Steadman Philippon Research Institute, 181 W. Meadow Dr., Vail, CO, 81657, USA.
The Steadman Clinic and Steadman Philippon Research Institute, 181 W. Meadow Dr., Vail, CO, 81657, USA.
Knee Surg Sports Traumatol Arthrosc. 2020 Apr;28(4):1270-1275. doi: 10.1007/s00167-018-5289-4. Epub 2018 Nov 22.
The purpose of this study was to compare the clinical practices between expert and non-expert arthroscopy hip surgeons.
Registered orthopedic surgeons completed anonymous surveys during a hip arthroscopy meeting. The survey included 60 questions on physician's level of expertise, surgical anesthesia, procedures performed, hospital stay, pain control, rehabilitation and socioeconomic parameters, and the results are presented. Comparisons were made between hip arthroscopy experts (> 500 cases performed) and non-experts (≤ 500 cases performed) on aspects of patient care.
Forty-eight (74%) surgeons responded. Forty-four questionnaires were filled out completely. There were no significant differences in recommendations between 15 (34%) hip arthroscopy experts and 29 (66%) non-experts on hip capsular management and cartilage repair techniques, use of antithrombotic prophylaxis and opioid analgesics, time of rehabilitation initiation and patient compliance factors, use of hip brace and CPM, and patient evaluation to return to sports following surgery. Surgical expertise was significantly associated with the performance of hip labral reconstruction (p = 0.016), subspine decompression (p = 0.039) and recommendation of a longer period of restricted weight bearing following the performance of microfractures (p = 0.011). There were no significant differences in clinical practice between surgeons who performed hip arthroscopy exclusively versus those who did not.
Hip arthroscopy is a relatively new field, and clinical practice may vary among physicians based on the surgical expertise. In this study, hip arthroscopy experts agree with non-experts on most aspects of patient care. Surgical expertise was associated with performance of advanced techniques and recommendation of longer period of restricted weight bearing following performance of microfractures. This study highlights different care patterns that need to be investigated to determine which treatment results in improved patient care.
V.
本研究旨在比较专家和非专家关节镜髋关节外科医生的临床实践。
注册骨科医生在髋关节镜会议期间完成了匿名调查。该调查包括 60 个关于医生专业水平、手术麻醉、手术程序、住院时间、疼痛控制、康复和社会经济参数的问题，结果如下。在患者护理方面，对髋关节镜专家（>500 例）和非专家（≤500 例）进行了比较。
48 名（74%）外科医生做出了回应。44 份问卷填写完整。在髋关节囊管理和软骨修复技术、使用抗血栓预防和阿片类镇痛药、康复开始和患者依从性因素、使用髋关节支具和 CPM 以及术后患者重返运动的评估方面，15 名（34%）髋关节镜专家和 29 名（66%）非专家的建议没有显著差异。手术专业知识与髋关节盂唇重建（p=0.016）、脊柱下减压（p=0.039）以及在进行微骨折后建议更长时间的限制负重（p=0.011）的执行显著相关。仅进行髋关节镜检查的外科医生与未进行髋关节镜检查的外科医生之间的临床实践没有显著差异。
髋关节镜检查是一个相对较新的领域，临床实践可能因外科医生的手术专业知识而异。在这项研究中，髋关节镜专家在大多数患者护理方面与非专家意见一致。手术专业知识与先进技术的执行以及在进行微骨折后建议更长时间的限制负重有关。本研究强调了不同的护理模式，需要进行调查以确定哪种治疗方法能改善患者的护理效果。
V。
