title: Surgical education of eccentric rotational acetabular osteotomy for hip trainees.
abstract: BACKGROUND
  Periacetabular osteotomy is an excellent intervention for patients at early-stage osteoarthritis, but surgical education for this technique is more difficult than that for total hip arthroplasty.
  
  
  METHODS
  47 joints were included from patients who underwent eccentric rotational acetabular osteotomy (ERAO) performed by 6 trainees under the instructing physician's guidance. We evaluated operative time, blood loss, radiographic parameters, clinical scores, perioperative complications, and 10-year survival rates. We also compared trainees' cases with 47 joints from patients in a sex- and age-matched control group that underwent ERAO performed by the instructing physician.
  
  
  RESULTS
  Hip surgery trainees took an average of 152 minutes and the instructor took 103 minutes. Blood loss during surgery by the trainees and the instructor was 382 and 276 g, respectively. Postoperatively, for the trainee and instructor groups, respectively, the Harris Hip Score improved to 88.9 and 93.7 points; the average centre-edge angle improved to 34.0°and 36.1°; and the average acetabular head index was 93.9% and 95.7%. Perioperative and postoperative complications were observed in 14 patients of the trainee group and 3 patients of the instructor group, which were significantly different (p = 0.0061). The 10-year survival rates were 97.8% and 100% for the trainee and instructor groups, respectively.
  
  
  CONCLUSIONS
  Postoperative imaging evaluations showed no evident differences in coverage. Postoperative clinical outcomes were also satisfactory. Thus, under proper guidance, education to hip surgery trainees on operative techniques is possible. Instructors need to make more effort to prevent complications by providing good education.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya - Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Amano
authors.affiliation: Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya - Japan.
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Orthopaedic Surgery, Konan Kosei Hospital, Konan - Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kawasaki
authors.affiliation: Department of Orthopaedic Surgery, Chubu Rosai Hospital, Nagoya - Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Yamaguchi
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya - Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Seki
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya - Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000193:education*; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000193:education*; D015207:Osteoarthritis, Hip / Q000601:surgery; D010027:Osteotomy / Q000193:education*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires