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Surgeon-Specific Traction Time During Hip Arthroscopy for Primary Labral Repair Can Continue to Decrease After a

Mitchell B Meghpara¹, Samantha C Diulus², Marshall Haden³

¹American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.; AMITA Health St. Alexis Medical Center, Hoffman Estates, Illinois, U.S.A.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association

|June 14, 2021

Summary

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Editorial Commentary: Outcome After Ipsilateral Hip Arthroscopy Predicts Outcomes on the Contralateral Side, Regardless of Time Between Surgeries.

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Hip arthroscopy surgeons can improve traction time during their initial 500 cases. Total traction time and traction time per anchor placed (TTAP) plateaued, indicating a learning curve for this hip preservation surgery.

Area of Science:

Orthopedic surgery
Hip arthroscopy
Sports medicine

Background:

Femoroacetabular impingement (FAI) is a common cause of hip pain.
Labral repair is a key procedure in hip arthroscopy for FAI.
Optimizing surgical efficiency, including traction time, is crucial for patient outcomes and surgeon proficiency.

Purpose of the Study:

To evaluate the learning curve for total traction time and traction time as a function of anchors placed (TTAP) in primary hip labral repair.
To determine when surgical efficiency metrics plateau during hip arthroscopy performed by a single surgeon.

Main Methods:

Retrospective case series of 2,350 primary hip labral repairs performed by a single surgeon.
Inclusion criteria: primary labral repair with or without acetabuloplasty, chondroplasty, or ligamentum teres debridement for FAI.

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Exclusion criteria: prior hip surgery, hip conditions, Tönnis grade >1, open procedures, microfracture, ligamentum teres reconstruction, or labral reconstruction. TTAP calculated as total traction time divided by the number of anchors placed.

Main Results:

Total traction time plateaued after 374 cases (55.92 minutes).
Traction time as a function of anchors placed (TTAP) plateaued after 487 cases (14.93 minutes).
Mean overall total traction time was 58.16 minutes, and mean TTAP was 16.24 minutes across 2,350 cases.

Conclusions:

Surgeons can anticipate improvements in hip arthroscopy traction time within the first 500 surgeries.
The learning curve for total traction time and TTAP suggests a period of increasing efficiency during initial cases.
These findings provide benchmarks for surgeons developing their hip arthroscopy practice.