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Learning curve of acetabular cup positioning in total hip arthroplasty using a cumulative summation test for learning
Young-Kyun Lee1, David J Biau2, Byung-Ho Yoon1
1Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam, South Korea.
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.
