How Long Does Orthopedic Surgery Take? A Guide by Procedure

"How long will the operation take?" is one of the questions patients ask most consistently before surgery — and one that rarely gets a satisfying answer in the time available at a pre-operative appointment.

The honest answer is that surgical time depends on the specific procedure, the complexity of the case, the patient's anatomy, and whether any unexpected findings need to be addressed. But most major orthopedic procedures fall within fairly predictable ranges.

This guide gives realistic time estimates for the most common orthopedic operations performed in India — not to set expectations in stone, but to help patients understand what the timeline looks like.

A Few Things to Know Before the Numbers

Surgical time ≠ time in the operation theatre: The surgical time quoted by your surgeon refers to the time from first incision to final wound closure. But you will spend time in the holding area (pre-op preparation), then additional time in recovery (PACU) after surgery is complete. Total time away from the ward is typically 2–4 hours longer than the stated operative time.

Complex cases take longer: A first-time, straightforward procedure on a patient with good bone quality and normal anatomy takes less time than a revision surgery, a complex fracture, or a case with significant deformity.

Anaesthetic time adds to total: General or spinal anaesthesia requires 15–30 minutes before surgery begins, and emergence from anaesthesia adds 15–30 minutes after the procedure.

Joint Replacement Surgery

1. Total Knee Replacement (TKR)

Typical duration: 60–90 minutes

A primary (first-time) total knee replacement in a patient with standard anatomy typically takes 60–90 minutes. This includes the incision, exposure, bone cuts on the femur and tibia, trialling, cementing the final implant, and wound closure.

Computer-assisted or robotic-assisted techniques add 15–30 minutes for setup and navigation.

Bilateral (both knees at once): 2.5–4 hours total.

Revision knee replacement: 2–4 hours, sometimes longer if significant bone loss or retained cement hardware requires extensive work.

2. Total Hip Replacement (THR)

Typical duration: 60–90 minutes

Similar to knee replacement in timeframe. The posterior approach typically takes slightly less time than the anterior approach (which requires more specific positioning and setup). Robotic-assisted hip replacement adds 15–30 minutes.

Revision hip replacement: 2–4 hours or more.

3. Shoulder Replacement

Typical duration: 90–150 minutes

Shoulder replacement is slightly more complex in execution than hip or knee replacement, due to the three-dimensional orientation challenges of the glenoid and the need to carefully handle the rotator cuff.

Reverse shoulder replacement may take slightly longer than anatomic total shoulder replacement in some cases.

Sports Medicine and Ligament Surgery

1. ACL Reconstruction

Typical duration: 60–90 minutes

Arthroscopic ACL reconstruction involves graft harvest (if autograft), arthroscopic tunnel drilling, graft passage, and fixation. The procedure is well-standardised and experienced surgeons routinely complete it within 60–90 minutes.

If concurrent meniscal repair or meniscectomy is being performed, add 15–45 minutes.

2. Meniscal Surgery (Arthroscopic)

Partial meniscectomy: 20–40 minutes

Meniscal repair: 45–90 minutes (repair is considerably more time-consuming than removal)

3. Rotator Cuff Repair (Arthroscopic)

Typical duration: 60–120 minutes depending on tear size

A small single-tendon repair may take 45–60 minutes. A large or complex multi-tendon repair can take 90–120 minutes or more.

Knee Arthroscopy (Diagnostic ± Simple Procedure)

Typical duration: 30–60 minutes

A diagnostic arthroscopy with simple loose body removal or chondroplasty (smoothing of damaged cartilage) is a short procedure. Most straightforward knee arthroscopy cases are completed within 45 minutes.

Fracture Surgery

Intramedullary Nail (Femoral or Tibial Shaft Fracture)

Typical duration: 45–90 minutes

A straightforward femoral or tibial shaft fracture nailed with a closed technique (no open incision over the fracture) typically takes 45–75 minutes. Open or complex fractures take longer.

ORIF (Open Reduction and Internal Fixation — Plate and Screws)

Wrist fracture (distal radius): 45–60 minutes

Ankle fracture (bimalleolar or trimalleolar): 60–90 minutes

Periarticular fractures (knee, elbow): 90–150 minutes

Pelvis and acetabulum: 2–4 hours or longer

Hip Fracture Surgery

Dynamic hip screw (DHS) for intertrochanteric fracture: 45–60 minutes

Hemiarthroplasty (partial hip replacement) for femoral neck fracture: 60–90 minutes

Total hip replacement for femoral neck fracture (fit young patients): 90 minutes

Clavicle ORIF

Typical duration: 30–45 minutes

Spine Surgery

Microdiscectomy (Lumbar)

Typical duration: 45–75 minutes

A minimally invasive lumbar microdiscectomy for a straightforward L4/L5 or L5/S1 disc herniation is typically completed within an hour in experienced hands.

Lumbar Decompression (Laminectomy/Laminotomy)

Single level: 60–90 minutes

Multi-level: 90–150 minutes

Lumbar Spinal Fusion

Single level TLIF/PLIF: 90–150 minutes

Multi-level fusion: 3–5 hours

ACDF (Anterior Cervical Discectomy and Fusion)

Single level: 60–90 minutes

Two levels: 90–120 minutes

Vertebroplasty / Kyphoplasty (for osteoporotic vertebral fracture)

Typical duration: 30–45 minutes per level

Post-Operative Recovery Times

Recovery room (PACU): 45–90 minutes after most procedures. Monitoring of vital signs, pain control, and anaesthesia recovery.

Ward return: After PACU, patients return to the ward for the remainder of their stay.

Typical hospital stays:

| Procedure | Typical Hospital Stay | |---|---| | Total knee replacement | 3–5 days | | Total hip replacement | 3–5 days | | Shoulder replacement | 2–4 days | | ACL reconstruction | 1–2 days (often day surgery) | | Meniscal surgery (arthroscopy) | Day surgery or 1 night | | Microdiscectomy | 1–2 days | | Lumbar fusion (single level) | 3–5 days | | Hip fracture surgery (DHS) | 3–7 days | | Wrist ORIF | 1–2 days |

What Increases Operative Time?

Several factors consistently extend surgical time:

Revision surgery: Removing a prior implant, managing bone loss, and working around scar tissue are all more time-consuming than primary surgery.

Obesity: Access is technically more difficult in obese patients.

Severe deformity: Significant varus or valgus deformity in knee replacement, or severe scoliosis in spine surgery, requires more planning and intraoperative adjustment.

Concurrent procedures: Addressing meniscal tears during ACL reconstruction, or replacing both knees in one session, adds proportional time.

Unexpected findings: Occasionally the operative findings differ from pre-operative imaging — a larger fracture than expected, more extensive cartilage damage, a harder-than-anticipated cement removal. Good surgeons take the time needed to address these properly.

Questions to Ask Your Surgeon Before Your Procedure

• How long do you expect this specific operation to take?
• How many of these procedures do you perform per month?
• What might extend the operative time in my case?
• What is the plan if unexpected findings arise?

These questions help set realistic expectations and also give you information about the surgeon's experience with the specific procedure.

At Prakash Hospital, Noida

All major orthopedic procedures — joint replacement, arthroscopic surgery, fracture fixation, and spine surgery — are performed at Prakash Hospital, Sector 33, Noida, under Dr. Mayank Chauhan's care. Pre-operative consultations cover the procedure, expected operative time, and recovery timeline in detail.

To book a consultation, call the number listed on the website.