Influence of surgeon experience in total hip arthroplasty. Dependence on operating time and complication risk

BACKGROUND: As a consequence of limited personnel and financial resources, the increase in total hip arthroplasties places higher demands on orthopedic surgeons. OBJECTIVES: In order to maintain high quality treatment, the correlation between surgical experience, duration of surgery and risk of complications was examined. MATERIAL AND 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. CONCLUSION: 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.