title: Learning curves in orthopaedic surgery: a case for super-specialisation?
abstract: BACKGROUND
  The objective of this study was to assess if there is a significant learning curve in the treatment of developmental dysplasia of the hip.
  
  
  METHODS
  We followed up cases of developmental dysplasia of the hip treated by a single surgeon over a 12-year period. There were 96 cases, 56 treated by open reduction and 40 treated by closed reduction. Assessment was made of the incidence and degree of avascular necrosis in the treated hips, as a radiological outcome measure.
  
  
  RESULTS
  Plotting the cumulative percentage of satisfactory outcomes demonstrated an increasingly high percentage of satisfactory results with increasing number of procedures performed, i.e. as the surgeon progressed up the 'learning curve'.
  
  
  CONCLUSIONS
  This study demonstrates a learning curve in the treatment of developmental dysplasia of the hip. It may be possible to draw parallels to other treatments, and also support for the growing trend to specialisation.
authors.affiliation: University Department of Orthopaedics, Southampton General Hospital, Southampton, UK.
authors.forename: N P M
authors.initials: NP
authors.lastname: Jain
authors.forename: A J L
authors.initials: AJ
authors.lastname: Jowett
authors.forename: N M P
authors.initials: NM
authors.lastname: Clarke
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006618:Hip Dislocation, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008485:Medical Audit; D019637:Orthopedic Procedures / Q000592:standards*; D009985:Orthopedics / Q000193:education*; D012189:Retrospective Studies; D013038:Specialization