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European Journal of Orthopaedic Surgery & Traumatology

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Open Access 01-02-2018 | Original Article • HIP - ARTHROPLASTY

The learning curve in short-stem THA: influence of the surgeon’s experience on intraoperative adjustments due to intraoperative radiography

Authors: Lennard Loweg, Karl Philipp Kutzner, Matthias Trost, Marlene Hechtner, Philipp Drees, Joachim Pfeil, Michael Schneider

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2018

Abstract

Introduction

Short-stem THA has become increasingly popular over the last decade. However, implantation technique differs from conventional THA and thus possibly involves a distinct learning curve. The purpose of this study was to evaluate the value of intraoperative radiography and the influence of the surgeon’s experience on intraoperative adjustments in short-stem THA.

Methods

A total of 287 consecutive short-stem THAs, operated by a total of 24 senior consultants, consultants and residents in training, were prospectively included. Intraoperative radiography was performed after trial reduction. Preoperative planning and intraoperative outcome with regard to positioning, sizing of components as well as resulting offset and leg length were compared. Frequency, reason and type of intraoperative adjustments were documented in relation to the surgeon’s experience. Operation time was assessed.

Results

One hundred and fifty-six (54.4%) procedures were carried out by one of three senior consultants, and a total of nine consultants and 12 residents in training performed 105 (36.6%) and 26 (9.0%) operations, respectively. In 121 cases (42.2%), intraoperative adjustments were made following intraoperative radiography. Intraoperative adjustments of one or more components were made by senior consultants in 51 cases (32.7%), by consultants in 53 cases (50.5%) and by residents in 17 cases (65.4%), respectively. The most common cause was undersizing of the stem. Operation time varied markedly between groups of surgeons.

Discussion

Short-stem THA involves a learning curve. Intraoperative radiography is decisive for prevention of malpositioning and undersizing of components, as well as loss of offset and leg length discrepancies. Hence, it should be considered mandatory, especially for less experienced surgeons.

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Title: The learning curve in short-stem THA: influence of the surgeon’s experience on intraoperative adjustments due to intraoperative radiography
Authors: Lennard Loweg
Karl Philipp Kutzner
Matthias Trost
Marlene Hechtner
Philipp Drees
Joachim Pfeil
Michael Schneider
Publication date: 01-02-2018
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2018
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-017-2049-y

At a glance: The STEP trials

Springer Medicine

The learning curve in short-stem THA: influence of the surgeon’s experience on intraoperative adjustments due to intraoperative radiography

Abstract

Introduction

Methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

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