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髋关节镜检查学习曲线:一项前瞻性单术者研究。

Hip arthroscopy learning curve: a prospective single-surgeon study.

作者信息

Kautzner Jakub, Zeman Petr, Stančák Andrej, Havlas Vojtěch

机构信息

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.

出版信息

Int Orthop. 2018 Apr;42(4):777-782. doi: 10.1007/s00264-017-3666-0. Epub 2017 Oct 18.


DOI:10.1007/s00264-017-3666-0
PMID:29046931
Abstract

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.

摘要

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。

相似文献

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[2]
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[3]
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[5]
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[6]
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[7]
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[8]
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[9]
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[3]
Functional outcome improvement and surgical time reduction in a single-surgeon consecutive case series of hip arthroscopy for femoroacetabular impingement: A minimum 5 years follow-up study.

J Exp Orthop. 2025-1-22

[4]
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J Orthop. 2023-12-7

[5]
Eye tracking metrics of orthopedic surgeons with different competency levels who practice simulation-based hip arthroscopic procedures.

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[6]
A three-dimensional (3D) printed simulator as a feasible assessment tool for evaluating hip arthroscopy skills.

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[7]
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Int J Comput Assist Radiol Surg. 2022-10

[8]
A novel arthroscopy training program based on a 3D printed simulator.

J Orthop. 2022-5-7

[9]
Three-Dimensional Quantification of Cam Resection Using MRI Bone Models: A Comparison of 2 Techniques.

Orthop J Sports Med. 2022-5-6

[10]
Portal Setup: the Key Point in the Learning Curve for Hip Arthroscopy Technique.

Orthop Surg. 2021-8

本文引用的文献

[1]
Editorial Commentary: Hip Femoroacetabular Impingement Correction: Risk Versus Reward, or How Much Is Too Much?

Arthroscopy. 2017-4

[2]
Avoiding Failure in Hip Arthroscopy: Complications, Pearls, and Pitfalls.

Clin Sports Med. 2016-7

[3]
Hip arthroscopy.

Rev Bras Ortop. 2014-5-14

[4]
Safety measures in hip arthroscopy and their efficacy in minimizing complications: a systematic review of the evidence.

Arthroscopy. 2014-7-11

[5]
Results of the learning curve for interventional hip arthroscopy: a prospective study.

Acta Orthop Belg. 2014-3

[6]
Hip arthroscopy for femoroacetabular impingement: the changing nature and severity of associated complications over time.

Arthroscopy. 2014-8

[7]
The knee arthroscopy learning curve: quantitative assessment of surgical skills.

Arthroscopy. 2014-5

[8]
Complications in hip arthroscopy: necessity of supervision during the learning curve.

Knee Surg Sports Traumatol Arthrosc. 2014-4

[9]
The learning curve for hip arthroscopy: a systematic review.

Arthroscopy. 2014-1-22

[10]
Femoroacetabular impingement: an arthroscopic solution.

Bone Joint J. 2013-11

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