[Characteristics of the learning curve in total hip endoprosthesis exemplified by the BiContact prosthesis].
OBJECTIVE
Total hip arthroplasty is a common operation but there are few data describing the learning curve of this operation. The aim of the presented study is to prove and describe the learning curve in total hip arthroplasty.


METHODS
Between 1991 and 1993, 168 patients were included in this prospective study, operated by three surgeons having different experiences in operating total hip arthroplasty. Perioperative complications and postoperative X-rays were analysed. Patients were re-examined clinically and radiologically and by a questionnaire 5 years after operation.


RESULTS
Radiological complications of the first 84 operated patients were statistically significantly higher than those of the following 84 patients, except for minimal bone fractures and leg lengthening. The learning curve of all surgeons was finished after 20 operations independent of their experience. Clinical results were not influenced by the learning curve at follow-up.


CONCLUSIONS
Regardless of the experience of the surgeon, the learning curve in total hip arthroplasty is finished after about 20 operations for each surgeon. Intensive preoperative planning and exchange of experience inside and outside every clinic will shorten the length of the learning curve.
Flamme
C H
CH
Orthopädische Klinik der MH Hannover im Annastift e.V. flamme@annastift.de
Wirth
C J
CJ
Stukenborg-Colsmann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000193:education*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography