Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 5/2012

01-05-2012 | Original Paper

Mentoring in complex surgery: minimising the learning curve complications from peri-acetabular osteotomy

Authors: Donald W. Howie, Martin Beck, Kerry Costi, Susan M. Pannach, Reinhold Ganz

Published in: International Orthopaedics | Issue 5/2012

Login to get access

Abstract

Purpose

The aim of this study was to determine whether a complex surgical procedure such as peri-acetabular osteotomy could be safely learnt by using a programme involving mentoring by a distant expert. To determine this, we examined the incidence of intra-operative complications, the acetabulum correction achieved, the late incidence of re-operation and progressive degenerative arthritis.

Methods

Between 1992 and 2004, peri-acetabular osteotomy was performed in 26 hips in 23 patients. The median follow-up was ten (5–17) years. The median age of the patients at operation was 28 (14–41) years. Clinical outcomes were reported and radiographic results were determined by an independent expert.

Results

There were no intra-articular osteotomies, sciatic nerve injuries, hingeing deformities or vascular injuries. There was one ischial nonunion. The lateral centre-edge angle improved from a median 4° pre-operatively to 25°. One revision osteotomy, one osteectomy and three total hip replacements were required, two for progression of osteoarthritis.

Conclusions

The programme of mentoring was successful in that there was a low incidence of the major intra-operative complications that are often reported during the learning curve period and the acetabular corrections achieved were similar to the originators.
Literature
1.
Biedermann R, Donnan L, Gabriel A, Wachter R, Krismer M, Behensky H (2008) Complications and patient satisfaction after periacetabular pelvic osteotomy. Int Orthop 32:611–617PubMedCrossRef
2.
Clohisy JC, Barrett SE, Gordon JE, Delgado ED, Schoenecker PL (2005) Periacetabular osteotomy in the treatment of severe acetabular dysplasia. J Bone Joint Surg Am 87(2):254–259PubMedCrossRef
3.
Cook A, Khoury A, Bagli D, McLorie GA, El-Ghoneimi A, Farhat WA (2005) The development of laparoscopic surgical skills in pediatric urologists: longterm outcome of a mentorship-training model. Can J Urol 12(5):2824–2828PubMed
4.
Crockarell J Jr, Trousdale RT, Cabanela ME, Berry DJ (1999) Early experience and results with the periacetabular osteotomy. The Mayo Clinic experience. Clin Orthop Relat Res 363:45–53PubMedCrossRef
5.
Davey JP, Santore RF (1999) Complications of periacetabular osteotomy. Clin Orthop Relat Res 363:33–37PubMedCrossRef
6.
Farhat W, Khoury A, Bagli D, McLorie G, El-Ghoneimi A (2003) Mentored retroperitoneal laparoscopic renal surgery in children: a safe approach to learning. BJU Int 92(6):617–620PubMedCrossRef
7.
Ganz R, Klaue K, Vinh TS, Mast JW (1988) A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results. Clin Orthop Relat Res 232:26–36PubMed
8.
Garras DN, Crowder TT, Olson SA (2007) Medium-term results of the Bernese periacetabular osteotomy in the treatment of symptomatic developmental dysplasia of the hip. J Bone Joint Surg Br 89(6):721–724PubMedCrossRef
9.
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755PubMed
10.
Heyman CH, Herndon CH (1950) Legg-Perthes disease; a method for the measurement of the roentgenographic result. J Bone Joint Surg Am 32(4):767–778PubMed
11.
Hussell JG, Mast JW, Mayo KA, Howie DW, Ganz R (1999) A comparison of different surgical approaches for the periacetabular osteotomy. Clin Orthop Relat Res 363:64–72PubMed
12.
Hussell JG, Rodriguez JA, Ganz R (1999) Technical complications of the Bernese periacetabular osteotomy. Clin Orthop Relat Res 363:81–92PubMed
13.
Lazennec JY, Mora Valladares N, Laudet CG, Barabas D, Ramare S, Hansen S, Guerin-Surville H, Saillant G (1998) Anatomic bases of a new technique of juxta-acetabular osteotomy. Technical principles and performance. Surg Radiol Anat 20(3):153–159PubMed
