Kautzner Jakub, Zeman Petr, Stančák Andrej, Havlas Vojtěch
Department of Orthopaedics and Traumatology, 2nd Faculty of Medicine, Motol Hospital Prague, Charles University, V Uvalu 84, 15006, Prague, Czech Republic.
Department of Orthopaedics and Traumatology, Medical Faculty Pilsen, Charles University, Pilsen, Czech Republic.
Int Orthop. 2018 Apr;42(4):777-782. doi: 10.1007/s00264-017-3666-0. Epub 2017 Oct 18.
PURPOSE: Arthroscopy of the hip joint is considered a demanding procedure with long learning curve. There are only a few studies that concentrate on this topic. This prospective clinical study evaluates the learning curve of the hip arthroscopy based on clinical outcomes, surgical time, and complication rate. MATERIALS: In this study, we first evaluated 150 hip arthroscopy procedures performed by a single surgeon. The patient group consisted of 86 females and 64 males with mean age 37 years (range 16-69). Study cohorts were divided into groups of 50 patients. Surgical time, complication rate and clinical results based on NAHS score were recorded for each group. Statistical analysis of differences between groups was performed using the ANOVA method and paired t-test. RESULTS: We found a statistically significant decrease of complication rate with more procedures performed. There were significantly better clinical outcomes after at least 100 procedures. No difference in surgical time was found, but towards the end of the learning curve, more complex procedures were performed. The only statistical difference was the portal setup time. The learning curves were constructed based on these results. CONCLUSIONS: Hip arthroscopy provides very good clinical outcomes if precisely indicated and performed. It is, however, a demanding procedure with many possible pitfalls and complications. According to our study, at least 100 procedures are needed to gain basic technical and indication skills. The presence of a more skilled surgeon in the beginning of the learning curve is advised to reduce the complication rate.
目的:髋关节镜检查被认为是一项具有较长学习曲线的高要求手术。仅有少数研究关注这一主题。这项前瞻性临床研究基于临床结果、手术时间和并发症发生率评估髋关节镜检查的学习曲线。 材料:在本研究中,我们首先评估了由一名外科医生实施的150例髋关节镜手术。患者组包括86名女性和64名男性,平均年龄37岁(范围16 - 69岁)。研究队列被分为每组50名患者的小组。记录每组的手术时间、并发症发生率以及基于NAHS评分的临床结果。使用方差分析方法和配对t检验对组间差异进行统计分析。 结果:我们发现随着手术例数增加,并发症发生率有统计学意义的下降。至少进行100例手术后临床结果明显更好。未发现手术时间有差异,但在学习曲线末期,实施了更复杂的手术。唯一的统计学差异是入路设置时间。基于这些结果构建了学习曲线。 结论:如果适应证明确且操作精准,髋关节镜检查可提供非常好的临床结果。然而,这是一项高要求的手术,存在许多潜在的陷阱和并发症。根据我们的研究,至少需要进行100例手术才能获得基本的技术和适应证判断技能。建议在学习曲线初期有更熟练的外科医生在场以降低并发症发生率。
Int Orthop. 2018-4
J Bone Joint Surg Am. 2011-5
Clin Orthop Relat Res. 2017-4
Sports Med Arthrosc Rev. 2015-12
Iowa Orthop J. 2025
Knee Surg Sports Traumatol Arthrosc. 2023-5
Int J Comput Assist Radiol Surg. 2022-10
J Orthop. 2022-5-7
Orthop J Sports Med. 2022-5-6
Clin Sports Med. 2016-7
Rev Bras Ortop. 2014-5-14
Acta Orthop Belg. 2014-3
Knee Surg Sports Traumatol Arthrosc. 2014-4
Arthroscopy. 2014-1-22
Bone Joint J. 2013-11