EP3.45 Factors Influencing Surgical Duration in Hip Arthroscopy: The Role of Surgeon Experience and Hip Morphology

Abstract Background Operative time in hip arthroscopy is influenced by both surgeon- and patient-related factors. Although surgeon experience affects case length, the relative contribution of demographic and imaging-based measures of case complexity remains unclear. This study identified factors independently associated with surgical duration in hip arthroscopy and quantified the effect of surgeon experience. Methods A retrospective study was performed of hip arthroscopy cases by a single sports medicine and hip preservation fellowship-trained surgeon with a predominantly hip preservation practice. Surgical duration was defined as time from incision to closure. Candidate predictors included demographic factors (age, sex, height, weight, Beighton score, symptom duration); radiographic measures (Tönnis grade, joint space, lateral center-edge angle, crossover sign, and modified Dunn alpha angle); MRI findings (labral tear and acetabular or femoral chondral defects); CT variables (alpha angle, femoral version, neck-shaft angle, coronal center-edge angle, and McKibbin index). Surgeon related factors included surgeon experience based on case count.. Multivariable linear regression was used to model surgical duration, with model selection guided by AIC, AICC, SBC, and adjusted R2. Results Of 919 eligible cases, 105 were excluded for missing data, leaving 814 cases for analysis. Mean operative time was 96.2 minutes; mean modified Dunn alpha angle, 66.4° ± 11.5°; and mean CT alpha angle, 58.6° ± 11.6°. Surgeon case count, modified Dunn alpha angle, and CT alpha angle remained independently associated with surgical duration in the final multivariable model (R2 = 0.503; RMSE 18.34 minutes). Increasing surgeon case count was associated with shorter operative time (β = -0.066 min/case; p < 0.0001), while greater modified Dunn alpha angle (β = 0.520 min/degree; p < 0.0001) and CT alpha angle (β = 0.268 min/degree; p < 0.0001) were associated with longer operative time. Mean operative time decreased from 111.5 ± 25.6 minutes in the first 50% of cases to 82.2 ± 18.0 minutes in the latter 50% of cases. Surgeon case count had the greatest contribution to operative time variability on Type III testing. Conclusion Surgeon experience was the strongest predictor of surgical duration in hip arthroscopy in this single surgeon retrospective study, supporting a significant learning curve effect. Preoperative cam deformity severity was also independently associated with longer operative times.