A systematic review and meta-analysis of trainee- versus consultant surgeon-performed elective total hip arthroplasty

[摘要] performed operations worldwide. Demand for THA is set to increase over the next decade with a 174% increase in the USA estimated by 2030,1,2 largely due to longer life expectancy, an ageing population and higher functional demand in the developed world.3 Training future orthopaedic surgeons is clearly crucial if supply is to meet demand. However, such training raises several conflicting issues. Although trainees must have adequate operative experience to be deemed competent in a procedure, this must be balanced with increasing scrutiny of outcomes, the widespread use of joint registries and pressure on surgical teams to maximize efficiency. Concerns have been raised that trainee-performed operations may be associated with poorer outcomes for patients, a reduction in efficiency and a consequent rise in healthcare delivery costs.4-8 Schoenfeld et al conducted a retrospective review of outcomes using registry data for 12 commonly performed orthopaedic operations, noting a mild to moderate risk of complications for operations involving a resident.5 Similarly, Marston et al compared outcomes following trainee- and consultant-performed THA, noting a higher revision rate among trainee-performed procedures.9 The growing use of validated simulation packages for training has helped to familiarize trainees with orthopaedic procedures and offset the learning curve for THA.10 However, there is no substitute for gaining competence by repetitively undertaking a procedure.

[学科分类] 神经科学

[关键词] total hip arthroplasty;surgical training;supervision