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The Off-Table Technique Increases Operating Room Efficiency in Direct Anterior Hip Replacement.
Trevor M Owen1, John V Horberg1, Kristoff Corten2
1Department of Orthopaedic Surgery, Virginia Tech Carilion Clinic, Roanoke, VA, USA.
Arthroplasty Today
|May 23, 2022
Summary
The off-table direct anterior approach (DAA) for total hip arthroplasty significantly improves operating room efficiency. This technique reduces setup, surgical, and total room times, potentially allowing for an extra procedure daily.
Area of Science:
- Orthopedic Surgery
- Surgical Technique Optimization
- Operating Room Efficiency
Background:
- Total hip arthroplasty (THA) via the direct anterior approach (DAA) often uses a traction table.
- This method involves significant costs, setup time, and specialized staff.
- An alternative "off-table" technique aims to streamline the procedure.
Purpose of the Study:
- To compare operating room efficiency between on-table and off-table DAA techniques for THA.
- To evaluate the impact of transitioning to an off-table DAA approach on procedure times.
Main Methods:
- Retrospective review of THA patients performed by a single surgeon.
- Three cohorts were analyzed: 40 on-table, 40 initial off-table, and 40 subsequent off-table DAA.
- Operative record timestamps were used to calculate setup, surgical, and total room times.
Main Results:
- Transitioning from on-table to off-table DAA reduced setup time by 7 minutes (14.44%) and further by 7 minutes (15.47%) in subsequent cohorts.
- Surgical time decreased by 32 minutes (25.88%) and total room time by 40 minutes (21.96%) with the off-table technique.
- Cumulative improvements from initial on-table to later off-table DAA resulted in a 43-minute (23.37%) reduction in total room time.
Conclusions:
- The off-table DAA technique enhances operating room efficiency in THA.
- Significant reductions in setup, surgical, and total room times were observed.
- Adopting this technique may enable an additional surgical case per day.