14.
Lequesne M, de Sèze S (1961) Le faux profil du bassin. Nouvelle incidence radiographique pour l’étude de la hanche. Son utilité dans les dysplasies et les differentes coxopathies. Rev Rhum Mal Osteoartic 28:643–652PubMed
15.
Li PL, Ganz R (2003) Morphologic features of congenital acetabular dysplasia: one in six is retroverted. Clin Orthop Relat Res 416:245–253PubMedCrossRef
16.
Matta JM, Stover MD, Siebenrock K (1999) Periacetabular osteotomy through the Smith-Petersen approach. Clin Orthop Relat Res 363:21–32PubMed
17.
Myers SR, Eijer H, Ganz R (1999) Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res 363:93–99PubMedCrossRef
18.
Peters CL, Erickson JA, Hines JL (2006) Early results of the Bernese periacetabular osteotomy: the learning curve at an academic medical center. J Bone Joint Surg Am 88(9):1920–1926PubMedCrossRef
19.
Pogliacomi F, Stark A, Wallensten R (2005) Periacetabular osteotomy. Good pain relief in symptomatic hip dysplasia, 32 patients followed for 4 years. Acta Orthop 76(1):67–74PubMedCrossRef
20.
Reynolds D, Lucas J, Klaue K (1999) Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br 81(2):281–288PubMedCrossRef
21.
Sambandam SN, Hull J, Jiranek WA (2009) Factors predicting the failure of Bernese periacetabular osteotomy: a meta-regression analysis. Int Orthop 33:1483–1488PubMedCrossRef
22.
Severin E (1941) Contribution to the knowledge of congenital dislocation of the hip joint. Late results of closed reduction and arthrographic studies of recent cases. Acta Chir Scand 84(63):1–142
23.
Siebenrock KA, Schöll E, Lottenbach M, Ganz R (1999) Bernese periacetabular osteotomy. Clin Orthop Relat Res 363:9–20PubMedCrossRef
24.
Siebenrock KA, Schoeniger R, Ganz R (2003) Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am 85:278–286PubMed
25.
Tönnis D, Behrens K, Tscharani F (1981) A modified technique of the triple pelvic osteotomy: early results. J Pediatr Orthop 1(3):241–249PubMedCrossRef
26.
Tönnis D (1987) Congenital dysplasia and dislocation of the hip in children and adults. Springer, BerlinCrossRef
27.
Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL (1995) Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am 77(1):73–85PubMed
28.
Trousdale RT, Cabanela ME (2003) Lessons learned after more than 250 periacetabular osteotomies. Acta Orthop Scand 74(2):119–126PubMedCrossRef
29.
Wiberg G (1939) Studies on dysplastic acetabula and congenital subluxation of the hip joint with special reference to the complication of osteoarthritis. Parts I–IV. Acta Chir Scand 83(58):1–135
30.
Xie J, Naito M, Maeyama A (2010) Evaluation of acetabular versions after a curved periacetabular osteotomy for dysplastic hips. Int Orthop 34:473–477PubMedCrossRef
Metadata
Title
Mentoring in complex surgery: minimising the learning curve complications from peri-acetabular osteotomy
Authors
Donald W. Howie
Martin Beck
Kerry Costi
Susan M. Pannach
Reinhold Ganz
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 5/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1347-y

Other articles of this Issue 5/2012

International Orthopaedics 5/2012 Go to the issue

Original Paper

Proximal ulna endoprosthetic replacement for bone tumours in young patients

Original Paper

Computer Tomography assessment of the fusion rate after posterior arthroscopic subtalar arthrodesis

Original Paper

Retention of a well-fixed acetabular component in the setting of acetabular osteolysis

Original Paper

The influence of low molecular weight heparin on the expression of osteogenic growth factors in human fracture healing

Original Paper

Fractures of a sandwich ceramic liner at ten year follow-up

Original Paper

Correlation between plasma and synovial fluid basic fibroblast growth factor with radiographic severity in primary knee osteoarthritis