Abstract
Longer operative times may be required in complex total knee arthroplasty (TKA), however little is known about outcomes in procedures performed rapidly. We analysed 58,009 primary TKAs from the New Zealand National Joint Registry. The mean surgical duration was 89minutes, and 50% of procedures lasted between 60 and 89minutes. There was no difference in adjusted revision rates for groups lasting between 40 and 120minutes, however procedures lasting >120minutes had significantly higher revision rates. There was a higher revision rate in TKAs lasting <40minutes (0.71 vs 0.48 revisions per 100 component years) but this was not statistically significant (P=0.1). For primary TKAs lasting less than 120minutes, further shortening operative time did not improve outcome, and very rapid procedures (<40minutes) may lead to an increased risk of revision.