Effect of Procedure Duration on Total Hip Arthroplasty and Total Knee Arthroplasty Survivorship in the United States Medicare Population

There is limited information regarding the effects of procedure duration on total hip arthroplasty (THA) and total knee arthroplasty (TKA) implant survivorship in the United States. We examined the association between procedure duration with primary THA and TKA survivorship at 8 years in the Medicare population. Medicare claims data from 1997 to 2004 were used to identify primary THA and TKA procedures. Procedure duration was determined from the claims data by using anesthesia time as a proxy (Silber et al). Implant survivorship at 8 years (revision end point) was evaluated. Kaplan-Meier analysis and Cox regression were used to determine implant survivorship and hazard ratios associated with procedure duration.