Freking Collin, Reddy Ravali, Gartner Austin, Albers Haley, Sojka John, Crist Jamie, Mar Damon, Frager Luke, Hund Samuel, Heddings Archie
University of Kansas Health System, Kansas City, USA.
Eur J Orthop Surg Traumatol. 2025 Sep 11;35(1):392. doi: 10.1007/s00590-025-04509-9.
To investigate the impacts of utilizing dual-scrubbing surgeons on both perioperative and postoperative outcomes in acetabular open reduction and internal fixation (ORIF) procedures.
Design retrospective comparative cohort study. Setting single academic medical center in Kansas City, KS. Patient selection criteria patients aged 18-90 who underwent acetabular ORIF between January 1, 2007-September 1, 2022, by two fellowship-trained orthopedic traumatologists either individually or simultaneously. Outcome Measures and Comparisons operating time, estimated blood loss (EBL), Matta's quality of reduction, follow-up time, number of follow-up appointments, and intra-operative and postoperative complications were extracted and analyzed.
169 cases were included in the analysis. 125 (74%) were single-surgeon cases, while 44 (26%) were dual-surgeon cases. Body mass index (BMI) was significantly higher in the dual-surgeon group, while single-surgeon group had more incidences of prior hip or surgery. Postoperative complications including infection, avascular necrosis, sciatic nerve palsy, and nonunion did not vary between the two groups. The dual-surgeon group demonstrated significantly greater operating times and EBL with a notably inferior quality of reduction assessed by Matta's criteria. Lack of postoperative complication was an independent predictor for achieving a quality reduction. Dual-surgeon cases, older age, male sex, and prior surgery were associated with poorer reduction outcomes..
Dual-surgeon acetabular ORIF cases were associated with longer operating times, increased EBL, and inferior quality of reduction in comparison to cases performed by the single surgeon cohort. Despite these observations, further investigation with randomized controlled trials is warranted to establish definitive conclusions regarding the benefits or disadvantages of dual-surgeon utilization for acetabular ORIF.
探讨在髋臼切开复位内固定（ORIF）手术中使用双人刷手外科医生对围手术期和术后结果的影响。
设计回顾性比较队列研究。地点为堪萨斯州堪萨斯城的单一学术医疗中心。患者选择标准为年龄在18 - 90岁之间，于2007年1月1日至2022年9月1日期间接受髋臼ORIF手术的患者，手术由两名接受过 fellowship 培训的骨科创伤专家单独或同时进行。提取并分析结果指标和比较内容，包括手术时间、估计失血量（EBL）、Matta复位质量、随访时间、随访预约次数以及术中及术后并发症。
169例病例纳入分析。125例（74%）为单医生手术病例，44例（26%）为双医生手术病例。双医生组的体重指数（BMI）显著更高，而单医生组既往髋关节或手术的发生率更高。两组术后并发症包括感染、缺血性坏死、坐骨神经麻痹和骨不连无差异。双医生组手术时间和EBL显著更长，根据Matta标准评估的复位质量明显较差。无术后并发症是实现高质量复位的独立预测因素。双医生手术病例、年龄较大、男性以及既往手术与较差的复位结果相关。
与单医生队列进行的病例相比，双医生髋臼ORIF病例手术时间更长、EBL增加且复位质量较差。尽管有这些观察结果，但仍需通过随机对照试验进行进一步研究，以确定关于双医生用于髋臼ORIF的利弊的确切结论。
