Do trainee surgeons have an adverse effect on the outcome after total hip arthroplasty?

a ten-year review

M. J. Reidy (Lead / Corresponding author), A. Faulkner, B. Shitole, B. Clift

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    AIMS: The long-term functional outcome of total hip arthroplasty (THA) performed by trainees is not known. A multicentre retrospective study of 879 THAs was undertaken to investigate any differences in outcome between those performed by trainee surgeons and consultants.

    PATIENTS AND METHODS: A total of 879 patients with a mean age of 69.5 years (37 to 94) were included in the study; 584 THAs (66.4%) were undertaken by consultants, 138 (15.7%) by junior trainees and 148 (16.8%) by senior trainees. Patients were scored using the Harris Hip Score (HHS) pre-operatively and at one, three, five, seven and ten years post-operatively. Surgical outcome, complications and survival were compared between groups. The effect of supervision was determined by comparing supervised and unsupervised trainees. A primary univariate analysis was used to select variables for inclusion in multivariate analysis.

    RESULTS: There was no evidence that the grade of the surgeon had a significant effect on the survival of the patients or the rate of revision (p = 0.987 and 0.405, respectively) up to 12 years post-operatively. There was no significant difference in post-operative functional HHS or total HHS among consultants, junior and seniors up to ten years post-operatively (p = 0.401 and 0.331), respectively. There was no significant difference in hospital stay (p = 0.855) between different grades of surgeons. There was no evidence that the level of supervision had an effect on the survival of the patients or the rate of revision (p = 0.837 and 0.203, respectively) up to 12 years post-operatively. There was no significant difference between supervised and unsupervised trainee groups in post-operative functional HHS or total HHS up to ten years post-operatively (p = 0.213 and 0.322, respectively). There was no significant difference in the mean hospital stay between supervised and unsupervised trainees (p = 0.908).

    TAKE HOME MESSAGE: This study suggests that when trainees are appropriately supervised, they can obtain results comparable with those of their consultant colleagues when performing THA.

    Original languageEnglish
    Pages (from-to)301-306
    Number of pages6
    JournalBone and Joint Journal
    Volume98-B
    Issue number3
    Early online date26 Feb 2016
    DOIs
    Publication statusPublished - Mar 2016

    Fingerprint

    Arthroplasty
    Hip
    Consultants
    Tacrine
    Survival
    Length of Stay
    Surgeons
    Multicenter Studies
    Multivariate Analysis
    Retrospective Studies

    Keywords

    • Adult
    • Aged
    • Aged, 80 and over
    • Arthroplasty, Replacement, Hip
    • Clinical competence
    • Consultants
    • Education, Medical, Graduate
    • Female
    • Hip prosthesis
    • Humans
    • Kaplan-Meier Estimate
    • Length of stay
    • Male
    • Middle aged
    • Prosthesis design
    • Prosthesis failure
    • Reoperation
    • Retrospective studies
    • Treatment outcome
    • Journal article
    • Multicenter study

    Cite this

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    title = "Do trainee surgeons have an adverse effect on the outcome after total hip arthroplasty?: a ten-year review",
    abstract = "AIMS: The long-term functional outcome of total hip arthroplasty (THA) performed by trainees is not known. A multicentre retrospective study of 879 THAs was undertaken to investigate any differences in outcome between those performed by trainee surgeons and consultants.PATIENTS AND METHODS: A total of 879 patients with a mean age of 69.5 years (37 to 94) were included in the study; 584 THAs (66.4{\%}) were undertaken by consultants, 138 (15.7{\%}) by junior trainees and 148 (16.8{\%}) by senior trainees. Patients were scored using the Harris Hip Score (HHS) pre-operatively and at one, three, five, seven and ten years post-operatively. Surgical outcome, complications and survival were compared between groups. The effect of supervision was determined by comparing supervised and unsupervised trainees. A primary univariate analysis was used to select variables for inclusion in multivariate analysis.RESULTS: There was no evidence that the grade of the surgeon had a significant effect on the survival of the patients or the rate of revision (p = 0.987 and 0.405, respectively) up to 12 years post-operatively. There was no significant difference in post-operative functional HHS or total HHS among consultants, junior and seniors up to ten years post-operatively (p = 0.401 and 0.331), respectively. There was no significant difference in hospital stay (p = 0.855) between different grades of surgeons. There was no evidence that the level of supervision had an effect on the survival of the patients or the rate of revision (p = 0.837 and 0.203, respectively) up to 12 years post-operatively. There was no significant difference between supervised and unsupervised trainee groups in post-operative functional HHS or total HHS up to ten years post-operatively (p = 0.213 and 0.322, respectively). There was no significant difference in the mean hospital stay between supervised and unsupervised trainees (p = 0.908).TAKE HOME MESSAGE: This study suggests that when trainees are appropriately supervised, they can obtain results comparable with those of their consultant colleagues when performing THA.",
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    author = "Reidy, {M. J.} and A. Faulkner and B. Shitole and B. Clift",
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    Do trainee surgeons have an adverse effect on the outcome after total hip arthroplasty? a ten-year review. / Reidy, M. J. (Lead / Corresponding author); Faulkner, A.; Shitole, B.; Clift, B.

