Technical Obstacles for Low-Volume Surgeons in Primary Anterior Cruciate Ligament Reconstruction

Kengo Harato, Shu Kobayashi, Takashi Toyoda, Takayuki Hasegawa, Yasunori Tsukimura, Yasuo Niki

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


A longer surgical time will lead to postoperative complications in orthopaedic surgery. According to previous reports, surgeon volume affects a surgical time in anterior cruciate ligament (ACL) reconstruction. However, little attention has been paid to difference of a surgical time between high- and low-volume surgeons in ACL reconstruction. The purpose of the present study was to investigate the surgical time for both high- and low-volume surgeons and to clarify technical obstacles as well as the important technique to reduce the surgical time in ACL reconstruction. A total of 103 knees in 103 patients with ACL tear were enrolled. All the procedures were performed by 13 different surgeons. The surgeons were divided into two surgeon groups (high- and low-volume groups) based on the number of annual cases. The operative technique was divided into the same five steps to perform comparisons of step-by-step surgical time between the surgeon groups of different volumes. The statistical comparison was done between high- and low-volume groups in terms of surgical time in each step. Total operation times were 87.8 ± 17.6 and 129.9 ± 42.9 minutes in high- and low-volume group, respectively. Low-volume surgeons took much time in tendon harvesting and bone tunnel creation using arthroscopy. Low-volume surgeons took more time for primary ACL reconstruction, especially in tendon harvesting, compared with high-volume surgeons. Tendon harvesting was extremely important, as well as bone tunnel creation, for low-volume surgeons to reduce surgical time in primary ACL reconstruction.

Original languageEnglish
Article number190029oa
Pages (from-to)1238-1242
Number of pages5
JournalJournal of Knee Surgery
Issue number12
Publication statusPublished - 2020 Dec 1


  • anterior cruciate ligament reconstruction
  • low-volume surgeon
  • surgical
  • tendon harvesting
  • time

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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