title: Learning curve of acetabular cup positioning in total hip arthroplasty using a cumulative summation test for learning curve (LC-CUSUM).
abstract: Despite advances in surgical techniques and instrumentation, optimal cup positioning in total hip arthroplasty (THA) is challenging with a limited accuracy. We evaluated whether a learning curve exists for the optimal cup positioning, using the LC-CUSUM test (Learning curve cumulative summation test). We evaluated the first 100 consecutive THA performed by two surgeons, who had a year of fellowship training in the same teaching hospital. A learning curve of cup positioning was plotted in each series using the LC-CUSUM score. There was no significant difference of numbers of outlier between two surgeons (P = 0.079). Both surgeons completed the learning curve of optimal cup positioning before 50 procedures, and maintained competence. A substantial learning period is necessary in the optimal positioning of an acetabular cup.
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, South Korea.
authors.forename: Young-Kyun
authors.initials: YK
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors.forename: David J
authors.initials: DJ
authors.lastname: Biau
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, South Korea.
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Yoon
authors.affiliation: Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, South Korea.
authors.forename: Tae-Young
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Dongjak-gu, Seoul, South Korea.
authors.forename: Yong-Chan
authors.initials: YC
authors.lastname: Ha
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Seongnam, South Korea.
authors.forename: Kyung-Hoi
authors.initials: KH
authors.lastname: Koo
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: LC-CUSUM test; cup position; hip; learning curve; total hip arthroplasty