Study: Running Two TJA Rooms Is Safe
While you wouldn’t want to be running from OR to OR during the most critical aspects of surgeries, new research indicates that overlapping rooms is safe.
The study, “Running Two Rooms” Does Not Compromise Outcomes or Patient Safety in Joint Arthroplasty,” appears in the January 15, 2018 edition of The Journal of Arthroplasty.
William G. Hamilton, M.D., hip and knee surgeon at Anderson Orthopaedic Clinic in Alexandria, Virginia, and co-author on this study, commented to OTW, “This topic is of interest to many players in orthopedics, including the media as well as the U.S. Congress. The impetus for initiating the study came from a 2015 Boston Globe article that featured the controversial topic on concurrent surgery, followed by a December 2016 report from the Senate Finance Committee where they concluded that more data was required on this subject. We initiated our study at that time to try and provide data on this timely topic.”
“Because we have tracked our total joint outcomes for many years, combined with the fact that surgeons from our institution have run both consecutive rooms (one operating room on one day) as well as overlapping rooms (two operating rooms with one surgeon going back and forth between them), we felt that we had the opportunity to provide data to help in the debate of this topic.”
The authors wrote, “Using an institutional database, all primary hip and knee arthroplasties from 2006-2016 were identified. Six surgeons performed a total of 16,916 cases, including 7,511 total hips and 9,405 knee arthroplasties.”
Dr. Hamilton told OTW, “We looked at over 16,000 total hip and total knee arthroplasties, with a fairly even split between consecutive and overlapping rooms, and found no statistical difference in the revision or reoperation rates between the two groups. We concluded that at our institution over 10 years there was no increased risk if surgeons performed overlapping rooms.”
“We must recognize that these results are from one institution and do not universally suggest that running two rooms is safe. Surgeons also should recognize that this practice refers to overlapping rooms, where we use the time it takes to transport, set up and break down the case in one room while a surgery is performed in the other room. We do not support the practice of ‘concurrent surgery,’ where critical portions of two surgeries are performed at the same time.”
“We also recommend that surgeons provide some form of informed consent to their patients and be prepared to educate our patients on the practice of overlapping rooms. As papers like ours are published and the media discusses this more, we must emphasize to our patients that we have their safety as our top priority. At the same time, performing overlapping rooms allows patients improved access to expert surgeons while increasing surgical efficiency and volume to the benefit of hospitals and surgeons alike.”
