Parwaiz Hammad, Whitham Robert, Flintoftburt Matthew, Tasker Andrew, Woods David
Trauma and Orthopaedics, Great Western Hospital, Swindon, GBR.
Trauma and Orthopaedics, Yeovil District Hospital, Yeovil, GBR.
Cureus. 2022 Mar 20;14(3):e23337. doi: 10.7759/cureus.23337. eCollection 2022 Mar.
Aims We analyse the impact of implementing dual surgeon operating for reverse geometry total shoulder replacement (RGTSR) as part of the "Getting It Right First Time" (GIRFT) recommendations in our shoulder and elbow unit, and the learning curve associated with it. Methods We performed a retrospective cohort study comparing operative time and complication rates in patients who underwent RGTSR performed by a single consultant surgeon versus two consultant surgeons over a six-year period in a single centre, in addition to an analysing the learning curve over the same period. Results A total of 74 RGTSRs were performed over a six-year period: 35 patients had a single surgeon perform their procedure and 39 had dual surgeon operating. Observed complication rates for RGTSR nearly halved following the introduction of dual surgeon operating (22.9% vs 12.8%, p=0.36). The complication rate for the first 37 cases was 9/37 (24.4%) versus 4/37 (10.8%, p=0.22) for the next 37 cases. Conclusion The implementation of dual surgeon operating may lead to reduced operative complications, provide cost savings to the hospital and produced several other non-tangible benefits to the surgeons and the department. An observed reduction in complication rates demonstrates the learning curve associated with this procedure.
目的 我们分析了在我们的肩肘科实施双外科医生手术进行反向几何全肩关节置换术（RGTSR）的影响，这是“一次做对”（GIRFT）建议的一部分，以及与之相关的学习曲线。方法 我们进行了一项回顾性队列研究，比较了在一个中心的六年时间里，由一名顾问外科医生与两名顾问外科医生进行RGTSR手术的患者的手术时间和并发症发生率，此外还分析了同一时期的学习曲线。结果 在六年期间共进行了74例RGTSR手术：35例患者由一名外科医生进行手术，39例由双外科医生进行手术。引入双外科医生手术后，RGTSR的观察到的并发症发生率几乎减半（22.9%对12.8%，p = 0.36）。前37例的并发症发生率为9/37（24.4%），而后37例为4/37（10.8%，p = 0.22）。结论 双外科医生手术的实施可能会降低手术并发症，为医院节省成本，并给外科医生和科室带来其他一些无形的好处。观察到的并发症发生率的降低表明了与该手术相关的学习曲线。
