Medical College of Wisconsin
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Multi-factorial analysis of time efficiency in total knee arthroplasty. Comput Aided Surg 2009;14(1-3):58-62 PMID: 19557583

Pubmed ID



The objective of this retrospective review was to determine whether time efficiency could be gained by optimizing the navigation protocol based on a surgeon's specific technique and work flow. Three groups of 30 consecutive patients operated on by the same surgeon were studied. The groups were from three distinct periods between 2002 and 2008. The first group consisted of patients in which no navigation was performed (the control group); the second group consisted of patients in which navigation was performed using a standard protocol; and the third group consisted of patients in which navigation was performed using a customized protocol that eliminated certain steps. Statistical analysis considered analysis of variance for covariates of total time in the operating room, duration of the procedure, and tourniquet time. Chi-square analysis considered categorical variables of age, gender, body mass index (BMI), Knee Society score, and patellar resurfacing against the surgical group. Multiple linear regression analysis evaluated surgical time adjusted for preoperative deformity, BMI, and patellar resurfacing. In the adjusted model, the customized navigation protocol significantly reduced the surgical time by 10 minutes compared to the non-customized navigation. Not resurfacing the patella significantly reduced the surgical time by 9 minutes. Variables of age, gender, BMI, preoperative deformity and Knee Society score were not related to differences in operating time. Time efficiency may be gained with the use of improved computer navigation protocols and patellar non-resurfacing.

Author List

Stiehl JB, Jackson S, Szabo A


Aniko Szabo PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin


2-s2.0-77950619884   8 Citations

MESH terms used to index this publication - Major topics in bold

Analysis of Variance
Arthroplasty, Replacement, Knee
Confidence Intervals
Data Interpretation, Statistical
Health Status Indicators
Image Processing, Computer-Assisted
Linear Models
Models, Statistical
Multivariate Analysis
Retrospective Studies
Surgery, Computer-Assisted
Time Factors
jenkins-FCD Prod-299 9ef562391eceb2b8f95265c767fbba1ce5a52fd6