surgeon volume correlated with shorter procedure times for these joint replacement surgeries.
Area of Science:
- Orthopedic Surgery
- Health Services Research
- Medical Informatics
Background:
- Procedure duration is a recognized risk factor for complications in total hip arthroplasty (THA) and total knee arthroplasty (TKA).
- Limited data exists on the trends and influencing factors of THA and TKA procedure duration within the United States.
Purpose of the Study:
- To identify patient, hospital, and procedural characteristics affecting the duration of THA and TKA.
- To establish baseline data on procedure duration trends in the U.S. for future outcome analysis.
Main Methods:
- Analysis of Medicare claims data from 1997 to 2004.
- Determination of factors influencing procedure duration for primary THA and TKA.
Main Results:
- Median procedure duration for THA decreased from 171.0 to 142.5 minutes; for TKA, from 160.5 to 138.0 minutes (1997-2004).
- Increased hospital and surgeon volume was associated with shorter procedure durations for both THA and TKA.
- Younger patients, males, those without osteoarthritis, and patients with more comorbidities experienced longer procedures. Larger hospitals (>500 beds) had longer procedures, while nonprofit hospitals had shorter ones.
Conclusions:
- Significant reductions in THA and TKA procedure times were observed between 1997 and 2004.
- Hospital and surgeon volume are key factors in optimizing procedure duration for joint replacements.
- Patient and hospital characteristics influence procedure length, providing critical baseline data for outcome research.
Abstract:
Procedure duration is a potential risk factor for total hip arthroplasty (THA) and total knee arthroplasty (TKA) complications. Presently, limited information regarding THA and TKA procedure duration in the United States is available. Patient, hospital, and procedure characteristics that influence procedure duration were determined using Medicare claims data (1997-2004). The median procedure duration decreased from 171.0 to 142.5 minutes for THA and 160.5 to 138.0 minutes for TKA between 1997 and 2004. The median procedure duration decreased as hospital and surgeon volume for both primary THA and TKA increased. Younger patients, males, patients not diagnosed with OA, and patients with more comorbidities generally underwent longer THA and TKA procedures. Larger hospitals (> or =500 beds) were associated with longer THA and TKA procedures, and nonprofit hospitals were associated with shorter procedures. This analysis provides baseline data for future investigation of the influence of procedure duration on total joint arthroplasty outcomes from a national perspective.