Have Total Hip Arthroplasty Operative Times Changed Over the Past Decade? An Analysis of 157,574 Procedures

With the recent reevaluation of surgeon reimbursement for total hip arthroplasty (THA) by the Centers for Medicare and Medicaid Services, there is increasing need for information regarding trends in operative time. While single-institutional analyses exist, there is a lack of large-scale, nationally representative, multi-institutional data. Therefore, the purpose of our study is to (1) evaluate past/present operative time trends for THA and (2) investigate factors influencing operative times from a 10-year, large multi-institutional database.

All primary THAs conducted between 2008 and 2018 were queried using Current Procedural Terminology code 27130 from the American College of Surgeons-National Surgical Quality Improvement Program database, yielding 157,574 patients. Operative time, demographics, and comorbidity data were collected and analyzed. Multivariable linear models were created, and trend analyses were used where appropriate.

Median operative time was 87 minutes. Operative time was stable across included study years, with all calculated values within 5 minutes of the median (range, 86-92 minutes). Operative time was statistically stable over the last 3 years ( P = .121). Age, body mass index, resident involvement, modified Charlson comorbidity index, and preoperative laboratory values influenced operative time ( P < .001). Length of stay, readmission, superficial wound infection, and sepsis decreased over the study period. Nonelective procedures were statistically longer than elective ( P < .0001).

While numerous factors influence the duration of THA, this study found that THA operative time has remained stable in recent years. Therefore, revaluation for THA based on intraservice time is not supported. Future analyses should continue to analyze factors that influence operative time in order to ensure patient safety and maintain positive outcomes.