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. 2012 May;36(5):921-5.
doi: 10.1007/s00264-011-1347-y. Epub 2011 Sep 7.

Mentoring in complex surgery: minimising the learning curve complications from peri-acetabular osteotomy

Donald W Howie  1 , Martin Beck, Kerry Costi, Susan M Pannach, Reinhold Ganz
Affiliations

Mentoring in complex surgery: minimising the learning curve complications from peri-acetabular osteotomy

Donald W Howie et al. Int Orthop. 2012 May.

Abstract

Purpose: The aim of this study was to determine whether a complex surgical procedure such as peri-acetabular osteotomy could be safely learnt by using a programme involving mentoring by a distant expert. To determine this, we examined the incidence of intra-operative complications, the acetabulum correction achieved, the late incidence of re-operation and progressive degenerative arthritis.

Methods: Between 1992 and 2004, peri-acetabular osteotomy was performed in 26 hips in 23 patients. The median follow-up was ten (5-17) years. The median age of the patients at operation was 28 (14-41) years. Clinical outcomes were reported and radiographic results were determined by an independent expert.

Results: There were no intra-articular osteotomies, sciatic nerve injuries, hingeing deformities or vascular injuries. There was one ischial nonunion. The lateral centre-edge angle improved from a median 4° pre-operatively to 25°. One revision osteotomy, one osteectomy and three total hip replacements were required, two for progression of osteoarthritis.

Conclusions: The programme of mentoring was successful in that there was a low incidence of the major intra-operative complications that are often reported during the learning curve period and the acetabular corrections achieved were similar to the originators.

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Figures

Fig. 1
Fig. 1
a A pre-operative radiograph of a 21-year-old woman with dysplasia and subluxation. b A postoperative radiograph taken 17 years after the operation showing normal joint space
See this image and copyright information in PMC

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