Literature DB >> 17346408

Learning curves in orthopaedic surgery: a case for super-specialisation?

N P M Jain1, A J L Jowett, N M P Clarke.   

Abstract

INTRODUCTION: The objective of this study was to assess if there is a significant learning curve in the treatment of developmental dysplasia of the hip. PATIENTS AND METHODS: We followed up cases of developmental dysplasia of the hip treated by a single surgeon over a 12-year period. There were 96 cases, 56 treated by open reduction and 40 treated by closed reduction. Assessment was made of the incidence and degree of avascular necrosis in the treated hips, as a radiological outcome measure.
RESULTS: Plotting the cumulative percentage of satisfactory outcomes demonstrated an increasingly high percentage of satisfactory results with increasing number of procedures performed, i.e. as the surgeon progressed up the 'learning curve'.
CONCLUSIONS: This study demonstrates a learning curve in the treatment of developmental dysplasia of the hip. It may be possible to draw parallels to other treatments, and also support for the growing trend to specialisation.

Entities:  

Mesh:

Year:  2007        PMID: 17346408      PMCID: PMC1964561          DOI: 10.1308/003588407X155798

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


  12 in total

Review 1.  New surgical procedures: can we minimise the learning curve?

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Journal:  BMJ       Date:  2000-01-15

2.  Mortality and volume of cases in paediatric cardiac surgery: retrospective study based on routinely collected data.

Authors:  David J Spiegelhalter
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4.  The learning curve of an academic cardiac surgeon: use of the CUSUM method.

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6.  Volume-outcome relationships in cardiovascular operations: New York State, 1990-1995.

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Journal:  J Thorac Cardiovasc Surg       Date:  1999-03       Impact factor: 5.209

7.  Assessment of whether in-hospital mortality for lobectomy is a useful standard for the quality of lung cancer surgery: retrospective study.

Authors:  Tom Treasure; Martin Utley; Alan Bailey
Journal:  BMJ       Date:  2003-07-12

8.  Avascular necrosis following treatment of congenital dislocation of the hip.

Authors:  A Kalamchi; G D MacEwen
Journal:  J Bone Joint Surg Am       Date:  1980-09       Impact factor: 5.284

9.  Congenital dislocation of the hip in boys.

Authors:  J L Borges; S J Kumar; J T Guille
Journal:  J Bone Joint Surg Am       Date:  1995-07       Impact factor: 5.284

10.  Avascular necrosis after open reduction for congenital dislocation of the hip: analysis of causative factors and natural history.

Authors:  I H Thomas; A J Dunin; W G Cole; M B Menelaus
Journal:  J Pediatr Orthop       Date:  1989 Sep-Oct       Impact factor: 2.324

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  8 in total

1.  Acetabuloplasties at Open Reduction Prevent Acetabular Dysplasia in Intentionally Delayed Developmental Dysplasia of the Hip: A Case-control Study.

Authors:  M Belen Carsi; Nicholas M P Clarke
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2.  What Is the Early/Mid-term Survivorship and Functional Outcome After Bernese Periacetabular Osteotomy in a Pediatric Surgeon Practice?

Authors:  George Grammatopoulos; Jeremy Wales; Alpesh Kothari; Harinderjit S Gill; Andrew Wainwright; Tim Theologis
Journal:  Clin Orthop Relat Res       Date:  2016-05       Impact factor: 4.176

3.  Comparative learning curves for early complications in anatomical and reverse shoulder arthroplasty.

Authors:  Jcs Beazley; J P Evans; N D Furness; C D Smith
Journal:  Ann R Coll Surg Engl       Date:  2018-04-25       Impact factor: 1.891

4.  Learning curves in hip fracture surgery.

Authors:  Kristian Bjorgul; Wendy M Novicoff; Khaled J Saleh
Journal:  Int Orthop       Date:  2010-02-20       Impact factor: 3.075

5.  Surgical trial design - learning curve and surgeon volume: Determining whether inferior results are due to the procedure itself, or delivery of the procedure by the surgeon.

Authors:  A H R W Simpson; C R Howie; J Norrie
Journal:  Bone Joint Res       Date:  2017-04       Impact factor: 5.853

6.  Learning Curve of Closed Reduction and Internal Fixation for Supracondylar Fractures of the Humerus in Children.

Authors:  Chuang Qian; Yiming Zheng; Junrong Meng; Yueqiang Mo; Jinhua Sun; Hao Li; Dahui Wang
Journal:  Front Pediatr       Date:  2022-07-07       Impact factor: 3.569

7.  Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip: A PRISMA-compliant meta-analysis of observational studies.

Authors:  Ya-Jie Wang; Fan Yang; Qi-Jun Wu; Shi-Nong Pan; Lian-Yong Li
Journal:  Medicine (Baltimore)       Date:  2016-07       Impact factor: 1.889

8.  Learning curve with a new primary total knee arthroplasty implant: a multicenter perspective with more than 2000 patients.

Authors:  John-Paul Whittaker; Kimberly A Dwyer; James Howard; Verdonna Huey; James Lesko; Ryan M Nunley; Peter Verdonk
Journal:  Arthroplast Today       Date:  2018-07-09
  8 in total

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