Flamme C H, Stukenborg-Colsman C, Wirth C J
Orthopaedic Department, Hannover Medical School, Hannover, Germany.
Hip Int. 2006 Jul-Sep;16(3):191-7. doi: 10.1177/112070000601600302.
The aim of the paper is to prove and to portray the learning curve in total hip arthroplasty. This prospective study included 168 patients who were operated on by three surgeons, all demonstrating different degrees of experience in performing total hip arthroplasty. Perioperative complications and postoperative radiographs were analysed. Patients were re-examined clinically and radiologically five years postoperatively. In addition, a second study with 41 patients was performed, evaluating especially the learning curve of the highly skilled surgeon in using a femoral neck prosthesis. Radiological complications presented by the first 84 operated patients (2 nd study: 25 hips) were significantly higher than those in the following 84 patients (2 nd study: 26 hips). The learning curve of all surgeons was completed after 20 operations regardless of their experience. Clinical results at follow-up were not influenced by the learning curve. Intensive preoperative planning and exchange of experiences will reduce the length of the learning curve within and outside every clinic.
本文的目的是证明并描绘全髋关节置换术的学习曲线。这项前瞻性研究纳入了168例患者，由三位外科医生进行手术，他们在全髋关节置换术方面均表现出不同程度的经验。分析了围手术期并发症和术后X线片。患者在术后五年进行临床和影像学复查。此外，还对41例患者进行了第二项研究，特别评估了技术高超的外科医生使用股骨颈假体的学习曲线。前84例手术患者（第二项研究：25髋）出现的放射学并发症明显高于后84例患者（第二项研究：26髋）。所有外科医生的学习曲线在完成20例手术后均告结束，无论其经验如何。随访时的临床结果不受学习曲线的影响。术前进行深入规划并交流经验将缩短每个临床科室内部和外部的学习曲线长度。
