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Trauma

DO TRAINEE SURGEONS ADVERSELY IMPACT THR OUTCOME? A TEN-YEAR REVIEW

Scottish Committee for Orthopaedics and Trauma (SCOT)



Abstract

A multicentre retrospective study of 879 total hip replacements (THR) was undertaken to investigate any differences in outcome between trainee surgeons and consultants. The effect of trainee supervision was also assessed. The primary outcome measures were survivorship and the Harris Hip Score (HHS). Length of stay was a secondary outcome.

Patients were evaluated pre-operatively and at 1, 3, 5, 7 and 10 years post-operatively. Surgical outcome was compared between junior trainees, senior trainees and consultants. The effect of supervision was determined by comparing supervised and unsupervised trainees. There was no significant difference in post-operative HHS among consultants, senior and junior trainees at 1 year (p=0.122), at 3 years (p=0.282), at 5 years (p=0.063), at 7 years (p=0.875), or at 10 years (p=0.924) follow up. Additionally there was no significant difference in HHS between supervised and unsupervised trainees at 1 year (p=0.220), 3 years (p=0.0.542), 5 years (p=0.880), 7 years (p=0.953) and 10-year (p=0.787) follow-up. Comparison of surgical outcome between the supervised and unsupervised trainees also shows no significant difference in hospital stay (p=0.989), or implant survival years (p=0.257). This study provides evidence that when trainees are appropriately supervised, they can obtain equally good results compared with consultants when performing THR.