Overlapping Surgery in Primary Total Knee Arthroplasty: Are 6-Week Complications Worse than Single Operating Room Scheduling?

Alexander M Troester; Nathan R Hendrickson; Natalie A Glass; Nicholas A Bedard; Nicolas O Noiseux

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Overlapping Surgery in Primary Total Knee Arthroplasty: Are 6-Week Complications Worse than Single Operating Room Scheduling?

Journal article

Open access

Peer reviewed

Overlapping Surgery in Primary Total Knee Arthroplasty: Are 6-Week Complications Worse than Single Operating Room Scheduling?

Alexander M Troester, Nathan R Hendrickson, Natalie A Glass, Nicholas A Bedard and Nicolas O Noiseux

The Iowa orthopaedic journal, Vol.39(1), pp.29-35

2019

PMCID: PMC6604525

PMID: 31413671

Appears in Diamond Open Access

Files and links (1)

url

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604525View

Published (Version of record) Open Access

Abstract

Overlapping surgery is common in high-volume total knee arthroplasty (TKA) practices and has come under recent scrutiny in the press. The aim of this study was to evaluate differences in 6-week clinical and radiographic outcomes for primary TKA patients between single and overlapping operating room (OR) days. We retrospectively reviewed individual patient records of a consecutive series of primary TKAs with complete 6-week follow-up performed by a single academic surgeon between 2008-2016 (N= 452). Patients were stratified by single vs. overlapping OR days. 177 patients (39%) had an overlapping surgery. Age, body mass index (BMI), Charlson Comorbidity Index (CCI) and American Society of Anesthesiologists (ASA) class were recorded to assess for confounding variables. Outcomes included anesthesia time, 6-week readmission, unplanned return to OR, medical and surgical complication, and 6-week radiographic alignment. There were no significant differences in anesthesiology time (165.5 vs 164.5 min, p=0.85), medical or surgical complication rates (10.5% vs 6.2%, p=0.11), 6-week readmissions (4.4% vs 1.7%, p=0.12), or return to OR (1.8% vs 1.7%, p=1.00) before or after adjusting for age, BMI, gender, ASA and CCI. There was no difference between overlapping and single OR cohorts in rate of neutral coronal alignment (2°-8° valgus) (98.3% vs 98.9%, respectively, p=0.68) or presence of periprosthetic lucency (p=0.43). This study demonstrates no differences in 6-week clinical or radiographic outcomes between patients undergoing primary TKA on single versus overlapping OR days. These results support the safe practice of overlapping surgical scheduling in high-volume primary TKA centers. III.

Academic Medical Centers

Aged

Appointments and Schedules

Arthroplasty, Replacement, Knee - adverse effects

Arthroplasty, Replacement, Knee - methods

Databases, Factual

Female

Hospitals, High-Volume

Humans

Length of Stay

Male

Middle Aged

Operating Rooms - organization & administration

Patient Readmission - statistics & numerical data

Patient Safety

Postoperative Complications - epidemiology

Postoperative Complications - physiopathology

Prognosis

Retrospective Studies

Time Factors

Details

Title: Subtitle: Overlapping Surgery in Primary Total Knee Arthroplasty: Are 6-Week Complications Worse than Single Operating Room Scheduling?
Creators: Alexander M Troester - Department of Orthopedics and Rehabilitation Iowa City, IA USA
Nathan R Hendrickson - Department of Orthopedics and Rehabilitation Iowa City, IA USA
Natalie A Glass - Department of Orthopedics and Rehabilitation Iowa City, IA USA
Nicholas A Bedard - Department of Orthopedics and Rehabilitation Iowa City, IA USA
Nicolas O Noiseux - Department of Orthopedics and Rehabilitation Iowa City, IA USA
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.39(1), pp.29-35
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 31413671
PMCID: PMC6604525
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2019
Academic Unit: Orthopedics and Rehabilitation; Surgery
Record Identifier: 9984303968502771

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