Does surgeon experience affect patient-reported outcomes 1 year after primary total hip arthroplasty?

Acta Orthop. 2018 Jun;89(3):265-271. doi: 10.1080/17453674.2018.1444300. Epub 2018 Mar 6.

Abstract

Background and purpose - Several studies have reported on the influence of various factors on patient-reported outcomes (PROs) after total hip arthroplasty (THA), but very few have focused on the experience of the surgeon. We investigated any association between surgeons' experience and PROs 1 year after primary THA. Patients and methods - Patient characteristics and surgical data at 10 hospitals in western Sweden were linked with PROs (EQ-5D-3L, Satisfaction Visual Analogue Scale (VAS), Pain VAS). These data were retrieved from the Swedish Hip Arthroplasty Register (SHAR). The surgeon's level of experience was divided into 4 subgroups related to experience: < 8 years, 8-15 years, and >15 years of clinical practice after specialist certificate. If no specialist certificate was obtained the surgery was classified as a trainee surgery. Surgeons with >15 years' experience as an orthopedic specialist were used as reference group in the analyses. Results - 8,158 primary THAs due to osteoarthritis were identified. We identified the surgeons' level of experience in 8,116 THAs. Data from SHAR on pre- and postoperative PROs and satisfaction at 1 year were available for 6,713 THAs. We observed a statistically significant difference among the 4 groups of surgeons regarding mean patient age, ASA classification, Charnley classification, diagnosis, and fixation technique. At 1-year follow-up, there were no statistically significant differences in Pain VAS, EQ-5D index, or EQ VAS among the subgroups of orthopedic specialists. Patients operated on by orthopedic trainees reported less satisfaction with the result of the surgery compared with the reference group. Interpretation - These findings indicate that patients can expect similar health improvements, pain reduction, and satisfaction 1 year after a primary THA operation irrespective of years in practice after specialty certification as an orthopedic surgeon.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / statistics & numerical data*
  • Clinical Competence*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / surgery*
  • Patient Reported Outcome Measures*
  • Patient Satisfaction
  • Registries*
  • Sweden
  • Time Factors