Does Operative Time Affect Infection Rate in Primary Total Knee Arthroplasty?

Background Prolonged operative time may increase the risk of infection after total knee arthroplasty (TKA). Both surgeon-related and patient-related factors can contribute to increased operative times. Questions/purposes The purpose of this study was to determine (1) whether increased operative time...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2015-01, Vol.473 (1), p.64-69
Main Authors: Naranje, Sameer, Lendway, Lisa, Mehle, Susan, Gioe, Terence J.
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement, Knee - adverse effects
Arthroplasty, Replacement, Knee - instrumentation
Body Mass Index
Clinical Competence
Conservative Orthopedics
Humans
Knee
Knee Joint - surgery
Knee Prosthesis - adverse effects
Learning Curve
Medicine
Medicine & Public Health
Minnesota
Obesity - complications
Obesity - diagnosis
Operative Time
Orthopedics
Proportional Hazards Models
Prosthesis Design
Prosthesis-Related Infections - etiology
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Sports Medicine
Surgery
Surgical Orthopedics
Symposium: 2014 Knee Society Proceedings
Time Factors
Treatment Outcome
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Summary:Background Prolonged operative time may increase the risk of infection after total knee arthroplasty (TKA). Both surgeon-related and patient-related factors can contribute to increased operative times. Questions/purposes The purpose of this study was to determine (1) whether increased operative time is an independent risk factor for revision resulting from infection after TKA; (2) whether increasing body mass index (BMI) increased operative time; and (3) whether increasing experience substantially decreased operative time. Methods We retrospectively evaluated primary TKAs from our joint registry between March 2000 and August 2012. Cox proportional hazard models were used to assess the relationship between operative time and revision resulting from infection after accounting for age, sex, BMI, and Agency for Healthcare Research and Quality comorbidity score. Of 9973 instances of primary TKA, 73 underwent revision surgery for infection (0.73%). Results After accounting for the confounders of age and sex, operative time was not found to have a significant effect; a 15-minute increase in operative time increased the hazard of revision resulting from infection by only 15.6% (p = 0.053; 95% confidence interval, 0.0%–34.0%). In addition, a five-unit increase in BMI was found to increase mean operative time by 1.9 minutes, on average, regardless of sex (p 
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-014-3628-4