Mentoring in complex surgery: minimising the learning curve complications from peri-acetabular osteotomy

Int Orthop. 2012 May;36(5):921-5. doi: 10.1007/s00264-011-1347-y. Epub 2011 Sep 7.

Abstract

Purpose: The aim of this study was to determine whether a complex surgical procedure such as peri-acetabular osteotomy could be safely learnt by using a programme involving mentoring by a distant expert. To determine this, we examined the incidence of intra-operative complications, the acetabulum correction achieved, the late incidence of re-operation and progressive degenerative arthritis.

Methods: Between 1992 and 2004, peri-acetabular osteotomy was performed in 26 hips in 23 patients. The median follow-up was ten (5-17) years. The median age of the patients at operation was 28 (14-41) years. Clinical outcomes were reported and radiographic results were determined by an independent expert.

Results: There were no intra-articular osteotomies, sciatic nerve injuries, hingeing deformities or vascular injuries. There was one ischial nonunion. The lateral centre-edge angle improved from a median 4° pre-operatively to 25°. One revision osteotomy, one osteectomy and three total hip replacements were required, two for progression of osteoarthritis.

Conclusions: The programme of mentoring was successful in that there was a low incidence of the major intra-operative complications that are often reported during the learning curve period and the acetabular corrections achieved were similar to the originators.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / surgery*
  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Hip Joint / surgery*
  • Humans
  • Incidence
  • Male
  • Mentors*
  • Orthopedics / education*
  • Osteoarthritis / epidemiology
  • Osteotomy* / methods
  • Postoperative Complications / epidemiology
  • Radiography
  • Reoperation / statistics & numerical data*
  • Treatment Outcome
  • Young Adult