    In: Bone and Joint Journal, Vol. 98-B, No. 3, 03.2016, p. 301-306.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Do trainee surgeons have an adverse effect on the outcome after total hip arthroplasty?

    T2 - a ten-year review

    AU - Reidy, M. J.

    AU - Faulkner, A.

    AU - Shitole, B.

    AU - Clift, B.

    N1 - ©2016 The British Editorial Society of Bone & Joint Surgery.

    PY - 2016/3

    Y1 - 2016/3

    N2 - AIMS: The long-term functional outcome of total hip arthroplasty (THA) performed by trainees is not known. A multicentre retrospective study of 879 THAs was undertaken to investigate any differences in outcome between those performed by trainee surgeons and consultants.PATIENTS AND METHODS: A total of 879 patients with a mean age of 69.5 years (37 to 94) were included in the study; 584 THAs (66.4%) were undertaken by consultants, 138 (15.7%) by junior trainees and 148 (16.8%) by senior trainees. Patients were scored using the Harris Hip Score (HHS) pre-operatively and at one, three, five, seven and ten years post-operatively. Surgical outcome, complications and survival were compared between groups. The effect of supervision was determined by comparing supervised and unsupervised trainees. A primary univariate analysis was used to select variables for inclusion in multivariate analysis.RESULTS: There was no evidence that the grade of the surgeon had a significant effect on the survival of the patients or the rate of revision (p = 0.987 and 0.405, respectively) up to 12 years post-operatively. There was no significant difference in post-operative functional HHS or total HHS among consultants, junior and seniors up to ten years post-operatively (p = 0.401 and 0.331), respectively. There was no significant difference in hospital stay (p = 0.855) between different grades of surgeons. There was no evidence that the level of supervision had an effect on the survival of the patients or the rate of revision (p = 0.837 and 0.203, respectively) up to 12 years post-operatively. There was no significant difference between supervised and unsupervised trainee groups in post-operative functional HHS or total HHS up to ten years post-operatively (p = 0.213 and 0.322, respectively). There was no significant difference in the mean hospital stay between supervised and unsupervised trainees (p = 0.908).TAKE HOME MESSAGE: This study suggests that when trainees are appropriately supervised, they can obtain results comparable with those of their consultant colleagues when performing THA.

    AB - AIMS: The long-term functional outcome of total hip arthroplasty (THA) performed by trainees is not known. A multicentre retrospective study of 879 THAs was undertaken to investigate any differences in outcome between those performed by trainee surgeons and consultants.PATIENTS AND METHODS: A total of 879 patients with a mean age of 69.5 years (37 to 94) were included in the study; 584 THAs (66.4%) were undertaken by consultants, 138 (15.7%) by junior trainees and 148 (16.8%) by senior trainees. Patients were scored using the Harris Hip Score (HHS) pre-operatively and at one, three, five, seven and ten years post-operatively. Surgical outcome, complications and survival were compared between groups. The effect of supervision was determined by comparing supervised and unsupervised trainees. A primary univariate analysis was used to select variables for inclusion in multivariate analysis.RESULTS: There was no evidence that the grade of the surgeon had a significant effect on the survival of the patients or the rate of revision (p = 0.987 and 0.405, respectively) up to 12 years post-operatively. There was no significant difference in post-operative functional HHS or total HHS among consultants, junior and seniors up to ten years post-operatively (p = 0.401 and 0.331), respectively. There was no significant difference in hospital stay (p = 0.855) between different grades of surgeons. There was no evidence that the level of supervision had an effect on the survival of the patients or the rate of revision (p = 0.837 and 0.203, respectively) up to 12 years post-operatively. There was no significant difference between supervised and unsupervised trainee groups in post-operative functional HHS or total HHS up to ten years post-operatively (p = 0.213 and 0.322, respectively). There was no significant difference in the mean hospital stay between supervised and unsupervised trainees (p = 0.908).TAKE HOME MESSAGE: This study suggests that when trainees are appropriately supervised, they can obtain results comparable with those of their consultant colleagues when performing THA.

    KW - Adult

    KW - Aged

    KW - Aged, 80 and over

    KW - Arthroplasty, Replacement, Hip

    KW - Clinical competence

    KW - Consultants

    KW - Education, Medical, Graduate

    KW - Female

    KW - Hip prosthesis

    KW - Humans

    KW - Kaplan-Meier Estimate

    KW - Length of stay

    KW - Male

    KW - Middle aged

    KW - Prosthesis design

    KW - Prosthesis failure

    KW - Reoperation

    KW - Retrospective studies

    KW - Treatment outcome

    KW - Journal article

    KW - Multicenter study

    U2 - 10.1302/0301-620X.98B3.35997

    DO - 10.1302/0301-620X.98B3.35997

    M3 - Article

    VL - 98-B

    SP - 301

    EP - 306

    JO - Bone and Joint Journal

    JF - Bone and Joint Journal

    SN - 2049-4394

    IS - 3

    ER -