Factors Associated With Operative Time, Operating Room Idle Time, and Return to the Operating Room for Hip Arthroscopy: An Analysis of 740 Hip Arthroscopies for Femoroacetabular Impingement.

Background: Hip arthroscopy is one of the fastest-growing orthopaedic procedures. Minimizing operative time and room idle time may improve patient outcomes and reduce procedural costs. Purpose: To identify patient, surgeon, and procedural variables that are associated with operative and idle time that may result in improved patient outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: All patients undergoing hip arthroscopy for femoroacetabular impingement from 2014 to 2022 were retrospectively reviewed from a multi-institutional health system. Multivariate linear regression was employed using patient age, sex, body mass index, American Society of Anesthesiologists (ASA) classification, annual surgeon hip arthroscopy procedural volume (APV), capsular closure, use of a post, femoroplasty, acetabuloplasty, and labral debridement versus repair. Multivariable logistic regression determined whether operative time or idle time was associated with emergency department visits, readmissions, or returns to the operating room (RTORs) within 1 year. Results: A total of 740 hip arthroscopies (704 patients) performed by 25 surgeons were included. Male sex (B = 12.1 minutes; 95% CI, 6.1 to 18.0; P < .001), capsular closure (B = 20.1 minutes; 95% CI, 14.1 to 26.0; P < .001), and femoroplasty (B = 11.5 minutes; 95% CI, 4.7 to 18.3; P < .001) were associated with increased operative time. Age (B = -0.5 minutes; 95% CI, -0.7 to -0.3; P < .001), ASA classification (B = -5.4 minutes; 95% CI, -10.7 to -0.2; P = .04), and APV >25 (B = -33.3 minutes; 95% CI, -39.4 to -27.1; P < .001) were associated with decreased operative time. Use of a post (B = 5.0 minutes; 95% CI, 1.4 to 8.7; P = .007) was associated with increased idle time. APV >25 (B = -15.8 minutes; 95% CI, -18.7 to -12.8; P < .001) and labral repair over debridement (B = -5.9 minutes; 95% CI, -9.7 to -2.2; P = .002) were associated with decreased idle time. Every additional minute of idle time was associated with increased odds of unplanned RTOR for ipsilateral hip pathology within 1 year by 2.3% (95% CI, 1.0%-3.6%; P = .001). Conclusion: Our study demonstrated that shorter operative times were associated with several patient-specific factors, including older age and higher ASA classification. Surgeons who performed ≤25 hip arthroscopies per year were associated with longer idle times, and longer idle times were associated with a greater risk of reoperation for ipsilateral hip pathology within 1 year.