Abstract
Aim: It is widely accepted that surgical skills improve with experience. Part of this experience comes from operating on patients while honing new skills. Total hip arthroplasty is one such procedure. This paper examines outcomes in relation to the primary surgeon
Methodology: All patients who had an Exeter femoral component implanted and 2 years follow-up in the hospital joint register had their X-Ray, outcome scores and complications reviewed. Complications are routinely recorded as part of the joint register and hospital computer discharge system. Radiological outcome measures were taken as recommended by Johnston et al. Procedures were recorded as either performed by consultant surgeon or registrar supervised by consultant surgeon.
Results: Post operative WOMAC scores at six months and 2 years were similar in both groups (Consultant 19.6, registrar 22.32 at 6 months) SF-36 figures were similar at six months (Consultant performed 78.56, consultant supervised 75.39). There was a difference in SF-36 at 2 years (72.77 vs 63.11) but this was not statistically significant. Average abduction angle was lower in consultant supervised than consultant performed procedure. (36.75 vs 47 deg) Barrack cement grading was similar in both groups. Consultant inserted stems were more likely to be in neutral position compared to consultant supervised stems (84% vs 56%)
Conclusion: In both goups the quality of life indexes do show a difference in outcome which relates to the primary surgeon.. However decreased abduction angle may lead to decreased range of motion post operatively and should be addressed intraoperatively.
Correspondence should be addressed to Mr Richard Wallace at Musgrave Park Hospital, 20 Stockman’s Lane, Belfast BT9 7JB, Northern Ireland.
