Dropping of instrument by scrub team during hip and knee arthroplasty - Does patient's size matters?

Background: Medical literature suggest that Hip and Knee replacement surgery takes far more time to conduct in overweight and obese patients than in general population. Reasons for increase in operating time in obese patient are difficult positioning, more bleeding from fatty tissue and difficult retraction. One very interesting and to our knowledge never reported cause of increased operating time in obese patients undergoing hip and knee arthroplasty is accidental dropping of instruments onto the floor by operating team.