Osmanski-Zenk Katrin, Finze Susanne, Lenz Robert, Bader Rainer, Mittelmeier Wolfram
Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock.
Z Orthop Unfall. 2019 Feb;157(1):48-53. doi: 10.1055/a-0627-7586. Epub 2018 Jun 26.
The study aims to evaluate whether the postoperative outcome and the probability of complications of patients with total hip arthroplasty increases significantly when surgeons in training are in charge, assisted by a high volume surgeon, compared to a highly experienced orthopaedic surgeon, within the context of a high volume hospital certified to EndoCert.
192 patients with a primary hip arthroplasty were included. To assess the outcome, the Harris Hip Score, WOMAC, SF-36 and EuroQol-5D were surveyed pre- and 12 months postoperatively. As complications we considered the quality indicators defined by EndoCert.
We found significant improvements in the postoperative score values with the qualifications of the surgeon in charge, even when a high volume surgeon or a surgeon in training was responsible. If a surgeon in training is assisted by a highly experienced surgeon, the risk of complications does not increase, although the operating time was significantly increased.
Both the surgeon in training as well as the arthroplasty patient benefit from implementing the EndoCert system, because the postoperative outcome and the complication probability is independent of the qualifcation of the operating orthopaedic surgeon performing total hip arthroplasty when assisted by an experienced surgeon.
本研究旨在评估在获得EndoCert认证的高容量医院环境下，与经验丰富的骨科医生相比，当实习外科医生在高容量外科医生的协助下负责全髋关节置换术时，患者的术后结果和并发症发生率是否会显著增加。
纳入192例行初次髋关节置换术的患者。为评估结果，在术前和术后12个月对Harris髋关节评分、WOMAC、SF - 36和EuroQol - 5D进行调查。我们将EndoCert定义的质量指标视为并发症。
我们发现，无论负责的外科医生是高容量外科医生还是实习外科医生，术后评分值均有显著改善。如果实习外科医生在经验丰富的外科医生协助下，并发症风险不会增加，尽管手术时间显著延长。
实施EndoCert系统对实习外科医生和关节置换患者都有益，因为在经验丰富的外科医生协助下进行全髋关节置换术时，术后结果和并发症发生率与实施手术的骨科医生资质无关。
