Orthopedic trainees may yield comparable results for UKA vs. fully trained consultants
Click Here to Manage Email Alerts
Key takeaways:
- Unicompartmental knee arthroplasty performed by trainees yielded comparable failure rates vs. fully trained consultants.
- Level of supervision had no impact on failure rates for surgeries performed by trainees.
Published results showed orthopedic trainees may yield comparable outcomes and rates of implant failure vs. fully trained consultants for unicompartmental knee arthroplasty, regardless of level of supervision.
“The findings of our study are reassuring and support the safety and efficacy of the current methods by which surgeons are trained to perform UKA in England and Wales,” Timothy J. Fowler, a clinical research associate at The University of Bristol Medical School in the United Kingdom, told Healio. “This training system is highly regulated, and trainees receive close senior supervision.”
Fowler and colleagues used the National Joint Registry for England and Wales to perform an observational study of data from 106,206 primary UKAs performed between 2003 and 2019.
Fowler and colleagues compared rates of implant failure and all-cause revision between operating surgeons who were trainees vs. fully trained consultants. They also assessed the impact of supervision by a scrubbed consultant among surgeries performed by a trainee.
Overall, 4.1% of surgeries (n = 4,382) were performed by a trainee. Among surgeries performed by a trainee, 66.1% (n = 2,898) were supervised by a scrubbed consultant.
Fowler and colleagues noted mean follow up was 6.5 years for surgeries performed by a trainee and 5.6 years for surgeries performed by a consultant. At a mean of 4.3 years, 6,920 UKAs required revision.
Fowler and colleagues found the unadjusted cumulative 15-year probability of implant failure was 17.13% for consultants and 16.42% for trainees. More specifically, this rate was 15.98% for supervised trainees and 17.32% for unsupervised trainees.
After analysis of adjusted models, they found no association between surgeon level of training and all-cause revision rates (HR = 1.01). In addition, they found trainees had comparable all-cause survival rates vs. consultants, regardless of the level of supervision (supervised, HR = 0.99 vs. unsupervised, HR = 1.03).
“Our findings suggest that, within the current training system in England and Wales, UKAs performed by trainee surgeons last as long as those performed by consultants,” Fowler said. “This may have beneficial implications for the future provision of UKA in countries with comparable training programs.”
Fowler concluded future studies may aim to assess the outcomes of total knee replacements performed by trainees vs. consultants.
Collapse
Read more about
Click Here to Manage Email Alerts