Factors Affecting Operating Room Scheduling Accuracy for Primary and Revision Total Knee Arthroplasty: A Retrospective Study

Abstract

Background: Optimizing operating room (OR) scheduling accuracy is important for improving OR efficiency and maximizing value of total knee arthroplasty (TKA). However, data on factors that may impact TKA OR scheduling accuracy are limited. Materials and Methods: A retrospective review of 7655 knee arthroplasties (6999 primary TKAs and 656 revision TKAs) performed between January 2020 and May 2023 was conducted. Patient baseline characteristics, surgeon experience (years in practice), as well as actual vs scheduled OR times were collected. Actual OR times that were at least 15% shorter or longer than scheduled OR times were considered to be clinically important. Logistic regression analyses were employed to assess the influence of specific patient and surgeon factors on OR scheduling inaccuracies. Results: Using adjusted odds ratio, patients with primary TKA who had a lower body mass index ( P <.001) were independently associated with overestimation of scheduled surgical time. Conversely, younger age ( P <.001), afternoon procedure start time ( P <.001), surgeons with less than 10 years of experience ( P =.037), and higher patient body mass index ( P <.001) were associated with underestimation of scheduled surgical time. For revision TKA, female sex ( P =.021) and morning procedure start time ( P =.038) were associated with overestimation of scheduled surgical time, while surgeons with less than 10 years of experience ( P =.014) and patients who underwent spinal/epidural/block anesthesia ( P =.038) were associated with underestimation of scheduled surgical time. Conclusion: This study highlights patient, surgeon, and intraoperative variables that impact the accuracy of scheduling for TKA procedures. Health systems should take these variables into consideration when creating OR schedules to fully optimize resources and available space. [ Orthopedics . 202x;4x(x):xx–xx.]