title: [Influence of surgeon experience in total hip arthroplasty. Dependence on operating time and complication risk].
abstract: BACKGROUND
  As a consequence of limited personnel and financial resources, the increase in total hip arthroplasties places higher demands on orthopedic surgeons.
  
  
  OBJECTIVE
  In order to maintain high quality treatment, the correlation between surgical experience, duration of surgery and risk of complications was examined.
  
  
  METHODS
  The surgery time and, if applicable, complications (until discharge from hospital) of 1129 total hip arthroplasties over a period of 4 years were evaluated retrospectively.
  
  
  RESULTS
  The group of most experienced surgeons needed an average time of 53.2 ± 17.6 min for each implantation, followed by moderately experienced surgeons (74.5 ± 25.5 min) and less experienced surgeons (80.8 ± 21.9 min). Of all included cases, a total of 41 complications until discharge from hospital occurred. The number of complications increased with duration of surgery, whereby the risk of complications was significantly lower for shorter surgery times conducted by the most experienced surgeons as well as moderately experienced surgeons. The complication risk of less experienced surgeons remained constant independent of surgery duration.
  
  
  CONCLUSIONS
  These results underline the recommendations of the German Endocert system, which determine a minimum number of total joint arthroplasties as a quality indicator not only for hospitals but also for individual surgeons.
authors.affiliation: Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Doberaner Str. 142, 18057, Rostock, Deutschland, katrin.zenk@med.uni-rostock.de.
authors.forename: K
authors.initials: K
authors.lastname: Zenk
authors.forename: S
authors.initials: S
authors.lastname: Finze
authors.forename: D
authors.initials: D
authors.lastname: Kluess
authors.forename: R
authors.initials: R
authors.lastname: Bader
authors.forename: J
authors.initials: J
authors.lastname: Malzahn
authors.forename: W
authors.initials: W
authors.lastname: Mittelmeier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000592:standards* / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D018570:Risk Assessment; D016526:Workload / Q000592:standards / Q000706:statistics & numerical data*