title: Mentoring in complex surgery: minimising the learning curve complications from peri-acetabular osteotomy.
abstract: OBJECTIVE
  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.
authors: Department of Orthopaedics and Trauma, Royal Adelaide Hospital and the Discipline of Orthopaedics and Trauma, University of Adelaide, Level 4 Bice Building, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. donald.howie@adelaide.edu.au
authors: Donald W
authors: DW
authors: Howie
authors: Martin
authors: M
authors: Beck
authors: Kerry
authors: K
authors: Costi
authors: Susan M
authors: SM
authors: Pannach
authors: Reinhold
authors: R
authors: Ganz
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008611:Mentors; D009985:Orthopedics / Q000193:education*; D010003:Osteoarthritis / Q000453:epidemiology; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult