Determinants of Operative Time in Arthroscopic Rotator Cuff Repair

Abstract

Arthroscopic rotator cuff repairs have been reported to take between 72 and 113 min to complete. This team has adopted its practice to reduce rotator cuff repair times. We aimed to determine (1) what factors reduced operative time, and (2) whether arthroscopic rotator cuff repairs could be performed in under 5 min. Consecutive rotator cuff repairs were filmed with the intent of capturing a <5-min repair. A retrospective analysis of prospectively collected data of 2232 patients who underwent primary arthroscopic rotator cuff repair by a single surgeon was performed using Spearman’s correlations and multiple linear regression. Cohen’s f2 values were calculated to quantify effect size. Video footage of a 4-min arthroscopic repair was captured on the 4th case. Backwards stepwise multivariate linear regression found that an undersurface repair technique (f2 = 0.08, p < 0.001), fewer surgical anchors (f2 = 0.06, p < 0.001), more recent case number (f2 = 0.01, p < 0.001), smaller tear size (f2 = 0.01, p < 0.001), increased assistant case number (f2 = 0.01, p < 0.001), female sex (f2 = 0.004, p < 0.001), higher repair quality ranking (f2 = 0.006, p < 0.001) and private hospital (f2 = 0.005, p < 0.001) were independently associated with a faster operative time. Use of the undersurface repair technique, reduced anchor number, smaller tear size, increased surgeon and assistant surgeon case number, performing repairs in a private hospital and female sex independently lowered operative time. A <5-min repair was captured.

Total Intravenous Anesthesia Compared to Inhalational Anesthesia in Patients Undergoing Arthroscopic Rotator Cuff Repair

“…As arthroscopic procedures, including RCR, continue to shift to the ambulatory surgery center setting, an increased focus on factors influencing perioperative throughput has occurred [30][31][32][33][34]. While many factors that have been shown to influence throughput time, such as technical aspects of the repair and concomitant procedures performed, sex, and comorbidities, are not modifiable, anesthetic selection is within the control of the care team [32,35,36]. The overall perioperative time savings of approximately 21 minutes per patient observed in this study is not insignificant and could allow for the performance of additional cases during the operative day.…”