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The Off-Table Technique Increases Operating Room Efficiency in Direct Anterior Hip Replacement

dc.contributor.authorOwen, Trevor M.en
dc.contributor.authorHornberg, John V.en
dc.contributor.authorCorton, Kristoffen
dc.contributor.authorMoskal, Joseph T.en
dc.date.accessioned2024-11-13T15:04:28Zen
dc.date.available2024-11-13T15:04:28Zen
dc.date.issued2022-05-18en
dc.description.abstractBackground: When performing a total hip arthroplasty via the direct anterior approach (DAA), many orthopedic surgeons utilize an orthopedic traction table. This technique requires an expensive table, time for positioning, staff to operate the table, and time-consuming transitions when preparing the femur. Some surgeons advocate for an “off-table” technique to avoid these difficulties. In this paper, we compare operating room efficiency between on-table and off-table techniques. Material and methods: We retrospectively reviewed patients undergoing total hip arthroplasty by a single surgeon across the transition from on-table to off-table DAA technique. Three cohorts were defined; the last 40 on-table hips, the first 40 off-table hips, followed by the second 40 hips. Timestamps from the operative record were recorded to calculate setup, surgical, takedown, and total room time. Implant fixation, patient demographic data, comorbidities, and complications were recorded. Results: From cohort 1 to 2, there was a 7-minute (14.44%, P = .0002) improvement in setup time but no change in total room time. From cohort 2 to 3, there was an additional 7-minute (15.47%, P < .0001) improvement in setup time, 32-minute (25.88%, P < .0001) improvement in surgical time, and 40-minute (21.96%, P < .0001) improvement in total room time yielding cumulative changes from cohort 1 to 3 of 15 minutes (27.68%, P < .0001), 28 minutes (23.11%, P < .0001), and 43 minutes (23.37%, P < .0001), respectively. There was no correlation between height, weight, or body mass index and time at any interval. Conclusion: Conversion to an off-table DAA technique offers an improvement in operating room efficiency. This is seen in setup, operative, and total room time. Implementation could allow for an additional case each day.en
dc.description.versionPublished versionen
dc.format.extentPages 167-173en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1016/j.artd.2022.03.026en
dc.identifier.issn2352-3441en
dc.identifier.urihttps://hdl.handle.net/10919/121609en
dc.language.isoenen
dc.publisherElsevieren
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectTotal hip arthroplastyen
dc.subjectDirect anterior approachen
dc.subjectOff tableen
dc.subjectTable freeen
dc.subjectEfficiencyen
dc.titleThe Off-Table Technique Increases Operating Room Efficiency in Direct Anterior Hip Replacementen
dc.title.serialArthroplasty Todayen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
pubs.organisational-groupVirginia Techen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Orthopedicen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Orthopedic/General Orthopedicsen

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