Surgeons at Morriston Hospital, South Wales, have cut the time it takes to carry out total knee replacement (TKR) surgery by a third. Instead of the operation taking an average of 42 minutes, it can now be completed in just 27 minutes. “It is designed to increase efficiency and to get more replacements done. We were the first in the world to do this and now it is being adopted in East Kent and Aberdeen, ” said Mark Mullins, M.D.
TKR Time Reduced to 27 Minutes

Fellow surgeon David Woodnutt, M.D., who helped design the new system, explained, “Once we confirm the knee needs replacing the patient has an MRI scan and from that we generate a computer model of the knee. This then allows 3D printed jigs (cutting guides) to be made, improving the quality of surgery. All the planning is done in advance so there is a shorter operating time. This reduces the risk of complications and allows more cases to be done.”
The Morriston team has developed a new system whereby the amount of equipment needed to carry out knee replacement surgery has also been drastically reduced—saving turnaround time.
Mullins said that instead of using seven or eight big cases full of equipment to perform the operation they can do it with one or two as it is now specific to the individual patient. “That means that the inventory can be reduced. Sterilization costs are lower and there is less chance of equipment being damaged or contaminated, ” he said.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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