Good afternoon, and I'd like to extend thanks to my co-authors for their work on this project and also to the program committee for allowing us to present this research. My disclosures are in the website and also here. So if arthroplasty has grown at a fast pace over the past two decades, the procedure is challenging and often requires specialty training to gain competence. There's a significant learning curve that's been reported. Measuring the learning curve is interesting, and it's been done in several ways, and most of these ways are proxies for the actual learning curve. But we've looked at patient-reported outcomes, which hopefully will improve as the surgeon advances through the learning curve. Fluoroscopy usage will hopefully decrease as the surgeon advances through the learning curve, and complications rates will hopefully also decrease. The purpose of this study was to measure the effect of the hip arthroscopy learning curve on total operating room time. So basically this was when the patient rolled into the room to when they rolled out of the room, total surgical time from the incision to the wound closure, and then total setup time basically from rolling into the room to when the incision was made. This was a retrospective review of a single surgeon case list of approximately, not approximately, but exactly 225 cases. Only FAI and labral tear cases were included to maintain homogeneity of the cases. Times were recorded from the EMR, and the cases were divided into groups of 25 cases for analysis. Of the 225 cases that we reviewed, the mean OR time was two hours and 34 minutes. The mean surgical time was an hour and 54 minutes, and the mean setup time was 34 minutes. Looking at these three curves, we can see that there's a decrease in the times for all three categories. So the surgical time and the total OR time mirror each other, which makes sense because the main driver for total OR time is really the operative time. The setup time also decreased, however, it didn't decrease as much, and these are percentages. So really what we see is that the OR time and surgical time really leveled out approximately 70% of where they started, and the setup time leveled out approximately 80% to 85% of where it started. So if you break these down, for the first 150 cases performed, the total OR time was 152 minutes, and the surgical time was 123 minutes. For the 151st to 225th case performed, the total OR time was 138, and the surgical time was 98 minutes. Setup time decreased really for the first 25 cases, but after that, it was leveled out. So for the first 25 cases, we had an average of 38 minutes, and afterwards, 31 minutes. There are certainly limitations to the study. This is an individual case series, so individual results could vary, and care is needed when we interpret these results because we know that surgical time, setup time, operative time, although these things matter to our facilities and matter to us as surgeons, they're not really a proxy for successful surgery or for patient outcomes or satisfaction. Also as the series progressed, the complexity of the procedures changed. So as the surgeon advanced through these cases, we began doing more capsule repairs, capsule replications, AIS decompressions, so these were not the same surgeries towards the end of the series as they were at the beginning, and we didn't control for this. So in conclusion, the study reinforces the existence of a learning curve for hip arthroscopy based on the reduction of surgical times. OR staff also may have a learning curve, however, they seem to learn faster than we do, and their learning curve was really only 25 cases. And during their early careers, surgeons should be mindful of this and also plan on adequate time for the procedure because performing a procedure during your first 25 cases may not be like it is during fellowship. Thank you.

learning curve

hip arthroscopy

setup time

surgeon advancement

adequate time