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Surgery performed by supervised registrars does not adversely affect medium-term functional outcomes after total knee

N Beattie1, J F Maempel1, S Roberts1

  • 1NHS Fife , UK.

Annals of the Royal College of Surgeons of England
|October 13, 2017
PubMed
Summary

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Total knee arthroplasty (TKA) performed by supervised trainees yields functional outcomes equivalent to those by consultants. This study found no significant differences in patient recovery or long-term results, supporting trainee involvement in TKA.

Area of Science:

  • Orthopaedic Surgery
  • Surgical Training
  • Patient Outcomes

Background:

  • Total knee arthroplasty (TKA) is a common procedure for orthopaedic trainees.
  • Limited research exists on functional outcomes of TKA performed by supervised trainees compared to consultants.

Purpose of the Study:

  • To compare functional outcomes up to five years post-primary TKA between consultant and trainee surgeons.
  • To assess the impact of trainee involvement on operative time, length of stay, and complication rates.

Main Methods:

  • Retrospective analysis of prospectively collected data from 609 TKA patients.
  • Assessment using American Knee Society objective knee and functional scores (AKSK and AKSF) preoperatively and at 18 months, 3, and 5 years postoperatively.
Keywords:
Functional outcomesSurgical trainingTotal knee arthroplastyTrainee performed surgery

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Main Results:

  • No significant differences in preoperative characteristics, operative time, transfusion rates, length of stay, manipulation under anesthesia, or mortality between consultant and trainee groups.
  • Similar improvements in AKSK and AKSF scores, and comparable range of motion at five years post-TKA.

Conclusions:

  • Supervised trainee-performed TKA achieves functional outcomes equivalent to consultant-performed TKA.
  • Trainee involvement does not negatively impact operative efficiency, length of stay, transfusion rates, or patient range of motion.