Complications in hip arthroscopy: Necessity of supervision during the learning curve
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Complications in hip arthroscopy: Necessity of supervision during the learning curve. / Dietrich, Florian; Ries, Christian; Eiermann, Claus; Miehlke, Wolfgang; Sobau, Christian.
In: KNEE SURG SPORT TR A, Vol. 22, No. 4, 04.2014, p. 953-8.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Complications in hip arthroscopy: Necessity of supervision during the learning curve
AU - Dietrich, Florian
AU - Ries, Christian
AU - Eiermann, Claus
AU - Miehlke, Wolfgang
AU - Sobau, Christian
PY - 2014/4
Y1 - 2014/4
N2 - PURPOSE: The aim of this study was to determine whether the learning curve of arthroscopic treatment of femoroacetabular impingement (FAI) could be verified by analyzing the complication rate of this procedure. Additionally, it was investigated whether supervision by an experienced surgeon leads to a steeper learning curve (lower number of complications) when starting to perform arthroscopic FAI treatment.METHODS: The complications occurring in 317 consecutive patients treated with the sole diagnosis of FAI were analyzed. 256 patients (collective A) were treated by surgeon A between June 2005 and January 2010. Sixty-one patients (collective B) were treated by surgeon B between August 2008 and December 2009. From January to June 2008, surgeon B performed many hip arthroscopies under supervision of surgeon A. Complications were recorded in a central complication register. Statistic analysis of the complication rates was performed using Fischer's exact T test.RESULTS: Subdividing collective A chronologically into thirds a significant decline of complications (p = 0.0044) was found with growing experience of the surgeon. Comparing the first 61 patients of both surgeons a significantly lower complication rate was discovered in the patients of surgeon B (p = 0.0375). In total there were 21 complications (6.6 %; CI 4.4-9.9 %). The observed complication rate was 7.0 % in collective A and 4.9 % in collective B.CONCLUSION: The learning curve can be comprehended by the distribution of complications in collective A. Having spent 6 months performing under supervision of surgeon A, surgeon B has a lower complication rate than surgeon A when comparing the first 61 patients each surgeon operated on. This implies that surgeon B benefits from the experience of surgeon A. According to this analysis, beginners in arthroscopic FAI treatment should be taught at a specialized centre to reduce the number of complications.
AB - PURPOSE: The aim of this study was to determine whether the learning curve of arthroscopic treatment of femoroacetabular impingement (FAI) could be verified by analyzing the complication rate of this procedure. Additionally, it was investigated whether supervision by an experienced surgeon leads to a steeper learning curve (lower number of complications) when starting to perform arthroscopic FAI treatment.METHODS: The complications occurring in 317 consecutive patients treated with the sole diagnosis of FAI were analyzed. 256 patients (collective A) were treated by surgeon A between June 2005 and January 2010. Sixty-one patients (collective B) were treated by surgeon B between August 2008 and December 2009. From January to June 2008, surgeon B performed many hip arthroscopies under supervision of surgeon A. Complications were recorded in a central complication register. Statistic analysis of the complication rates was performed using Fischer's exact T test.RESULTS: Subdividing collective A chronologically into thirds a significant decline of complications (p = 0.0044) was found with growing experience of the surgeon. Comparing the first 61 patients of both surgeons a significantly lower complication rate was discovered in the patients of surgeon B (p = 0.0375). In total there were 21 complications (6.6 %; CI 4.4-9.9 %). The observed complication rate was 7.0 % in collective A and 4.9 % in collective B.CONCLUSION: The learning curve can be comprehended by the distribution of complications in collective A. Having spent 6 months performing under supervision of surgeon A, surgeon B has a lower complication rate than surgeon A when comparing the first 61 patients each surgeon operated on. This implies that surgeon B benefits from the experience of surgeon A. According to this analysis, beginners in arthroscopic FAI treatment should be taught at a specialized centre to reduce the number of complications.
KW - Adult
KW - Aged
KW - Arthroscopy/adverse effects
KW - Female
KW - Femoracetabular Impingement/diagnostic imaging
KW - Humans
KW - Learning Curve
KW - Male
KW - Mentors
KW - Middle Aged
KW - Radiography
KW - Young Adult
U2 - 10.1007/s00167-014-2893-9
DO - 10.1007/s00167-014-2893-9
M3 - SCORING: Journal article
C2 - 24519620
VL - 22
SP - 953
EP - 958
JO - KNEE SURG SPORT TR A
JF - KNEE SURG SPORT TR A
SN - 0942-2056
IS - 4
ER -