Abstract :
Aim: Background: The intricate relationship between the timing of surgical interventions and subsequent postoperative outcomes in total knee arthroplasty (TKA) has garnered increasing attention within the medical community. This heightened scrutiny stems from the recognition that patient physiological states, the alertness and performance of surgical teams, and the overall efficiency of hospital workflows can exhibit diurnal variations. This retrospective cohort study was designed to investigate whether stratifying surgical start times into specific “time capsules” (8:00–10:59 AM, 11:00 AM–1:59 PM, and 2:00 PM onward) exerts a discernible influence on postoperative length of stay, complication rates, and the broader recovery trajectory in patients undergoing TKA.Materials and Methods: A total of 103 consecutive patients who underwent primary unilateral TKA at a single tertiary care center between JAN 2023 and DEC 2024 were included in this retrospective analysis. Participants were systematically categorized into three groups based on their scheduled surgical start times: Group A (8:00–10:59 AM), Group B (11:00 AM–1:59 PM), and Group C (2:00 PM onward). Key parameters meticulously analyzed included patient demographics (age, gender), the precise duration of the surgical procedure, the occurrence of any postoperative complications, and the total duration of the postoperative hospital stay. Statistical analyses involved one-way ANOVA for continuous variables and chi-square tests for categorical variables, with a p-value of less than 0.05 predefined as the threshold for statistical significance.Results: The cohort of 103 patients comprised 37 individuals in Group A, 43 in Group B, and 23 in Group C.While the analysis revealed no statistically significant differences across the groups regarding patient age, gender distribution, average surgical duration, or postoperative hospital stay, a discernible trend towards higher complication rates was observed in Group A (early morning surgeries). However, these differences were not statistically significant. Limitations include underpowered sample size and lack of adjustment for confounders. These findings highlight the need for more rigorous prospective analysis.
Keyword :
Knee replacement, Surgical timing, Postoperative complications, Duration of stay