Determinants of Operative Time in Arthroscopic Rotator Cuff Repair

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 f(2) 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 (f(2) = 0.08, p < 0.001), fewer surgical anchors (f(2) = 0.06, p < 0.001), more recent case number (f(2) = 0.01, p < 0.001), smaller tear size (f(2) = 0.01, p < 0.001), increased assistant case number (f(2) = 0.01, p < 0.001), female sex (f(2) = 0.004, p < 0.001), higher repair quality ranking (f(2) = 0.006, p < 0.001) and private hospital (f(2) = 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.

Automated summary

This study aimed to identify factors that reduce operative time and investigate the feasibility of performing arthroscopic rotator cuff repairs in under 5 minutes. The researchers found that using undersurface repair technique, reducing surgical anchors, smaller tear size, increased surgeon and assistant case number, performing repairs in a private hospital, and female sex were associated with faster operative times. They also successfully captured a <5-min repair.