title: Does orthopedic training compromise the outcome in total hip arthroplasty?
abstract: BACKGROUND
  This study compares the outcomes of total hip arthroplasty surgery performed by a consultant with those performed by supervised and unsupervised orthopedic trainees.
  
  
  METHODS
  We reviewed 6 years of patient data from the New Zealand Joint Registry in patients undergoing total hip arthroplasty comparing the outcome measures of revision surgery and Oxford hip score at 6 months with the experience of the primary surgeon.
  
  
  RESULTS
  Over the study period 35,415 patients underwent elective total hip arthroplasty; 30,344 performed by a consultant, 2982 by a supervised trainee and 1067 by an unsupervised trainee. There was an overall revision rate of 0.77 per 100 component years. The revision rate was 0.75 (95% confidence interval [CI] 0.68-0.82) for consultants, 0.97 (95% CI, 0.72-1.28) for supervised trainees and 0.70 (95% CI, 0.36-1.22) for unsupervised trainees with no significant differences. There was no significant difference in the reason for revision surgery between the 3 groups.
  
  
  CONCLUSIONS
  The mean Oxford hip score was higher for consultants at 40.70 compared with 38.95 and 38.27 for supervised and unsupervised trainees respectively. These results are reassuring and indicate orthopedic training does not adversely compromise arthroplasty patient outcomes.
authors: Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand. inglistom@gmail.com
authors: Tom
authors: T
authors: Inglis
authors: Kristian
authors: K
authors: Dalzell
authors: Gary
authors: G
authors: Hooper
authors: Alastair
authors: A
authors: Rothwell
authors: Chris
authors: C
authors: Frampton
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D016009:Chi-Square Distribution; D002983:Clinical Competence; D006801:Humans; D009520:New Zealand; D009985:Orthopedics / Q000193:education*; D010043:Outcome and Process Assessment, Health Care; D016012:Poisson Distribution; D011183:Postoperative Complications / Q000601:surgery*; D012042:Registries; D012086:Reoperation / Q000706:statistics & numerical data; D012307:Risk Factors