Does Timing of Knee Replacement in a Day Have Implications on Postoperative Complications, Morbidity, and Duration of Stay?”

Authors: Mithin Aachi, Rakesh R K Ram, Krishna M Chaitanya, Mehnoor Fatima Soha, Swapnika Dhadvai

DOI: 10.18231/j.ijos.12368.1759215968

Keywords: Knee Replacement, Surgical Timing,Postoperative Complications,Duration of stay

Abstract: In recent years, the meticulous examination of how various factors influence postoperative outcomes has gained significant traction within the medical community. Among these, the surgical start time has emerged as a subject of increasing scrutiny, driven by the understanding that patient physiology, surgical team alertness, and hospital workflow can fluctuate throughout the day. This retrospective cohort study examined the impact of surgical start time on postoperative outcomes in patients undergoing primary unilateral total knee arthroplasty at a single tertiary care center between January 2023 and December 2024. Patients were grouped based on surgical start time: early morning (8:00–10:59 AM), late morning/early afternoon (11:00 AM–1:59 PM), and late afternoon (2:00 PM onward). Key variables analyzed included patient demographics, surgery duration, postoperative complications, and hospital length of stay. No statistically significant differences were observed between groups for age, gender, surgery duration, or length of stay. However, a non-significant trend suggested higher complication rates in early morning surgeries (27%) compared to later times (16.3% and 8.7%, p=0.08). While not conclusive, the findings indicate a potential association between surgical timing and complication rates, warranting further investigation.